{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T15:01:22Z","timestamp":1773068482410,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T00:00:00Z","timestamp":1605657600000},"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":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine if the gamma knife icon (GKI) can provide superior stereotactic radiotherapy (SRT) dose distributions for appropriately selected meningioma and post\u2010resection brain tumor bed treatments to volumetric modulated arc therapy (VMAT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Appropriately selected targets were not proximal to great vessels, did not have sensitive soft tissue including organs\u2010at\u2010risk (OARs) within the planning target volume (PTV), and did not have concave tumors containing excessive normal brain tissue. Four of fourteen candidate meningioma patients and six of six candidate patients with brain tumor cavities were considered for this treatment planning comparison study. PTVs were generated for GKI and VMAT by adding 1\u00a0mm and 3\u00a0mm margins, respectively, to the GTVs. Identical PTV V<jats:sub>100%<\/jats:sub>\u2010values were obtained for the GKI and VMAT plans for each patient. Meningioma and tumor bed prescription doses were 52.7\u201354.0 in 1.7\u20131.8\u00a0Gy fractions and 25\u00a0Gy in 5\u00a0Gy fractions, respectively. GKI dose rate was 3.735\u00a0Gy\/min for 16\u00a0mm collimators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PTV radical dose homogeneity index was 3.03\u00a0\u00b1\u00a00.35 for GKI and 1.27\u00a0\u00b1\u00a00.19 for VMAT. Normal brain <jats:italic>D<\/jats:italic><jats:sub>1%<\/jats:sub>, <jats:italic>D<\/jats:italic><jats:sub>5%<\/jats:sub>, and <jats:italic>D<\/jats:italic><jats:sub>10%<\/jats:sub> were lower for GKI than VMAT by 45.8\u00a0\u00b1\u00a010.9%, 38.9\u00a0\u00b1\u00a011.5%, and 35.4\u00a0\u00b1\u00a016.5% respectively. All OARs considered received lower maximum doses for GKI than VMAT. GKI and VMAT treatment times for meningioma plans were 12.1\u00a0\u00b1\u00a04.13\u00a0min and 6.2\u00a0\u00b1\u00a00.32\u00a0min, respectively, and, for tumor cavities, were 18.1\u00a0\u00b1\u00a05.1\u00a0min and 11.0\u00a0\u00b1\u00a00.56\u00a0min, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Appropriately selected meningioma and brain tumor bed patients may benefit from GKI\u2010based SRT due to the decreased normal brain and OAR doses relative to VMAT enabled by smaller margins. Care must be taken in meningioma patient selection for SRT with the GKI, even if they are clinically appropriate for VMAT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.13100","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T23:06:37Z","timestamp":1605740797000},"page":"246-252","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Stereotactic radiotherapy of appropriately selected meningiomas and metastatic brain tumor beds with gamma knife icon versus volumetric modulated arc therapy"],"prefix":"10.1002","volume":"21","author":[{"given":"Jacob S.","family":"Buatti","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Iowa Hospital and Clinics 200 Hawkins Drive Iowa City IA 52242 USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Buatti","sequence":"additional","affiliation":[{"name":"Department of Radiation 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