Automated hippocampal sparing whole brain radiotherapy with simultaneous integrated boost for multiple brain metastases: Halcyon, HyperArc on TrueBeam, and coplanar TrueBeam.

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2024-11-29 DOI:10.1002/acm2.14570

Shane McCarthy, Ryan Clark, Anthony Magliari, William St Clair, Damodar Pokhrel

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引用次数: 0

Abstract

Purpose: To demonstrate the ease and feasibility that hippocampal sparing whole brain (WB) simultaneous integrated boost (HSWB-SIB) plans can be generated using knowledge-based planning and Eclipse Scripting Application Programming Interface (ESAPI) for three different modalities, HyperArc on TrueBeam (TB-HA), a coplanar beam arrangement on TrueBeam (TB-Co), and the ring-mounted Halcyon LINAC (Hal).

Methods: Twelve patients with 2-14 brain metastases were retrospectively replanned for HSWB-SIB using a published HSWB RapidPlan model with modifications for the automated addition of SIB to metastases. Prescribed dose was 30 Gy to the WB planning target volume (PTV) and 50 Gy to the metastases in 10 fractions. Eclipse treatment planning system (v16.1) was used with a 6 MV-FFF beam and Acuros XB dose algorithm.

Results: The methodology was successfully used for all modalities, generating plans in under 30 min. The plan doses were normalized to the WB PTV D_95% receiving 30 Gy. Reporting values in the order of Hal, TB-Co, and TB-HA: The WB PTV received a V₄₈ _Gy of 4.58, 3.98, and 4.45 cc with statistically insignificant differences (p = 0.806). The boost PTVs received a D_95% of 50.60, 50.43, and 51.13 Gy with statistically significant comparisons between TB-HA and the other two modalities (p = 0.005). The hippocampus maximum dose was 11.81, 11.51, and 11.13 Gy with no statistically significant comparisons (p = 0.105). All other oragns-at-risk (OAR) doses were clinically acceptable. The modalities were evaluated using a dosimetric scorecard, achieving average scores of 84.85%, 86.45%, and 87.39%. End-to-end testing ensured the deliverability of the HSWB-SIB plans for all modalities.

Conclusion: The novel modification of the preexisting HSWB RapidPlan model with the automated inclusion of SIB objectives allows for easy, intuitive planning of complex HSWB-SIB treatments. All modalities demonstrated can be used with clinically comparable results. Other institutions are recommended to pursue and validate this HSWB-SIB technique to increase the accessibility of a single-course of high-quality treatment for patients with multiple brain lesions.

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic