Dosimetric effect of rotational setup errors in single-isocenter volumetric-modulated arc therapy of multiple brain metastases

Aim: The aim of this study is to investigate the dosimetric effects of rotational uncertainties in patient positioning on target coverage in stereotactic radiosurgery (SRS) of multiple brain metastases using single isocenter volumetric modulated arc therapy (VMAT). Materials and Methods: Ten SRS cas...

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Published in:Journal of medical physics 2019-04, Vol.44 (2), p.84-90
Main Authors: Selvan, Kasirajan, Padma, Ganesan, Revathy, Murugesan, Nambi Raj, N, Senthilnathan, K, Babu, P
Format: Article
Language:English
Subjects:
Accuracy
Brain
Brain cancer
Cancer metastasis
Computer simulation
Metastasis
Original
Pitch (inclination)
Planning
Radiation therapy
Radiology
Radiosurgery
Radiotherapy
Rolling motion
Rotation
Rotational errors
stereotactic radiosurgery
Studies
Surgery
Therapy
Tumors
Uncertainty
volumetric modulated arc therapy
Yaw
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container_issue 2
container_start_page 84
container_title Journal of medical physics
container_volume 44
creator Selvan, Kasirajan
Padma, Ganesan
Revathy, Murugesan
Nambi Raj, N
Senthilnathan, K
Babu, P
description Aim: The aim of this study is to investigate the dosimetric effects of rotational uncertainties in patient positioning on target coverage in stereotactic radiosurgery (SRS) of multiple brain metastases using single isocenter volumetric modulated arc therapy (VMAT). Materials and Methods: Ten SRS cases with multiple brain metastases(2-8) planned with single isocenter non-coplanar VMAT technique were investigated in this study. Pitch, yaw and roll displacements of 1, 3 and 5° were simulated about isocenter along each axes and nine plans were obtained for each case. Gross tumor volume (GTV) coverage obtained on simulated plans were compared with the original plan on four metrics of mean dose (Dmean), minimum dose to GTV (Dmin), dose to 95% of GTV (D95) and the volume covered by the 95% of the prescribed dose (V95). Results: At 1° rotation about 4% of the PTV had V95 and D95 values
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Materials and Methods: Ten SRS cases with multiple brain metastases(2-8) planned with single isocenter non-coplanar VMAT technique were investigated in this study. Pitch, yaw and roll displacements of 1, 3 and 5° were simulated about isocenter along each axes and nine plans were obtained for each case. Gross tumor volume (GTV) coverage obtained on simulated plans were compared with the original plan on four metrics of mean dose (Dmean), minimum dose to GTV (Dmin), dose to 95% of GTV (D95) and the volume covered by the 95% of the prescribed dose (V95). Results: At 1° rotation about 4% of the PTV had V95 and D95 values &lt;95%. The minimum dose obtained across all PTV was 85.1% and there was not much change in the mean dose values obtained. The PTV volume which had V95 and D95 values &lt;95% were in the range of 0.05 - 0.07cc and at a radial distance of 6.2 cm - 7.2 cm. At 3° rotation almost 50% of the PTV had V95 and D95 values &lt;95%. The minimum dose obtained across all PTV was 48.3% and the mean dose reduced to as low as 78.8%. At 5° rotation almost 74% of the PTV had V95and D95 values &lt;95%. The minimum dose obtained across all PTV was 21.2% and the mean dose reduced to as low as 49.2%. Conclusion: Our results indicate that correcting rotational uncertainties is critical in single-isocenter, multi-target SRS. For rotational deviations, radial distance of the target from isocenter along the respective axis has a strong influence on target coverage. For rotational setup deviation at a given radial distance larger targets tend to have lesser geometric miss compared to smaller targets. Mathematical model for spherical targets can be used to estimate V95 for given rotational errors.</description><identifier>ISSN: 0971-6203</identifier><identifier>EISSN: 1998-3913</identifier><identifier>DOI: 10.4103/jmp.jmp_103_18</identifier><identifier>PMID: 31359925</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Accuracy ; Brain ; Brain cancer ; Cancer metastasis ; Computer simulation ; Metastasis ; Original ; Pitch (inclination) ; Planning ; Radiation therapy ; Radiology ; Radiosurgery ; Radiotherapy ; Rolling motion ; Rotation ; Rotational errors ; stereotactic radiosurgery ; Studies ; Surgery ; Therapy ; Tumors ; Uncertainty ; volumetric modulated arc therapy ; Yaw</subject><ispartof>Journal of medical physics, 2019-04, Vol.44 (2), p.84-90</ispartof><rights>COPYRIGHT 2019 Medknow Publications and Media Pvt. Ltd.</rights><rights>2019. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright: © 2019 Journal of Medical Physics 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c711r-62aab872b4552e706e323069b292dcd86c323707eaaf4e9e4adcdbe04d6831d03</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580820/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2241978473?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27458,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31359925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selvan, Kasirajan</creatorcontrib><creatorcontrib>Padma, Ganesan</creatorcontrib><creatorcontrib>Revathy, Murugesan</creatorcontrib><creatorcontrib>Nambi Raj, N</creatorcontrib><creatorcontrib>Senthilnathan, K</creatorcontrib><creatorcontrib>Babu, P</creatorcontrib><title>Dosimetric effect of rotational setup errors in single-isocenter volumetric-modulated arc therapy of multiple brain metastases</title><title>Journal of medical physics</title><addtitle>J Med Phys</addtitle><description>Aim: The aim of this study is to investigate the dosimetric effects of rotational uncertainties in patient positioning on target coverage in stereotactic radiosurgery (SRS) of multiple brain metastases using single isocenter volumetric modulated arc therapy (VMAT). Materials and Methods: Ten SRS cases with multiple brain metastases(2-8) planned with single isocenter non-coplanar VMAT technique were investigated in this study. Pitch, yaw and roll displacements of 1, 3 and 5° were simulated about isocenter along each axes and nine plans were obtained for each case. Gross tumor volume (GTV) coverage obtained on simulated plans were compared with the original plan on four metrics of mean dose (Dmean), minimum dose to GTV (Dmin), dose to 95% of GTV (D95) and the volume covered by the 95% of the prescribed dose (V95). Results: At 1° rotation about 4% of the PTV had V95 and D95 values &lt;95%. The minimum dose obtained across all PTV was 85.1% and there was not much change in the mean dose values obtained. The PTV volume which had V95 and D95 values &lt;95% were in the range of 0.05 - 0.07cc and at a radial distance of 6.2 cm - 7.2 cm. At 3° rotation almost 50% of the PTV had V95 and D95 values &lt;95%. The minimum dose obtained across all PTV was 48.3% and the mean dose reduced to as low as 78.8%. At 5° rotation almost 74% of the PTV had V95and D95 values &lt;95%. The minimum dose obtained across all PTV was 21.2% and the mean dose reduced to as low as 49.2%. Conclusion: Our results indicate that correcting rotational uncertainties is critical in single-isocenter, multi-target SRS. For rotational deviations, radial distance of the target from isocenter along the respective axis has a strong influence on target coverage. For rotational setup deviation at a given radial distance larger targets tend to have lesser geometric miss compared to smaller targets. 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Materials and Methods: Ten SRS cases with multiple brain metastases(2-8) planned with single isocenter non-coplanar VMAT technique were investigated in this study. Pitch, yaw and roll displacements of 1, 3 and 5° were simulated about isocenter along each axes and nine plans were obtained for each case. Gross tumor volume (GTV) coverage obtained on simulated plans were compared with the original plan on four metrics of mean dose (Dmean), minimum dose to GTV (Dmin), dose to 95% of GTV (D95) and the volume covered by the 95% of the prescribed dose (V95). Results: At 1° rotation about 4% of the PTV had V95 and D95 values &lt;95%. The minimum dose obtained across all PTV was 85.1% and there was not much change in the mean dose values obtained. The PTV volume which had V95 and D95 values &lt;95% were in the range of 0.05 - 0.07cc and at a radial distance of 6.2 cm - 7.2 cm. At 3° rotation almost 50% of the PTV had V95 and D95 values &lt;95%. The minimum dose obtained across all PTV was 48.3% and the mean dose reduced to as low as 78.8%. At 5° rotation almost 74% of the PTV had V95and D95 values &lt;95%. The minimum dose obtained across all PTV was 21.2% and the mean dose reduced to as low as 49.2%. Conclusion: Our results indicate that correcting rotational uncertainties is critical in single-isocenter, multi-target SRS. For rotational deviations, radial distance of the target from isocenter along the respective axis has a strong influence on target coverage. For rotational setup deviation at a given radial distance larger targets tend to have lesser geometric miss compared to smaller targets. Mathematical model for spherical targets can be used to estimate V95 for given rotational errors.</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>31359925</pmid><doi>10.4103/jmp.jmp_103_18</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record>
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source Medknow Open Access Medical Journals; Publicly Available Content (ProQuest); PubMed Central
subjects Accuracy
Brain
Brain cancer
Cancer metastasis
Computer simulation
Metastasis
Original
Pitch (inclination)
Planning
Radiation therapy
Radiology
Radiosurgery
Radiotherapy
Rolling motion
Rotation
Rotational errors
stereotactic radiosurgery
Studies
Surgery
Therapy
Tumors
Uncertainty
volumetric modulated arc therapy
Yaw
title Dosimetric effect of rotational setup errors in single-isocenter volumetric-modulated arc therapy of multiple brain metastases
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