Treatment planning for stereotactic radiosurgery of intra-cranial lesions

Hanne M. Kooy, Lucien A. Nedzi, Jay S. Loeffler, Eben Alexander, Chee Wai Cheng, Edward G. Mannarino, Edward J. Holupka, Robert L. Siddon

Research output: Contribution to journalArticle

100 Scopus citations

Abstract

Stereotactic radiosurgery of intra-cranial lesions is a treatment modality where a well defined target volume receives a high radiation dose in a single treatment. Our technique delivers this dose using a set of non-coplanar arcs and small circular collimators. We use a standard linear accelerator in our treatments, and the adjustable treatment parameters are: isocenter location, gantry arc rotation interval, couch angle, collimator field size, and dose. The treatment planning phase of the treatment determines these parameters such that the target volume is sufficiently irradiated, and dose to surrounding healthy tissue and critical, dose-limiting structures is minimized. The attachment of a BRW localizing frame to the patient's cranium combined with CT imaging (and optionally MRI or angiography) provides the required accuracy for localizing individual structures in the treatment volume. The treatment is fundamentally 3-dimensional and requires a volumetric assessment of the treatment plan. The selection of treatment arcs relies primarily on geometric constraints and the beam's eye view concept to avoid irradiating critical structures. The assessment of a treatment plan involves isodose distributions throughout the volume and integral dose-volume histograms. We present the essential concepts of our treatment planning approach, and illustrate these in three clinical cases.

Original languageEnglish (US)
Pages (from-to)683-693
Number of pages11
JournalInternational journal of radiation oncology, biology, physics
Volume21
Issue number3
DOIs
StatePublished - Aug 1991

Keywords

  • 3-Dimensional treatment planning
  • Dose computation
  • Dose-volume histograms
  • Stereotactic radiosurgery
  • Visualization

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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