SU-E-T-674: Relationship Between Conformity Indices and Treatment Characteristics in Cone Based Linac Stereotactic Radiosurgery




To investigate the correlation between conformity indices and dose prescription methodologies for LINAC based stereotactic surgery (SRS) cone plans.


A vestibular schwannoma Linac based SRS cone plan was selected for this study. The target volume was 0.49cc and its equivalent sphere diameter is 1.0cm. Single 360 degree ARC Plans with different sizes of cones were done in Eclipse Cone planning System from Varian Medical. The plans were prescribed to satisfy to be normalized to 50% isodose line, 80% isodose line, 100% isodose line covering 95% of the target volume, at target mean dose and target minimum dose. The cones were select to be 10mm, 12mm, 14mm, 16mm, 18mm, 20mm, and 22mm in diameter. The indices for this study were conformity index(CI), which is defined to be the ratio between prescription isodose volume (PIV) and target volume (TV), and integrated conformity index (ICI), which is defined to be (TVpiv)2/(PIVxTV), where TVpiv is the intersection between PIV and TV.


When the plans were normalized to 50% of maximum dose, 80% of maximum dose, 100% isodose line covering 95% of the target volume, at target mean dose and target minimum dose, the corresponding values of ICI ranged from 0.45 to 0.04, 0.68 to 0.08, 0.58 to 0.54, 0.65 to 0.58, and 0.37 to 0.26; and the corresponding values of CI ranged from 2.2 to 22.8, 0.9 to 11.4, 1.5 to 1.7, 0.7 to 0.5, and 2.7 to 3.9.


The values of indices used to describe SRS plans vary with different prescription conditions for single 360 degree ARC cone plans. For plans satisfied 100 % isodose covering 95% of target volume, the values of CI were between 1 and 2. A dynamic sensitive analysis system should be developed to correlate the plan evaluation index such as CI and ICI with clinical parameters.