{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:57:11Z","timestamp":1772103431906,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T00:00:00Z","timestamp":1517961600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2018,3]]},"abstract":"Abstract<\/jats:title>Purpose<\/jats:title>The aim of this study is to compare the dosimetric differences between four techniques for spine stereotactic body radiotherapy (SBRT<\/jats:styled-content>): CyberKnife (CK<\/jats:styled-content>), volumetric modulated arc therapy (VMAT<\/jats:styled-content>), and helical tomotherapy (HT<\/jats:styled-content>) with dynamic jaws (HT<\/jats:styled-content>\u2010D) and fixed jaws (HT<\/jats:styled-content>\u2010F).<\/jats:p><\/jats:sec>Materials\/methods<\/jats:title>Data from 10 patients were utilized. All patients were planned for 24 Gy in two fractions, with the primary objectives being: (a) restricting the maximum dose to the cord to \u2264 17 Gy and\/or cauda equina to \u2264 20 Gy, and (b) to maximize the clinical target volume (CTV<\/jats:styled-content>) to receive the prescribed dose. Treatment plans were generated by separate dosimetrists and then compared using velocity AI<\/jats:styled-content>. Parameters of comparison include target volume coverage, conformity index (CI<\/jats:styled-content>), gradient index (GI<\/jats:styled-content>), homogeneity index (HI<\/jats:styled-content>), treatment time (TT<\/jats:styled-content>) per fraction, and monitor units (MU<\/jats:styled-content>) per fraction.<\/jats:p><\/jats:sec>Results<\/jats:title>PTV<\/jats:styled-content> D2 and D5 were significantly higher for CK<\/jats:styled-content> compared to VMAT<\/jats:styled-content>, HT<\/jats:styled-content>\u2010F, and HT<\/jats:styled-content>\u2010D (P<\/jats:italic> < 0.001). The average volume of CTV receiving the prescription dose (CTV D95) was significantly less for VMAT compared to CK, HT\u2010F and HT\u2010D (P<\/jats:italic> = 0.036). CI<\/jats:styled-content> improved for CK<\/jats:styled-content> (0.69), HT<\/jats:styled-content>\u2010F (0.66), and HT<\/jats:styled-content>\u2010D (0.67) compared to VMAT<\/jats:styled-content> (0.52) (P<\/jats:italic> = 0.013). CK<\/jats:styled-content> (41.86) had the largest HI<\/jats:styled-content> compared to VMAT<\/jats:styled-content> (26.99), HT<\/jats:styled-content>\u2010F (20.69), and HT<\/jats:styled-content>\u2010D (21.17) (P<\/jats:italic> < 0.001). GI<\/jats:styled-content> was significantly less for CK<\/jats:styled-content> (3.96) compared to VMAT<\/jats:styled-content> (6.76) (P<\/jats:italic> = 0.001). Likewise, CK<\/jats:styled-content> (62.4 min, 14059 MU<\/jats:styled-content>) had the longest treatment time and MU<\/jats:styled-content> per fraction compared to VMAT<\/jats:styled-content> (8.5 min, 9764 MU<\/jats:styled-content>), HT<\/jats:styled-content>\u2010F (13 min, 10822 MU<\/jats:styled-content>), and HT<\/jats:styled-content>\u2010D (13.5 min, 11418 MU<\/jats:styled-content>) (P<\/jats:italic> < 0.001).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Both CK<\/jats:styled-content> and HT<\/jats:styled-content> plans achieved conformal target coverage while respecting cord tolerance. Dose heterogeneity was significantly larger in CK<\/jats:styled-content>. VMAT<\/jats:styled-content> required the least treatment time and MU<\/jats:styled-content> output, but had the least steep GI<\/jats:styled-content>, CI<\/jats:styled-content>, and target coverage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.12271","type":"journal-article","created":{"date-parts":[[2018,2,8]],"date-time":"2018-02-08T04:06:37Z","timestamp":1518062797000},"page":"160-167","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of four techniques for spine stereotactic body radiotherapy: Dosimetric and efficiency analysis"],"prefix":"10.1002","volume":"19","author":[{"given":"Saif","family":"Aljabab","sequence":"first","affiliation":[{"name":"Radiation Medicine Program The Ottawa Hospital Cancer Centre Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balamurugan","family":"Vellayappan","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology National University Cancer Institute 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