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首页> 外文期刊>Cureus. >Effects of Multileaf Collimator Design and Function When Using an Optimized Dynamic Conformal Arc Approach for Stereotactic Radiosurgery Treatment of Multiple Brain Metastases With a Single Isocenter: A Planning Study
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Effects of Multileaf Collimator Design and Function When Using an Optimized Dynamic Conformal Arc Approach for Stereotactic Radiosurgery Treatment of Multiple Brain Metastases With a Single Isocenter: A Planning Study

机译：多叶准直器设计和功能在使用单次脑转移术治疗多脑转移的优化动态保形弧焊时的影响：规划研究

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Background Stereotactic radiosurgery (SRS) or fractionated SRS (fSRS) are effective options for the treatment of brain metastases. When treating multiple metastases with a linear accelerator-based approach, a single isocenter allows for efficient treatment delivery. In this study, we present our findings comparing dosimetric parameters of Brainlab (Munich, Germany) Elements? Multiple Brain Mets SRS (MME) software (version 1.5 versus version 2.0) for a variety of scenarios and patients. The impact of multileaf collimator design and function on plan quality within the software was also evaluated. Materials and methods Twenty previously treated patients with a total of 58 lesions (from one to seven lesions each) were replanned with an updated version of the multiple brain Mets software solution. For each plan, the mean conformity index (CI), mean gradient index (GI), the volume of normal brain receiving 12 Gy (Vsub12/sub), and mean brain dose were evaluated. Additionally, all v2.0 plans were further evaluated with jaw tracking for by Elekta (Stockholm, Sweden) and HD120? multileaf collimator by Varian Medical Systems (Palo Alto, USA). Results The new software version demonstrated improvements for CI, GI and Vsub12/sub (p 0.01). For the Elekta Agility? multileaf collimator, jaw tracking improved all dosimetric parameters except for CI (p =0.178) and mean brain dose (p =0.93). For the Varian with HD120 multileaf collimator, all parameters improved. Conclusions The software enhancements in v2.0 of the software provided improvements in planning efficiency and dosimetric parameters. Differences in multileaf collimator design may provide an additional incremental benefit in a subset of clinical scenarios.
机译：背景技术立体定位放射外科（SRS）或分级的SRS（FSRS）是治疗脑转移的有效选择。当用基于线性加速器的方法处理多种转移时，单个等中心允许有效的治疗递送。在这项研究中，我们介绍了我们的研究结果比较了Brainlab（慕尼黑，德国）元素的剂量分析？多个大脑满足SRS（MME）软件（版本1.5与版本2.0），适用于各种场景和患者。还评估了多叶准直器设计和功能对软件内的计划质量的影响。材料和方法二十先前治疗的患者共有58个病变（每次从一到七个病变中）被重新回归多脑Mets软件解决方案的更新版本。对于每个计划，平均符合性指数（CI），平均梯度指数（GI），常规脑的体积，接受12 Gy（V 12 ）和平均脑剂量。此外，所有v2.0计划都是通过Elekta（斯德哥尔摩，瑞典）和HD120的颚追踪进行评估由Varian Medical Systems（Palo Alto，USA）的多叶准直器。结果新软件版本展示了CI，GI和V 12 的改进（P <0.01）。为Elekta敏捷？多叶准直器，钳口跟踪改善了除CI（P = 0.178）和平均脑剂量（P = 0.93）外的所有剂量率参数。对于带有HD120 Multilaf准直器的Varian，所有参数都改进。结论软件的V2.0中的软件增强提供了规划效率和剂量分析的改进。多叶准直器设计的差异可以在临床情景的子集中提供额外的增量益处。

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