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KMID : 1164220220340010051
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Journal of Korean Society for Radiotherapeutic Technology
2022 Volume.34 No. 1 p.51 ~ p.60
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Feasibility study of using Halcyon LINAC for Double-target spine stereotactic body radiation therapy
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Jeong Hee-Ju
An Ye-Chan
Park Byoung-Suk
Park Myung-Hwan
Park Yong-Cheol
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Abstract
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Objectives: The purpose is to evaluate dosimetric performance and delivery efficiency of VMAT with Halcyon LINAC for double target spine SBRT
Materials and Methods: 12 patients with spine oligometastases were retrospectively studied. Single-isocenter spine SBRT plans was established using Halcyon® with Dual Layer MLC and Truebeam® with High Definition MLC. All patients' plans were created in Eclipse TPS through the identical conditions and optimization. C.I, H.I, G.I (Gradient Index), maximal and volumetric doses to spinal cord and low dose area were evaluated for comparison of both plans. Also, total MU and BOT(Beam On Time) were evaluated.
Results: Halcyon plans was no Statistical differences in C.I and H.I. However, the average of G.I was 4.64 for Halcyon, which decreased to 5.5% compared to Truebeam (P<0.001). Halcyon plans demonstrated statistically significant reduced G.I. The average of 50% and 25% isodose volume was 487.56 cc (-3.82%, P<0.001), 1859.45 cc (-4.75%, P<0.001) in Halcyon, respectively. Significantly reduced low dose spill were observed in Halcyon plans. In the evaluation of the spinal cord, the average of Dmean and V10 of Halcyon plans in the sample group with an overlap volume of less than 1 cc was 6.802 Gy (-3.504%, P=0.067), 5.766±1.683 cc (-8.199%, P=0.002), respectively. Halcyon plans demonstrated statistically significant reduced Dmean and V10. For delivery efficiency, MU and BOT(maximum dose rate for each machine), on average, increased in Halcyon plans. However, the average of BOT(800MU/min for each machine) was 648.33 sec for Halcyon (-1.74%, P<0.001).
Conclusion: Halcyon plan for double-target spine SBRT demonstrated advantages in the low dose area with a steep dose gradient, while having dosimetrically equivalent target dose distribution and spinal cord protective effect. As a result, Halcyon LINAC produced a dosimetrically improved plan for double-target spine SBRT.
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KEYWORD
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Spine SBRT, SIMT-VMAT, Halcyon, Dual layer MLC, Truebeam, High definition MLC
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