@article{325e85664652475b82a186a641ffe5cf,
title = "The effect of MLC leaf width in single-isocenter multi-target radiosurgery with volumetric modulated arc therapy",
abstract = "Purpose: Single-isocenter multi-target (SIMT) volumetric modulated arc therapy (VMAT) is primarily limited to linear accelerators utilizing 2.5 mm leaf width MLCs. We explore feasibility of applying this technique to linear accelerators utilizing MLCs with leaf width of 5 mm. Methods: Twenty patients with 3-10 intracranial brain metastases originally treated with 2.5 mm MLCs were re-planned using 5 mm MLCs and relevant dosimetric indices were compared. We also evaluated various strategies of adding VMAT arcs to mitigate degradations of dose quality values. Results: Wider MLCs caused small changes in total MUs (5827 ± 2334 vs 5572 ± 2220, p = 0.006), and conformity index (CI) (2.22% ± 0.05%, p = 0.045), but produced more substantial increases in brain V30%[%] and V50%[%] (27.75% ± 0.16% and 20.04% ± 0.13% respectively, p < 0.001 for both), and V12Gy[cc] (16.91% ± 0.12%, p < 0.001). Conclusion: SIMT radiosurgery delivered via VMAT using 5 mm wide MLCs can achieve similar CI compared to that using 2.5 mm leaf width MLCs but with moderately increased isodose spill, which can be only partially mitigated by increasing the number of VMAT arcs.",
keywords = "2.5 mm leaf width MLCs, 5 mm leaf width MLCs, Intracranial brain metastases, SIMT, SRS, VMAT",
author = "Zhanerke Abisheva and Floyd, {Scott R.} and Salama, {Joseph K.} and John Kirkpatrick and Yin, {Fang Fang} and Moravan, {Michael J.} and William Giles and Justus Adamson",
note = "Funding Information: Fang-Fang Yin discloses research and licensing agreements with Varian Medical Systems, not related to this study and is also supported by NIH: 2R21CA218940, 1R01 CA184173-01A1, 5R21CA195317-02. John Kirkpatrick discloses research agreement with Var-ian Medical Systems and ownership of ClearSight RT LLC, both of which are unrelated to this study. Justus Adamson discloses ownership of ClearSight RT LLC, which is unrelated to this study. Other authors have nothing to disclose. Funding Information: Fang-Fang Yin discloses research and licensing agreements with Varian Medical Systems, not related to this study and is also supported by NIH: 2R21CA218940, 1R01 CA184173-01A1, 5R21CA195317-02. John Kirkpatrick discloses research agreement with Varian Medical Systems and ownership of ClearSight RT LLC, both of which are unrelated to this study. Justus Adamson discloses ownership of ClearSight RT LLC, which is unrelated to this study. Other authors have nothing to disclose. Publisher Copyright: {\textcopyright} 2019 Old City Publishing, Inc.",
year = "2019",
language = "English",
volume = "6",
pages = "131--138",
journal = "Journal of Radiosurgery and SBRT",
issn = "2156-4639",
number = "2",
}