{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:15:26Z","timestamp":1786976126139,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T00:00:00Z","timestamp":1639958400000},"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":[[2022,2]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n Treatment of multiple brain metastases by linac\u2010based stereotactic radiotherapy (SRT) can employ either a multiple\u2010isocenter (MI) or single\u2010isocenter (SI) approach. The purposes of this study were to evaluate the dosimetric results of MI and SI approaches and compare the impacts of intra\u2010fractional setup discrepancies on the robustness of respective approaches using isocenter shifts, whether the same magnitude of translational and rotational effects could lead to a significant difference between the two approaches.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Twenty\u2010two patients with multiple brain metastases treated by linac\u2010based SRT were recruited. Treatment plans were computed with both the MI and SI approaches. For the MI approach, the isocenter was located at the geometric center of each planning target volumes (PTVs), whereas the isocenter of the SI approach was located midway between the PTV centroids. To simulate the intra\u2010fractional errors, isocenter displacements including translational and rotational shifts were hypothetically applied. Apart from the dosimetric outcomes of the two approaches, the impact of the isocenter shifts on PTVs and organs at risk (OARs) were recorded in terms of the differences (\n \u03b4<\/jats:italic>\n ) in dose parameters relative to the reference plan and was then compared between the MI and SI approaches.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both MI and SI plans met the plan acceptance criteria. The mean\n Paddick conformity index<\/jats:italic>\n (\n Paddick CI<\/jats:italic>\n ) and\n \n D\n max<\/jats:sub>\n <\/jats:italic>\n of most OARs between MI and SI plans did not show a significant difference, except that higher doses to the left optic nerve and optic chiasm were found in SI plans (\n p<\/jats:italic>\n \u00a0=\u00a00.03). After the application of the isocenter shifts,\n \u03b4CI<\/jats:italic>\n increased with an increase in the magnitude of the isocenter shift. When comparing between MI and SI plans, the\n \u03b4CIs<\/jats:italic>\n were similar (\n p<\/jats:italic>\n \u00a0>\u00a00.05) for all extents of translational shifts, but\n \u03b4CIs<\/jats:italic>\n were significantly higher in SI plans after application of all rotations particularly \u00b11.5\u00b0 and \u00b12.0\u00b0 shifts. Despite the result that the majority of\n \n \u03b4D\n Max<\/jats:sub>\n <\/jats:italic>\n of OARs were higher in the SI plans, only the differences in the left optic nerve and chiasm showed generally consistent significance after both translational \u2265\u00b11\u00a0mm and rotational shifts of \u2265\u00b11\n \n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Both MI and SI approaches could produce clinically acceptable plans. However, isocenter shifts brought dosimetric impacts to both MI and SI approaches and the effects increased with the increase of the shift magnitude. Although similar impacts were shown in plans of both approaches after translational isocenter shift, SI plans were relatively more vulnerable than MI plans to rotational shifts.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.13484","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T23:59:41Z","timestamp":1640044781000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparison of dosimetric impact of intra\u2010fractional setup discrepancy between multiple\u2010 and single\u2010isocenter approaches in linac\u2010based stereotactic radiotherapy of multiple brain metastases"],"prefix":"10.1002","volume":"23","author":[{"given":"Sylvia S. W.","family":"Tsui","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology Prince of Wales Hospital Shatin Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent W. C.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Health Technology & Informatics The Hong Kong Polytechnic University Hung Hom Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry S. C.","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology Queen Mary Hospital Pok Fu Lam Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000763"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-018-0985-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2016.06.007"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.21.2483"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.30.1655"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2008.44.6.358"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.08.035"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.10.026"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.01.004"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-7-63"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.05.029"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.07.1726"},{"issue":"2","key":"e_1_2_10_14_1","first-page":"117","article-title":"Improved clinical efficiency in CNS stereotactic radiosurgery (SRS) using a flattening filter free (FFF) linear accelerator","volume":"1","author":"Prendergast BM","year":"2011","journal-title":"J Radiosurg SBRT"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep34511"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2015.04.001"},{"issue":"1","key":"e_1_2_10_17_1","first-page":"1","article-title":"On a single isocenter volumetric modulated arc therapy SRS planning technique for multiple brain metastases","volume":"2","author":"Hardcastle N","year":"2012","journal-title":"J Radiosurg SBRT"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.05.048"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.12.030"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(02)04597-2"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.05.075"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.01.052"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/55\/1\/001"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semradonc.2003.10.003"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.06.022"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.05.030"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.11.010"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.02.074"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.07.2262"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-015-1767-4"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2006.08.024"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-8-135"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3438081"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2017.09.007"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v12i2.3449"},{"issue":"2","key":"e_1_2_10_36_1","first-page":"101","article-title":"ICRU REPORT 91: Prescribing, Recording, and Reporting of Stereotactic Treatments with Small Photon Beams","volume":"14","year":"2014","journal-title":"J International Commission on Radiation Units and Measurements"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-6-158"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v14i6.4297"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12815"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2000.93.supplement_3.0219"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(96)00422-1"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2014.05.009"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2008.02.005"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.9839"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-016-0593-y"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(98)00468-4"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-5-42"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.13484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.13484","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.13484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T10:36:20Z","timestamp":1693132580000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.13484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,20]]},"references-count":46,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1002\/acm2.13484"],"URL":"https:\/\/doi.org\/10.1002\/acm2.13484","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,20]]},"assertion":[{"value":"2021-12-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13484"}}