| Title: |
Use of dose-area product to assess plan quality in robotic radiosurgery |
| Authors: |
Markus Eichner; Alexandra Hellerbach; Mauritius Hoevels; Klaus Luyken; Michael Judge; Daniel Rueß; Maximilian Ruge; Martin Kocher; Stefan Hunsche; Harald Treuer |
| Source: |
Zeitschrift für Medizinische Physik, Vol 34, Iss 3, Pp 428-435 (2024) |
| Publisher Information: |
Elsevier |
| Publication Year: |
2024 |
| Collection: |
Directory of Open Access Journals: DOAJ Articles |
| Subject Terms: |
Stereotactic radiosurgery; Dose-area product; Non-isocentric irradiation; Treatment plan optimization; Plan quality; Pareto efficiency; Medical physics. Medical radiology. Nuclear medicine; R895-920 |
| Description: |
Purpose: In robotic stereotactic radiosurgery (SRS), optimal selection of collimators from a set of fixed cones must be determined manually by trial and error. A unique and uniformly scaled metric to characterize plan quality could help identify Pareto-efficient treatment plans. Methods: The concept of dose-area product (DAP) was used to define a measure (DAPratio) of the targeting efficiency of a set of beams by relating the integral DAP of the beams to the mean dose achieved in the target volume. In a retrospective study of five clinical cases of brain metastases with representative target volumes (range: 0.5–5.68 ml) and 121 treatment plans with all possible collimator choices, the DAPratio was determined along with other plan metrics (conformity index CI, gradient index R50%, treatment time, total number of monitor units TotalMU, radiotoxicity index f12, and energy efficiency index η50%), and the respective Spearman's rank correlation coefficients were calculated. The ability of DAPratio to determine Pareto efficiency for collimator selection at DAPratio < 1 and DAPratio < 0.9 was tested using scatter plots. Results: The DAPratio for all plans was on average 0.95 ± 0.13 (range: 0.61–1.31). Only the variance of the DAPratio was strongly dependent on the number of collimators. For each target, there was a strong or very strong correlation of DAPratio with all other metrics of plan quality. Only for R50% and η50% was there a moderate correlation with DAPratio for the plans of all targets combined, as R50% and η50% strongly depended on target size. Optimal treatment plans with CI, R50%, f12, and η50% close to 1 were clearly associated with DAPratio < 1, and plans with DAPratio < 0.9 were even superior, but at the cost of longer treatment times and higher total monitor units. Conclusions: The newly defined DAPratio has been demonstrated to be a metric that characterizes the target efficiency of a set of beams in robotic SRS in one single and uniformly scaled number. A DAPratio < 1 indicates Pareto ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S0939388923000016; https://doaj.org/toc/0939-3889; https://doaj.org/article/dd0e5ecf30d442afa9b48026c99a420e |
| DOI: |
10.1016/j.zemedi.2023.01.001 |
| Availability: |
https://doi.org/10.1016/j.zemedi.2023.01.001; https://doaj.org/article/dd0e5ecf30d442afa9b48026c99a420e |
| Accession Number: |
edsbas.840764C0 |
| Database: |
BASE |