Abstract
Stereotactic radiosurgery has become a widely used technique to treat solid tumors and secondary metastases of the brain. Multiple targets can be simultaneously treated with a single isocenter in order to reduce the set-up time to improve patient comfort and workflow. In this study, a 5-arc multifocal RapidArc treatment was delivered to multiple PRESAGE® dosimeters in order to explore the repeatability of the treatment. The three delivery measurements agreed well with each other, with less than 3% standard deviation of dose in the target. The deliveries also agreed well with the treatment plan, with gamma passing rates greater than 90% (5% dose-difference, and 2 mm distance-to-agreement criteria). The optical-CT PRESAGE® system provided a reproducible measurement for treatment verification, provided measurements were made immediately following treatment.
Highlights
The use of high single dose fractions with steep gradients requires more stringent tolerances than standard hyperfractionated schemes, which in turn requires additional set up time
In this work we deliver the same complex treatment plan to 3 identical PRESAGE® dosimeters in order to determine the repeatability of the complex treatment delivery
Target dose distributions varied between each of the three deliveries very little, with less than 3% standard deviation in voxels located in the high dose regions
Summary
The use of high single dose fractions with steep gradients requires more stringent tolerances than standard hyperfractionated schemes, which in turn requires additional set up time. Stereotactic techniques have emerged which enable treatment of multiple intracranial targets with a single isocenter, thereby greatly reducing treatment time [1]. Verification of multifocal, RapidArc plans is a challenge due to the complexity of the dose distributions. Providing true 3D, fast, and high resolution 3D dosimetry could be an ideal solution for SRS treatment verification, and prior works reflect this interest [2,3,4,5]. In this work we deliver the same complex treatment plan to 3 identical PRESAGE® dosimeters in order to determine the repeatability of the complex treatment delivery
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