Document Detail

Does intensity modulation improve healthy tissue sparing in stereotactic radiosurgery of complex arteriovenous malformations?
MedLine Citation:
PMID:  17707196     Owner:  NLM     Status:  MEDLINE    
This planning study evaluates the potential of intensity modulated treatment fields and inverse planning techniques in stereotactic radiosurgery to reduce healthy tissue dose. Twenty patients previously treated with stereotactic radiosurgery for arteriovenous malformation (AVM) were replanned with each of 4 techniques: circular non-coplanar arcs, dynamic arcs, static conformal fields, and intensity modulated radiosurgery (IMRS). Patients were selected having a maximum AVM dimension at least 20 mm, or volume greater than 10 cm(3). Target volumes ranged from 2.12 cm(3) to 13.87 cm(3) with a median of 6.03 cm(3). Resulting dose distributions show a statistically significant improvement in target conformality between circular arcs and all other techniques (p </= 0.001), between conformal and both dynamic arcs and IMRS (p </= 0.03) and with no difference between dynamic arcs and IMRS. However, for AVMs of volume greater than 5.5 cm(3), IMRS gives better conformality than dynamic arcs (p = 0.04). IMRS showed consistently lower dose inhomogeneity compared to both dynamic arcs and conformal fields (p < 0.001). At low dose levels, the dynamic arc technique irradiates less healthy tissue than the other techniques (p </= 0.001). Both dynamic arcs and IMRS provide increased ability to conform to the AVM, with IMRS showing greater ability to control dose at the periphery.
Brenda Clark; Michael McKenzie; James Robar; Emily Vollans; Charlie Candish; Brian Toyota; Andrew Lee; Roy Ma; Karen Goddard; Sara Erridge
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical dosimetry : official journal of the American Association of Medical Dosimetrists     Volume:  32     ISSN:  0958-3947     ISO Abbreviation:  Med Dosim     Publication Date:  2007  
Date Detail:
Created Date:  2007-08-20     Completed Date:  2007-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908862     Medline TA:  Med Dosim     Country:  United States    
Other Details:
Languages:  eng     Pagination:  172-80     Citation Subset:  IM    
Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.
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MeSH Terms
Arteriovenous Malformations / surgery*
Radiosurgery / methods*
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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