PURPOSE: Flattening filter free (FFF) irradiation potentially reduces treatment delivery time in radiosurgery thus eliminating intrafraction motion and increasing patient comfort. We compared plan quality and efficiency of VMAT and IMRT plans for FFF- and standard delivery for brain metastases with single fraction doses of 20 Gy and validated the dosimetric accuracy of the FFF delivery. MATERIAL AND METHODS: CT data of 15 patients with brain metastases were included in this study. For every patient, 2 IMRT- and 2 VMAT-plans were created using a high-resolution MLC with two different delivery modes (6MV standard vs. 6MV FFF). Plan quality and efficiency was assessed by analysis of conformity, homogeneity, dose gradients, treatment delivery time and number of monitor units (MU). Dosimetric evaluation was performed for 10 FFF plans with radiochromic film and ion chamber. RESULTS: Plan quality was similar for both approaches. FFF provided a mean treatment time reduction of 51.5% with similar MU for VMAT and IMRT for this low-modulation paradigm. The dosimetric validations showed an absolute dose deviation of +0.93 ± 0.99% and γ-index analysis (3%/3mm and 3%/1mm) resulted in agreement of 99.08 ± 1.58% respectively 93.46 ± 2.41%. CONCLUSION: FFF radiosurgery is an efficient technique for intensity modulated hypofractionated or single fraction treatments with similar plan quality when compared to flattened beams at reduced treatment time.
PURPOSE: Flattening filter free (FFF) irradiation potentially reduces treatment delivery time in radiosurgery thus eliminating intrafraction motion and increasing patient comfort. We compared plan quality and efficiency of VMAT and IMRT plans for FFF- and standard delivery for brain metastases with single fraction doses of 20 Gy and validated the dosimetric accuracy of the FFF delivery. MATERIAL AND METHODS: CT data of 15 patients with brain metastases were included in this study. For every patient, 2 IMRT- and 2 VMAT-plans were created using a high-resolution MLC with two different delivery modes (6MV standard vs. 6MV FFF). Plan quality and efficiency was assessed by analysis of conformity, homogeneity, dose gradients, treatment delivery time and number of monitor units (MU). Dosimetric evaluation was performed for 10 FFF plans with radiochromic film and ion chamber. RESULTS: Plan quality was similar for both approaches. FFF provided a mean treatment time reduction of 51.5% with similar MU for VMAT and IMRT for this low-modulation paradigm. The dosimetric validations showed an absolute dose deviation of +0.93 ± 0.99% and γ-index analysis (3%/3mm and 3%/1mm) resulted in agreement of 99.08 ± 1.58% respectively 93.46 ± 2.41%. CONCLUSION: FFF radiosurgery is an efficient technique for intensity modulated hypofractionated or single fraction treatments with similar plan quality when compared to flattened beams at reduced treatment time.
Authors: Judit Boda-Heggemann; Ulrike Attenberger; Johannes Budjan; Anika Jahnke; Lennart Jahnke; Lena Vogel; Anna O Simeonova-Chergou; Carsten Herskind; Frederik Wenz; Frank Lohr Journal: Strahlenther Onkol Date: 2016-07-08 Impact factor: 3.621
Authors: Caroline Steenken; Jens Fleckenstein; Stefan Kegel; Lennart Jahnke; Anna Simeonova; Linda Hartmann; Jens Kübler; Marlon R Veldwijk; Frederik Wenz; Carsten Herskind; Frank Anton Giordano Journal: Strahlenther Onkol Date: 2015-03-13 Impact factor: 3.621
Authors: Steven K M Lau; Kaveh Zakeri; Xiao Zhao; Ruben Carmona; Erik Knipprath; Daniel R Simpson; Sameer K Nath; Gwe-Ya Kim; Parag Sanghvi; Jona A Hattangadi-Gluth; Clark C Chen; Kevin T Murphy Journal: Neurosurgery Date: 2015-08 Impact factor: 4.654
Authors: Morten Nielsen; Christian R Hansen; Carsten Brink; Anders S Bertelsen; Charlotte Kristiansen; Jeppesen Stefan S; Olfred Hansen Journal: J Radiosurg SBRT Date: 2016
Authors: J Rieber; E Tonndorf-Martini; O Schramm; B Rhein; S Stefanowicz; J Kappes; H Hoffmann; K Lindel; J Debus; S Rieken Journal: Strahlenther Onkol Date: 2016-07-04 Impact factor: 3.621