Treatment plan quality for stereotactic treatment of multiple cranial metastases: Comparison of C-arm and O-ring treatment platforms
Bibliographic record
Abstract
C-arm linacs have been used widely to treat multiple cranial metastases using stereotactic radiosurgery (SRS). A new generation of O-ring linacs offer several workflow advantages when compared to C-arm platforms. However, O-ring linacs are not able to employ couch rotations for noncoplanar beams used in SRS treatments. This study was conducted in order to simulate further possible developments of O-ring treatment units by assessing their geometrical efficiency. In this work we compare the plan quality for C-arm versus an O-ring platform including metrics that are relevant to SRS for multiple metastases. The comparison is conducted by incorporating tilted arcs on the O-ring platform therefore introducing noncoplanarity. Total 40 patients previously treated for SRS with 20 Gy single fraction were replanned for C-arm with a standard noncoplanar 5-arc arrangement and O-ring with both coplanar and noncoplanar beams. For the O-ring plans, we considered a default 3-arc coplanar arrangement, as well as 3- and 5-arc arrangements with arcs tipped up to 10 degrees from the axial plane. Target coverage, organ-at-risk (OAR) doses, monitor unit (MU) efficiency, conformity and gradient indices were assessed for all plans. For most metrics the O-ring geometries, even the coplanar arrangement, produced statistically comparable results to the C-arm. Small but significant differences were found for the 3 arc O-ring for PTV: D90%, D2% and MU/Gy and for the 5 arc O-ring at D2% when both were compared to the C-arm. Cumulative dose volume histograms (DVHs) for normal brain showed a cross-over between the C-arm and coplanar O-ring geometry at a low dose (2.3 ± 1.8 Gy), with O-ring associated with higher volumes above this cross-over dose. However, no statistical difference was seen in the brainstem, optic pathway and volumes of normal brain receiving 12 Gy or 20 Gy. This study has found that O-ring geometry linacs can produce SRS plans of comparable quality to those from a C-arm for multiple cranial metastases.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".