SU-E-T-382: Evaluation of Clinical Application and Dosimetric Comparison for Treatment Plans of Gamma Knife and CyberKnife for Arteriovenous Malformations




To analyze and compare the characteristics of dose distributions between Gamma Knife (GK) and CyberKnife (CK), in treating arteriovenous malformations (AVMs), and evaluate the influences on their clinical applications.


Twenty four patients with AVMs treated with CK of prescribed dose (PD) of 16–25 Gy in single fraction were selected. Each patient's CT images used for CK treatment planning with contours of targets and critical organs were exported and then loaded into the GK planning system. GK treatment plan with the same PD used in CK was generated for each patient. The metrics for dose comparison between GK and CK included conformity index (CI), gradient index (GI) of 75%, 50% and 25% of the PD, heterogeneity index (HI), volume of brain tissues covered by 10 Gy and 12 Gy, maximum dose to brainstem and beam-on time. Paired Samples t-test was used to analyze these metrics for significance (p value).


The CI were 0.744 ± 0.075 (GK) and 0.768 ± 0.086 (CK), p = 0.281. The GI75%, GI50%, and GI25% in GK and CK were 1.735 ± 0.100 and 2.439 ± 0.338 (p < 0.001), 3.169 ± 0.265 and 4.972 ± 0.852 (p < 0.001), and 8.650 ± 0.914 and 14.261 ± 2.476 (p < 0.001). The HI were 0.728 ± 0.072 (GK) and 0.313 ± 0.069 (CK), p < 0.001. There were significant differences both for volume of brain tissues covered by 10 Gy and 12 Gy in GK and CK (p < 0.001). GK had smaller maximum dose to brainstem. CK had shorter beam-on time.


GK has similar dose conformity as CK, and has better normal tissue sparing but is less efficient than CK.