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. 2021 Oct 26;11(1):21029.
doi: 10.1038/s41598-021-00381-9.

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

Hsiu-Wen Ho  1 , Ching-Chieh Yang  1   2 , Hsiu-Man Lin  1 , Hsiao-Yun Chen  1   3 , Chun-Chiao Huang  1 , Shih-Chang Wang  1 , Yu-Wei Lin  4
Affiliations

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

Hsiu-Wen Ho et al. Sci Rep. .

Abstract

To evaluate the potential benefit of HyperArc (HA) fractionated stereotactic radiotherapy (FSRT) for the benign brain lesion. Sixteen patients with a single deep-seated, centrally located benign brain lesion treated by CyberKnife (CK, G4 cone-based model) were enrolled. Treatment plans for HA with two different optimization algorithms (SRS NTO and ALDO) and coplanar RapidArc (RA) were generated for each patient to meet the corresponding treatment plan criteria. These four FSRT treatment plans were divided into two groups-the homogeneous delivery group (HA-SRS NTO and coplanar RA) and the inhomogeneous delivery group (HA-ALDO and cone-based CK)-to compare for dosimetric outcomes. For homogeneous delivery, the brain V5, V12, and V24 and the mean brainstem dose were significantly lower with the HA-SRS NTO plans than with the coplanar RA plans. The conformity index, high and intermediate dose spillage, and gradient radius were significantly better with the HA-SRS NTO plans than with the coplanar RA plans. For inhomogeneous delivery, the HA-ALDO exhibited superior PTV coverage levels to the cone-based CK plans. Almost all the doses delivered to organs at risk and dose distribution metrics were significantly better with the HA-ALDO plans than with the cone-based CK plans. Good dosimetric distribution makes HA an attractive FSRT technique for the treatment of benign brain lesions.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Isodose curves for the applied HyperArc-SRS NTO, RapidArc, HyperArc-ALDO and CyberKnife plans. Clinical target volume: red; planning target volume: pink; brainstem: yellow. (a–c) The HyperArc-SRS NTO plan; (d–f) the RapidArc plan; (g–i) the HyperArc-ALDO plan; (j–l) the CyberKnife plan.
Figure 2
Figure 2
Dose-volume histograms for the applied HyperArc-SRS NTO, RapidArc, HyperArc-ALDO and CyberKnife plans. (a) Clinical target volumes (CTV) and planning target volumes (PTV) of the RapidArc and HyperArc-SRS NTO plans; (b) brain and brainstem of the RapidArc and HyperArc-SRS NTO plans; (c) CTV and PTV of the HyperArc-ALDO and CyberKnife plans; (d) brain and brainstem in HyperArc-ALDO and CyberKnife plans; X-axis, the percentage of the prescription dose; Y-axis, the volume percentage of the OAR.
Figure 3
Figure 3
Boxplots of dosimetric parameters HyperArc, RapidArc, HyperArc-ALDO and CyberKnife plans. (a) High dose spillage; (b) intermediate dose spillage; (c) conformity index; (d) gradient radius; (e) homogeneity index. Boxes, median value and upper and lower quartiles; whiskers, maximum and minimum values within 1.5× interquartile range; dots, outliers.
See this image and copyright information in PMC

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