{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:55:36Z","timestamp":1791230136499,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T00:00:00Z","timestamp":1575936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To retrospectively compare clinically treated step\u2010and\u2010shoot intensity modulated radiotherapy (ssIMRT) and volumetric modulated arc therapy (VMAT) spine stereotactic body radiotherapy (SBRT) plans in dosimetric endpoints and pretreatment quality assurance (QA) measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five single fraction spine SBRT (18\u00a0Gy) cases \u2014 including one cervical, two thoracic, and two lumbar spines \u2014 clinically treated with ssIMRT were replanned with VMAT, and all plans were delivered to a phantom for comparing plan quality and delivery accuracy. Furthermore, we analyzed 98 clinically treated plans (18\u00a0Gy single fraction), including 34 ssIMRT and 29 VMAT for cervical\/thoracic spine, and 19 ssIMRT and 16 VMAT for lumbar spine. The conformality index (CI) and homogeneity index (HI) were calculated, and QA measurement records were compared. For the spinal cord\/cauda equina, the maximum dose to 0.03\u00a0cc (D<jats:sub>0.03cc<\/jats:sub>) and volume receiving 10 or 12\u00a0Gy (V<jats:sub>10Gy<\/jats:sub>\/V<jats:sub>12Gy<\/jats:sub>) were recorded. Statistical significance was tested with the Mann\u2013Whitney U test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to ssIMRT, replanned VMAT plans had lower V<jats:sub>10Gy<\/jats:sub>\/V<jats:sub>12Gy<\/jats:sub> and D<jats:sub>0.03cc<\/jats:sub> to the spinal cord\/cauda equina in all five cases, and better CI in three out of five cases. The VMAT replans were slightly less homogeneous than those of ssIMRT plans. Both modalities passed IMRT QA with &gt;95% passing rate with (3%, 3\u00a0mm) gamma criteria. With the 98 clinical cases, for cervical\/thoracic ssIMRT and VMAT plans, the median V<jats:sub>10Gy<\/jats:sub> of spinal cord was 4.15% and 1.85% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004); the median D<jats:sub>0.03cc<\/jats:sub> of spinal cord was 10.85\u00a0Gy and 10.10\u00a0Gy (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.032); the median CI was 1.28 and 1.08 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.009); the median HI were 1.34 and 1.33 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.697), respectively. For lumbar spine, no significant dosimetric endpoint differences were observed. The two modalities were comparable in delivery accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>From our clinically treated plans, we found that VMAT plans provided better dosimetric quality and comparable delivery accuracy when compared to ssIMRT for single fraction spine SBRT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.12788","type":"journal-article","created":{"date-parts":[[2019,12,10]],"date-time":"2019-12-10T15:51:32Z","timestamp":1575993092000},"page":"62-68","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Treatment planning of VMAT and step\u2010and\u2010shoot IMRT delivery techniques for single fraction spine SBRT: An intercomparative dosimetric analysis and phantom\u2010based quality assurance measurements"],"prefix":"10.1002","volume":"21","author":[{"given":"Zi","family":"Ouyang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle V.","family":"LaHurd","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehsan H.","family":"Balagamwala","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel T.","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Taussig Cancer Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/2012.8.SPINE12303"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.02.019"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.05.053"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.05.067"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2012.01.005"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2013.07.022"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3438081"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.07.021"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.02.047"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.12.033"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.08.032"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-016-0603-0"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.05.005"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2017.12.009"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2017.04.001"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12022"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20120466"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2013.05.001"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177730491"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v16i1.5120"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.12.027"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12395"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3132234"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.06.013"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3675601"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-018-1314-2"}],"container-title":["Journal 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