Evaluation of a magnetic resonance guided linear accelerator for stereotactic radiosurgery treatment
Wen N, Kim J, Doemer A, Glide-Hurst C, Chetty IJ, Liu C, Laugeman E, Xhaferllari I, Kumarasiri A, Victoria J, Bellon M, Kalkanis S, Siddiqui MS, and Movsas B. Evaluation of a magnetic resonance guided linear accelerator for stereotactic radiosurgery treatment. Radiother Oncol 2018; Jun;127(3):460-466.
Radiotherapy and oncology
INTRODUCTION: The purpose of this study was to investigate the systematic localization accuracy, treatment planning capability, and delivery accuracy of an integrated magnetic resonance imaging guided Linear Accelerator (MR-Linac) platform for stereotactic radiosurgery.
MATERIALS AND METHODS: The phantom for the end-to-end test comprises three different compartments: a rectangular MR/CT target phantom, a Winston-Lutz cube, and a rectangular MR/CT isocenter phantom. Hidden target tests were performed at gantry angles of 0, 90, 180, and 270 degrees to quantify the systematic accuracy. Five patient plans with a total of eleven lesions were used to evaluate the dosimetric accuracy. Single-isocenter IMRT treatment plans using 10-15 coplanar beams were generated to treat the multiple metastases.
RESULTS: The end-to-end localization accuracy of the system was 1.0 ± 0.1 mm. The conformity index, homogeneity index and gradient index of the plans were 1.26 ± 0.22, 1.22 ± 0.10, and 5.38 ± 1.44, respectively. The average absolute point dose difference between measured and calculated dose was 1.64 ± 1.90%, and the mean percentage of points passing the 3%/1 mm gamma criteria was 96.87%.
CONCLUSIONS: Our experience demonstrates that excellent plan quality and delivery accuracy was achievable on the MR-Linac for treating multiple brain metastases with a single isocenter.
Medical Subject Headings
Brain Neoplasms; Humans; Magnetic Resonance Imaging; Particle Accelerators; Phantoms, Imaging; Radiosurgery; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; Radiotherapy, Intensity-Modulated; Retrospective Studies