SU-E-T-11: A Dosimetric Comparison of Robotic Prostatic Radiosugery Using Multi- Leaf Collimation Vs Circular Collimators




The study compared the dosimetry plans of Stereotatic Body Radiotherapy (SBRT) prostate cancer patients using the M6 Cyberknife with Multi-leaf Collimation (MLC) compared with the plans using G4 Cyberknife with circular collimators.


Eight previously treated prostate cancer patients' SBRT plans using circular collimators, designed with Multiplan v3.5.3, were used as a benchmark. The CT, contours and the optimization scripts were imported into Multiplan v5.0 system and replanned with MLC. The same planning objectives were used: more than 95% of PTV received 36.25Gy, 90% of prostate received 40Gy and maximum dose <45Gy, in five fractions. For organs at risk, less than 1cc of rectum received 36Gy and less than 10cc of bladder received 37Gy. Plans were evaluated on parameters derived from dose volume. The beam number, MU and delivery time were recorded to compare the treatment efficiency.


The mean CTV volume was 41.3cc (27.5∼57.6cc) and mean PTV volume was 76.77cc (59.1∼99.7cc). The mean PTV coverage was comparable between MLC (98.87%) and cone (98.74%). MLC plans had a slightly more favorable homogeneity index (1.22) and conformity index (1.17), than the cone (1.24 and 1.15). The mean rectum volume of 36 Gy (0.52cc) of MLC plans was slightly larger than cone (0.38cc) and the mean bladder volume of 37 Gy was smaller in MLC (1.82cc) than in cone plans (3.09cc). The mean number of nodes and beams were 65.9 and 80.5 in MLC vs 65.9 and 203.6 in cone. The mean MUs were significantly less for MLC plans (24,228MUs) than cone (32,347MUs). The total delivery time (which included 5 minutes for setup) was less, 29.6min (26∼32min) for MLC vs 45min (35∼55min) for cone.


While the differences in the dosimetry between the MLC and circular collimator plans were rather minor, the MLC plans were much more efficient and required significantly less treatment time.