PMID- 14604415
OWN - NLM
STAT- MEDLINE
DCOM- 20040120
LR  - 20200219
IS  - 1526-9914 (Electronic)
IS  - 1526-9914 (Linking)
VI  - 4
IP  - 4
DP  - 2003 Autumn
TI  - An integrated treatment delivery system for CSRS and CSRT and clinical 
      applications.
PG  - 261-73
AB  - An integrated treatment delivery system for conformal stereotactic radiosurgery 
      (CSRS) and radiotherapy (CSRT) has been developed through a collaboration 
      involving Siemens Medical Systems, Inc., Tyco/Radionics, Inc., and The University 
      of Texas M. D. Anderson Cancer Center. The system consists of a 6-MV linear 
      accelerator (LINAC) equipped with a Tyco/Radionics miniature multileaf collimator 
      (mMLC). For the conventional SRS treatment, the circular collimator housing can 
      be attached to the opening window of the mMLC. The treatment delivery system is 
      integrated with a radiotherapy treatment planning system and a record-and-verify 
      system. The purpose of this study is to report the characteristics, performance, 
      benefits, and the clinical applications of this delivery system. The technical 
      specifications of the LINAC and mMLC were tested, and all the specifications were 
      met. The 80% to 20% penumbral width for each mMLC leaf is approximately 3 mm and 
      is nearly independent of the off-axis positions of a leaf. The maximum interleaf 
      leakage is 1.4% (1.1% on average) and the maximum intra-leaf leakage is 1.0% 
      (0.9% on average). The leaf position precision is better than 0.5 mm for all the 
      leaves. The integration of the SRS/SRT treatment planning system, mMLC, and LINAC 
      has been evaluated successfully for transferring the patient treatment data file 
      through radiotherapy treatment planning system to the patient information and 
      treatment record-and-verify server and the mMLC controller. Subsequently, the 
      auto-sequential treatment delivery for SRS, CSRS/CSRT, and the step-and-shoot 
      intensity-modulated radiotherapy has also been tested successfully. The accuracy 
      of dose delivery was evaluated for a 2-cm spherical target in a Radiological 
      Physics Center SRS head phantom with GAFChromic films and TLD. Five non-coplanar 
      arcs, using a 2-cm diameter circular collimator, were used for this simulation 
      treatment. The accuracy to aim the center of the spherical target was within 0.5 
      mm and the deviation of dose delivery to the isocenter of the target was within 
      2% of the calculated dose. For the irregularly shaped tumor, a tissue-equivalent 
      head phantom was used to evaluate the accuracy of dose delivery for using either 
      geometric conformal treatment or IMRT. The accuracy of dose delivery to the 
      isocenter was within 2% and 3% of the calculated dose, respectively. From October 
      26, 1999 to September 30, 2002, we treated over 400 SRS patients and 70 SRT 
      patients. Four representative cases are presented to illustrate the capabilities 
      of this dedicated unit in performing conventional SRS, CSRS, and CSRT. For all 
      the cases, the geometric conformal-plan dose distributions showed a high degree 
      of conformity to the target shape. The degree of conformity can be evaluated 
      using the target-volume-ratio (TVR). Our preferred TVR values for highly 
      conformed dose distributions range from 1.6 to 2.0. The patient setup 
      reproducibility for the Gill-Thomas-Cosman (GTC) noninvasive head frame ranges 
      from 0.5 to 1 mm, and the head and neck noninvasive frame is within 2 mm. The 
      integrated treatment delivery system offers excellent conformation for 
      complicated planning target volumes with the stereotactic setup approach, 
      ensuring that dose delivery can be achieved within the specified accuracy. In 
      addition, the treatment time is comparable with that of single isocenter 
      multiple-arc treatments.
CI  - (c) 2003 American College of Medical Physics.
FAU - Shiu, A
AU  - Shiu A
AD  - Department of Radiation Physics, The University of Texas M. D. Anderson Cancer 
      Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA. ashiu@mdanderson.org
FAU - Parker, B
AU  - Parker B
FAU - Ye, J-S
AU  - Ye JS
FAU - Lii, J
AU  - Lii J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Validation Study
PL  - United States
TA  - J Appl Clin Med Phys
JT  - Journal of applied clinical medical physics
JID - 101089176
SB  - IM
MH  - Brain Neoplasms/radiotherapy/secondary/surgery
MH  - Carcinoma, Renal Cell/radiotherapy/secondary
MH  - Humans
MH  - Kidney Neoplasms/pathology
MH  - Lymphoma, Large B-Cell, Diffuse/radiotherapy
MH  - Nasopharyngeal Neoplasms/radiotherapy
MH  - Neoplasm Recurrence, Local/radiotherapy
MH  - Particle Accelerators/instrumentation
MH  - Radiosurgery/instrumentation/*methods
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Conformal/instrumentation/*methods
MH  - Radiotherapy, High-Energy/instrumentation/methods
PMC - PMC5724455
EDAT- 2003/11/08 05:00
MHDA- 2004/01/21 05:00
PMCR- 2003/09/01
CRDT- 2003/11/08 05:00
PHST- 2003/11/08 05:00 [pubmed]
PHST- 2004/01/21 05:00 [medline]
PHST- 2003/11/08 05:00 [entrez]
PHST- 2003/09/01 00:00 [pmc-release]
AID - ACM20261 [pii]
AID - 10.1120/jacmp.v4i4.2496 [doi]
PST - ppublish
SO  - J Appl Clin Med Phys. 2003 Autumn;4(4):261-73. doi: 10.1120/jacmp.v4i4.2496.