Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations

Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was...
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Autor*in:	Blamek, Sławomir [verfasserIn] Grządziel, Aleksandra Miszczyk, Leszek

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2013

Schlagwörter:	Arteriovenous malformations Dose distribution CyberKnife Linear accelerator Micro-multileaf collimator

Anmerkung:	© Blamek et al.; licensee BioMed Central Ltd. 2013

Übergeordnetes Werk:	Enthalten in: Radiation oncology - London : BioMed Central, 2006, 8(2013), 1 vom: 23. Aug.
Übergeordnetes Werk:	volume:8 ; year:2013 ; number:1 ; day:23 ; month:08

Links:	Volltext

DOI / URN:	10.1186/1748-717X-8-205

Katalog-ID:	SPR029659310

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520			\|a Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures.
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allfields	10.1186/1748-717X-8-205 doi (DE-627)SPR029659310 (SPR)1748-717X-8-205-e DE-627 ger DE-627 rakwb eng Blamek, Sławomir verfasserin aut Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Blamek et al.; licensee BioMed Central Ltd. 2013 Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. Arteriovenous malformations (dpeaa)DE-He213 Dose distribution (dpeaa)DE-He213 CyberKnife (dpeaa)DE-He213 Linear accelerator (dpeaa)DE-He213 Micro-multileaf collimator (dpeaa)DE-He213 Grządziel, Aleksandra aut Miszczyk, Leszek aut Enthalten in Radiation oncology London : BioMed Central, 2006 8(2013), 1 vom: 23. Aug. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:8 year:2013 number:1 day:23 month:08 https://dx.doi.org/10.1186/1748-717X-8-205 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2013 1 23 08
spelling	10.1186/1748-717X-8-205 doi (DE-627)SPR029659310 (SPR)1748-717X-8-205-e DE-627 ger DE-627 rakwb eng Blamek, Sławomir verfasserin aut Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Blamek et al.; licensee BioMed Central Ltd. 2013 Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. Arteriovenous malformations (dpeaa)DE-He213 Dose distribution (dpeaa)DE-He213 CyberKnife (dpeaa)DE-He213 Linear accelerator (dpeaa)DE-He213 Micro-multileaf collimator (dpeaa)DE-He213 Grządziel, Aleksandra aut Miszczyk, Leszek aut Enthalten in Radiation oncology London : BioMed Central, 2006 8(2013), 1 vom: 23. Aug. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:8 year:2013 number:1 day:23 month:08 https://dx.doi.org/10.1186/1748-717X-8-205 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2013 1 23 08
allfields_unstemmed	10.1186/1748-717X-8-205 doi (DE-627)SPR029659310 (SPR)1748-717X-8-205-e DE-627 ger DE-627 rakwb eng Blamek, Sławomir verfasserin aut Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Blamek et al.; licensee BioMed Central Ltd. 2013 Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. Arteriovenous malformations (dpeaa)DE-He213 Dose distribution (dpeaa)DE-He213 CyberKnife (dpeaa)DE-He213 Linear accelerator (dpeaa)DE-He213 Micro-multileaf collimator (dpeaa)DE-He213 Grządziel, Aleksandra aut Miszczyk, Leszek aut Enthalten in Radiation oncology London : BioMed Central, 2006 8(2013), 1 vom: 23. Aug. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:8 year:2013 number:1 day:23 month:08 https://dx.doi.org/10.1186/1748-717X-8-205 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2013 1 23 08
allfieldsGer	10.1186/1748-717X-8-205 doi (DE-627)SPR029659310 (SPR)1748-717X-8-205-e DE-627 ger DE-627 rakwb eng Blamek, Sławomir verfasserin aut Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Blamek et al.; licensee BioMed Central Ltd. 2013 Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. Arteriovenous malformations (dpeaa)DE-He213 Dose distribution (dpeaa)DE-He213 CyberKnife (dpeaa)DE-He213 Linear accelerator (dpeaa)DE-He213 Micro-multileaf collimator (dpeaa)DE-He213 Grządziel, Aleksandra aut Miszczyk, Leszek aut Enthalten in Radiation oncology London : BioMed Central, 2006 8(2013), 1 vom: 23. Aug. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:8 year:2013 number:1 day:23 month:08 https://dx.doi.org/10.1186/1748-717X-8-205 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2013 1 23 08
allfieldsSound	10.1186/1748-717X-8-205 doi (DE-627)SPR029659310 (SPR)1748-717X-8-205-e DE-627 ger DE-627 rakwb eng Blamek, Sławomir verfasserin aut Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations 2013 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Blamek et al.; licensee BioMed Central Ltd. 2013 Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. Arteriovenous malformations (dpeaa)DE-He213 Dose distribution (dpeaa)DE-He213 CyberKnife (dpeaa)DE-He213 Linear accelerator (dpeaa)DE-He213 Micro-multileaf collimator (dpeaa)DE-He213 Grządziel, Aleksandra aut Miszczyk, Leszek aut Enthalten in Radiation oncology London : BioMed Central, 2006 8(2013), 1 vom: 23. Aug. (DE-627)508725739 (DE-600)2224965-5 1748-717X nnns volume:8 year:2013 number:1 day:23 month:08 https://dx.doi.org/10.1186/1748-717X-8-205 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2119 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 8 2013 1 23 08
language	English
source	Enthalten in Radiation oncology 8(2013), 1 vom: 23. Aug. volume:8 year:2013 number:1 day:23 month:08
sourceStr	Enthalten in Radiation oncology 8(2013), 1 vom: 23. Aug. volume:8 year:2013 number:1 day:23 month:08
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Arteriovenous malformations Dose distribution CyberKnife Linear accelerator Micro-multileaf collimator
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container_title	Radiation oncology
authorswithroles_txt_mv	Blamek, Sławomir @@aut@@ Grządziel, Aleksandra @@aut@@ Miszczyk, Leszek @@aut@@
publishDateDaySort_date	2013-08-23T00:00:00Z
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author	Blamek, Sławomir
spellingShingle	Blamek, Sławomir misc Arteriovenous malformations misc Dose distribution misc CyberKnife misc Linear accelerator misc Micro-multileaf collimator Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations
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topic_title	Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations Arteriovenous malformations (dpeaa)DE-He213 Dose distribution (dpeaa)DE-He213 CyberKnife (dpeaa)DE-He213 Linear accelerator (dpeaa)DE-He213 Micro-multileaf collimator (dpeaa)DE-He213
topic	misc Arteriovenous malformations misc Dose distribution misc CyberKnife misc Linear accelerator misc Micro-multileaf collimator
topic_unstemmed	misc Arteriovenous malformations misc Dose distribution misc CyberKnife misc Linear accelerator misc Micro-multileaf collimator
topic_browse	misc Arteriovenous malformations misc Dose distribution misc CyberKnife misc Linear accelerator misc Micro-multileaf collimator
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title	Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations
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title_full	Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations
author_sort	Blamek, Sławomir
journal	Radiation oncology
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author_browse	Blamek, Sławomir Grządziel, Aleksandra Miszczyk, Leszek
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author-letter	Blamek, Sławomir
doi_str_mv	10.1186/1748-717X-8-205
title_sort	robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations
title_auth	Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations
abstract	Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. © Blamek et al.; licensee BioMed Central Ltd. 2013
abstractGer	Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. © Blamek et al.; licensee BioMed Central Ltd. 2013
abstract_unstemmed	Background Stereotactic irradiation of large or critically located arteriovenous malformations (AVMs) is a special challenge for clinicians and radiation physicists. To date, no comprehensive comparison of two linac-based radiosurgery systems used for hypofractionated radiotherapy of large AVMs was published. The aim of the study was to compare dose distributions between CyberKnife (CK) system and linac with a micro-multileaf collimator (L-mMLC) in high-grade or critically located cerebral AVMs. Methods Two sets of plans made for 15 different patients with at least 95% target coverage were selected for comparisons. Conformity (CI), homogeneity (HI) and gradient score (GSI) indices, conformity index proposed by Lomax (CIL), conformation number (CN), quality of coverage (Q), volumes of brain receiving 12,10,8,6,4, and 2 Gy, minimum and maximum doses for critical structures in both treatment planning systems (TPS) were compared. Finally, the number of monitor units needed to deliver the prescribed dose was compared. Results The mean minimum doses in the target volume were 93.3% (CK) and 90.7% (L-mMLC),p=n.s, maximum: 119.7 and 110%, respectively (p=0.004). The mean CI was 1.46 and 1.86, HI: 1.2, and 1.11, CIL 0.7, and 0.6, CN: 0.68 and 0.58 for CK and mMLC, respectively (p<0.05). The values of GSI and Q were not significantly different. The volumes of the brain receiving low doses (4 Gy and 2 Gy) were significantly lower in the CK system. The number of monitor units necessary to deliver the prescribed dose was significantly greater in case of the CK system. Conclusions Better conformity can favor the CK system for treatment of large AVMs at the cost of higher maximum doses and worse homogeneity. L-mMLC is superior when shorter treatment time is required. Neither system can assure satisfying dose gradients outside large targets surrounded by numerous critical structures. © Blamek et al.; licensee BioMed Central Ltd. 2013
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title_short	Robotic radiosurgery versus micro-multileaf collimator: a dosimetric comparison for large or critically located arteriovenous malformations
url	https://dx.doi.org/10.1186/1748-717X-8-205
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