Brain metastases: radiosurgery

Wolf, Amparo; Kondziolka, Douglas

doi:10.1016/b978-0-12-811161-1.00010-4

Cited by 7 publications

(2 citation statements)

References 39 publications

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“…Other than the well documented leuco-encephalopathy, radiation necrosis, radiation induced vasculopathy and optic neuropathy 19,20 . Douw et al assessed the impact of radiotherapy on the cognition in patients with low grade glioma and showed signs of progressive decline in attention functioning even in patients who received a fraction dose less than 2 Gy, a fraction regarded so far as safe (focal radiotherapy/2 cm margin around the lesion/mean total dose 56 Gy/1,6 to 2,5 Gy per fraction) 21 .…”

Section: Clinical Effects Of High Dose Exposition On the Brainmentioning

confidence: 99%

Effects of Ionizing Radiation and their Potential Risk on the Brain: A Review

Salhi

Filali

2019

JEOH

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Section: Clinical Effects Of High Dose Exposition On the Brainmentioning

confidence: 99%

Effects of Ionizing Radiation and their Potential Risk on the Brain: A Review

Salhi

Filali

2019

JEOH

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“…Due to the focused delivery of radiation dose with beams from many directions, radiosurgery has been shown to be an effective treatment method for intracranial tumors. 1,2 While systems such as the Gamma Knife and CyberKnife are commonly used to treat these tumors, the cost of treatment devices and their installation, including the installation of a vault, is often prohibitive. Recently, vault-free, gyroscopic radiosurgery has been proposed, which can reduce cost due to lower treatment facility requirements.…”

Section: Introductionmentioning

confidence: 99%

Automated isocenter optimization approach for treatment planning for gyroscopic radiosurgery

Stapper

Gerlach

Hofmann³

et al. 2023

Medical Physics

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BackgroundRadiosurgery is a well‐established treatment for various intracranial tumors. In contrast to other established radiosurgery platforms, the new ZAP‐X® allows for self‐shielding gyroscopic radiosurgery. Here, treatment beams with variable beam‐on times are targeted towards a small number of isocenters. The existing planning framework relies on a heuristic based on random selection or manual selection of isocenters, which often leads to a higher plan quality in clinical practice.PurposeThe purpose of this work is to study an improved approach for radiosurgery treatment planning, which automatically selects the isocenter locations for the treatment of brain tumors and diseases in the head and neck area using the new system ZAP‐X®.MethodsWe propose a new method to automatically obtain the locations of the isocenters, which are essential in gyroscopic radiosurgery treatment planning. First, an optimal treatment plan is created based on a randomly selected nonisocentric candidate beam set. The intersections of the resulting subset of weighted beams are then clustered to find isocenters. This approach is compared to sphere‐packing, random selection, and selection by an expert planner for generating isocenters. We retrospectively evaluate plan quality on 10 acoustic neuroma cases.ResultsIsocenters acquired by the method of clustering result in clinically viable plans for all 10 test cases. When using the same number of isocenters, the clustering approach improves coverage on average by 31 percentage points compared to random selection, 15 percentage points compared to sphere packing and 2 percentage points compared to the coverage achieved with the expert selected isocenters. The automatic determination of location and number of isocenters leads, on average, to a coverage of 97 ± 3% with a conformity index of 1.22 ± 0.22, while using 2.46 ± 3.60 fewer isocenters than manually selected. In terms of algorithm performance, all plans were calculated in less than 2 min with an average runtime of 75 ± 25 s.ConclusionsThis study demonstrates the feasibility of an automatic isocenter selection by clustering in the treatment planning process with the ZAP‐X® system. Even in complex cases where the existing approaches fail to produce feasible plans, the clustering method generates plans that are comparable to those produced by expert selected isocenters. Therefore, our approach can help reduce the effort and time required for treatment planning in gyroscopic radiosurgery.

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