Treatment planning of stereotactic radiosurgery for single brain metastases: impact of leaf width

Purpose/objective: Stereotactic radiosurgery of brain metastases requires highly conformal dose distributions. Besides beams setup, characteristics of the linear accelerator collimator may also play a role. In this study we compared the impact of leaf width on the dose outside the target for stereotactic radiosurgery of single brain metastases. Results: The mean dose was evaluated in the first 2 rings of 5 mm around the PTV(table 1). The difference in mean dose for the small lesions(Dpres=24 Gy) of the first ring of 5 mm is 1.8 Gy in favor of the Agility and 0.9 Gy for the larger lesions(Dpres=18 Gy)also in favor of the Agility. The difference is smaller for the larger lesions (figure1). Also for the second ring of 5 mm, adjacent to the first ring, the difference is is 1.1 Gy vs 0.8 Gy also in favor of the Agility. Conclusion: For the small lesions with a volume smaller than 4 cm³ the Agility shows a steeper gradient in the two surrounding rings than the MLCi1. Therefore we recommend the use of the Agility for treating the smaller lesions.