Is dosimetry of multiple mets radiosurgery vendor platform dependent? Y. Zhang
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1 Is dosimetry of multiple mets radiosurgery vendor platform dependent? Y. Zhang
2 Linac Based -TrueBeam -Trilogy CyberKnife GammaKnife 2
3 Objectives To provide an overview of the physics of GammaKnife, CyberKnife and TrueBeam based radiosurgery To compare plan quality for the treatment of multiple brain mets on GammaKnife, CyberKnife and TrueBeam. 3
4 Source Collimation Optimization Algorithm 4
5 Source 6 MV X-Ray(FFF) 6 MV X-ray Co-60 5
6 Collimation HD 120 MLC, 8cm 32 pairs of 2.5 mm leaves 14cm 28 pairs of 5 mm leaves 6
7 Collimation 7
8 Collimation 8
9 Collimation The Perfexion system replaces the multi-helmet collimator setup with a single integrated permanent collimator system that incorporates openings for 4mm, 8mm, and 16mm treatment beams. 192 beams 9
10 Source Collimation Optimization Algorithm 10
11 Optimization Algorithm Eclipse for TrueBeam - Step1 11
12 Optimization Algorithm Eclipse for TrueBeam Step2 12
13 Optimization Algorithm Eclipse for TrueBeam Step3 13
14 Optimization Algorithm Multiplan for CyberKnfie Optimization is performed in sequential steps, one objective at a time optimizer attempts to meet goals without violating constraints results from previous steps are used to constrain the current step s optimization 14
15 Optimization Algorithm Multiplan for CyberKnfie 15
16 Optimization Algorithm GammaKnife Optimization 16
17 Optimization Algorithm GammaKnife Optimization 17
18 Optimization Algorithm GammaKnife Optimization 18
19 Plan Quality Comparison To compare plan quality for the treatment of multiple brain mets with Gamma Knife, CyberKnife and TrueBeam. 7 Patients with multiple brain mets (4+) Techniques used for planning are Rapid Arc for Eclipse and iris collimator for Multiplan. The plans for GammaKnife were generated for delivery with the Perfexion unit Prescription dose was 18 Gy in one fraction. 19
20 Plan Quality Comparison Various dosimetric indices such as target coverage, conformality index, heterogeneity index, V12 Gy, V50%, maximum dose to left eye, right eye, brainstem, left and right optic nerves and chiasm. Additionally, total monitor units, beam on time and treatment times were also calculated. 20
21 Plan Quality Comparison 21
22 Plan Quality Comparison Eclipse Plan 22 CyberKnife Plan
23 Target Dosimetric Comparison Platforms Isodose Line (%) Coverage (%) Target Heterogeneity index Conformality index Gradient Index Eclipse 99.6 ± 80.5± ± ± ± CyberKnife 78.7 ± ± ± ± 1.57 GammaKni fe 55.0 ± ± ± ±
24 Normal Tissue Dosimetric Comparison 24
25 Normal Tissue Dosimetric Comparison 25
26 MU and Treatment Efficiency 26
27 Conclusion Dosimetry indices and delivery efficiency were calculated and evaluated for the treatment of multiple brain mets. The dose delivered to the normal brain are dependent on which platform is used. 27
28 Acknowledgement I would like to thank Dr. Huq, Dr. Heron, X. Li, J. Bhatnagar, G. Bednarz, C. Ozhasoglu, S. Burton, J. Flickinger, A. Clump, K. Holeva for their contributions to the project. I would like to thank Renee Banaszewski and Hillary Barron for their assistance. 28
29 29 Thanks for your attention!
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