{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:56:12Z","timestamp":1788357372713,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T00:00:00Z","timestamp":1668038400000},"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":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Volume staging involves dividing the target volume into smaller parts and treating each part separately. In this study, the feasibility of volume\u2010staged stereotactic radiosurgery (VS\u2010SRS) on a linear accelerator using volumetric modulated arc therapy (VMAT) and a frameless patient positioning system is investigated. Ten patients, previously treated with hypofractionated stereotactic radiotherapy with arteriovenous malformation (AVM) sized from 1.6 to 4.0\u00a0cm in diameter, were selected. VS\u2010SRS plans were created with the VMAT technique on the Varian Eclipse treatment planning system (TPS) using the TrueBeam STx linear accelerator. For each patient, an AVM\u2010VMAT set was planned with the AVM as the target and a PTV\u2010VMAT set using the (PTV\u00a0=\u00a0AVM+1\u00a0mm) as the target. All targets were divided into two sub\u2010volumes. The TPS data from the AVM\u2010VMAT plans was compared to Gamma Knife (GK) VS\u2010SRS plan data available in the literature. The AVM\u2010VMAT and PTV\u2010VMAT plans were compared to investigate the effect of a 1\u00a0mm PTV margin on normal brain (NB) dose. End\u2010to\u2010end testing was performed using a GaFchromic EBT3 film and point\u2010dose measurements. Dosimetric effects of multiple setups were investigated through film\u2010to\u2010film comparisons. Median target dose coverage, NB <jats:italic>V<\/jats:italic><jats:sub>12Gy<\/jats:sub>, and conformity index for the AVM\u2010VMAT plans were 97.5%, 17\u00a0cm<jats:sup>3<\/jats:sup>, and 0.8, respectively. PTV\u2010VMAT plans attained comparable target dose coverage, but the average NB <jats:italic>V<\/jats:italic><jats:sub>12Gy<\/jats:sub> increased by 48.9% when compared to the AVM\u2010VMAT plans. Agreement of point\u2010dose measurements with TPS calculations was \u22120.6% when averaged over all patients. Gamma analysis passing rates were above 90% for all film\u2010to\u2010film comparisons (2%\/1\u00a0mm criteria), and for the film to TPS comparison (5%\/1\u00a0mm). This work suggests that VMAT is capable of producing VS\u2010SRS plans with similar dose falloff characteristics as GK plans. NB dose depends on PTV margin size, and two\u2010stage treatment setups do not appear to contribute additional uncertainty to treatment delivery.<\/jats:p>","DOI":"10.1002\/acm2.13815","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T15:36:11Z","timestamp":1668094571000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Volume staging for arteriovenous malformation SRS treatment using VMAT"],"prefix":"10.1002","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0491-4726","authenticated-orcid":false,"given":"Claudia","family":"Mendez","sequence":"first","affiliation":[{"name":"Department of Physics and Astronomy University of British Columbia  Vancouver British Columbia Canada"},{"name":"BC Cancer, Abbotsford Center  Abbotsford British Columbia 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