{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:26:27Z","timestamp":1789496787206,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"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":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Class solution template trajectories are used clinically for efficiency, safety, and reproducibility. The aim was to develop class solutions for single cranial metastases radiotherapy\/radiosurgery based on intracranial target positioning and compare to patient\u2010specific trajectories in the context of 4\u03c0 optimization. Template trajectories were constructed based on the open\u2010source Montreal Neurological Institute (MNI) average brain. The MNI brain was populated with evenly spaced spherical target volumes (2 cm diameter, <jats:italic>N<\/jats:italic> = 243) and organs\u2010at\u2010risk (OARs) were identified. Template trajectories were generated for six anatomical regions (frontal, medial, and posterior, each with laterality dependence) based on previously published 4\u03c0 optimization methods. Volumetric modulated arc therapy (VMAT) treatment plans generated using anatomically informed template 4\u03c0 trajectories and patientspecific 4\u03c0 trajectories were compared against VMAT plans from a standard four\u2010arc template. Four\u2010arc optimization techniques were compared to the standard VMAT template by placing three spherical targets in each of six anatomical regions of a test patient. This yielded 54 plans to compare various plan quality metrics. Increasing plan technique complexity, the total number of OAR maximum dose reductions compared to the standard arc template for the 6 anatomical classes was 4+\/\u22122 (OFIXEDc) and 7+\/\u22122 (OFIXEDi). In 65.6% of all cases, optimized fixed\u2010couch positions outperformed the standard\u2010arc template. Of the three comparisons, the most complex (OFIXEDi) showed the greatest statistical significance compared to the least complex (VMATi) across 12 plan quality metrics of maximum dose to each OAR, V12Gy, total plan Monitor Units, conformity index, and gradient index (<jats:italic>p<\/jats:italic> &lt; 0.00417). In approximately 70% of all cases, 4\u03c0 optimization methods outperformed the standard\u2010arc template in terms of maximum dose reduction to OAR, by exclusively changing the arc geometry. We conclude that a tradeoff exists between complexity of a class solution methodology compared to patient\u2010specific methods for arc selection, in the context of plan quality improvement.<\/jats:p>","DOI":"10.1002\/acm2.13765","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T11:40:28Z","timestamp":1662118828000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of anatomically informed class solution template trajectories with patient\u2010specific trajectories for stereotactic radiosurgery and radiotherapy"],"prefix":"10.1002","volume":"23","author":[{"given":"John David","family":"Lincoln","sequence":"first","affiliation":[{"name":"Department of Physics and Atmospheric Science Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert 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