{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:12:00Z","timestamp":1791756720616,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"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":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study evaluates various radiotherapy techniques for treating metastatic brain tumor (BT), focusing on non\u2010coplanar volumetric modulated arc radiotherapy (NC\u2010VMAT), coplanar VMAT (C\u2010VMAT), Helical TomoTherapy (HT), CyberKnife (CK), Gamma Knife (GK), and ZAP\u2010X. CT images and structures of 12 patients who underwent CK for a single BT were utilized. Twelve treatment plans were created for each planning device. All plans adopted the approach of prescription doses to planning target volume D99.5%. They were divided into stereotactic radiosurgery (SRS) (prescription dose; 21\u201323\u00a0Gy) and stereotactic radiotherapy (SRT) (prescription dose; 30\u201336.5\u00a0Gy) groups and the same parameters evaluated included Gradient Index (GI), Paddick Conformity Index (CI), and treatment time (t\u2010time). In the SRS group, mean values of GI and CI values were: NC\u2010VMAT (4.28, 0.60), C\u2010VMAT (5.61, 0.44), HT (4.68, 0.42), CK (4.31, 0.61), GK (2.81, 0.82), and ZAP\u2010X (2.99, 0.80). In the SRT group: NC\u2010VMAT (3.27, 0.84), C\u2010VMAT (3.81, 0.82), HT (3.76, 0.65), CK (2.98, 0.77), GK (2.61, 0.90), and ZAP\u2010X (2.80, 0.84). There were no significant differences in the mean values of CI and GI between ZAP\u2010X and GK in both groups (<jats:italic>p<\/jats:italic>\u00a0&gt;\u00a00.05). NC\u2010VMAT and C\u2010VMAT had shorter t\u2010time than other techniques in both groups. ZAP\u2010X is relatively superior in CI and GI for small tumors, similar to GK, while differences with NC\u2010VMAT and CK diminish as tumor volume increases. ZAP\u2010X, CK, and GK have longer t\u2010time than other treatment techniques, regardless of volume.<\/jats:p>","DOI":"10.1002\/acm2.70046","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T17:01:38Z","timestamp":1741712498000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Stereotactic radiotherapy for metastatic brain tumors: A comparative analysis of dose distributions among VMAT, Helical TomoTherapy, CyberKnife, Gamma Knife, and ZAP\u2010X"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0414-5218","authenticated-orcid":false,"given":"Toshihiro","family":"Suzuki","sequence":"first","affiliation":[{"name":"CyberKnife Center Kasugai General Rehabilitation Hospital Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8636-4045","authenticated-orcid":false,"given":"Masahide","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Yamanashi Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Kamiyacho Neurosurgical Clinic Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6540-2906","authenticated-orcid":false,"given":"Hikaru","family":"Nemoto","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Yamanashi Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Yanagisawa","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Aizawa Comprehensive Cancer Center Aizawa Hospital Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuma","family":"Sawada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Kamiyacho Neurosurgical Clinic Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zennosuke","family":"Mochizuki","sequence":"additional","affiliation":[{"name":"CyberKnife Center Kasugai General Rehabilitation Hospital Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Sano","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Yamanashi Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Yamanashi Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"CyberKnife Center Kasugai General Rehabilitation Hospital Yamanashi Japan"},{"name":"Department of Neurosurgery Kasugai General Rehabilitation Hospital Yamanashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010018\u20100055\u2010y"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010002\u20100870\u20106"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571\u2010019\u20100320\u20103"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/jrr\/rraa013"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14740"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.13972"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885\u2010024\u201012710\u2010y"},{"issue":"4","key":"e_1_2_11_9_1","article-title":"Stereotactic radiosurgery plan comparison study of eclipse\/truebeam platform vs Zap\u2010X","volume":"15","author":"Keener J","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2023.05.005"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3438081"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3171\/sup.2006.105.7.194"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.ra.2014-0188"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12360"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2021.01.003"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2019.11.408"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.07.980"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2015.03.031"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.7.GKS16881"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533033819871621"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547\u2010017\u20100735\u20109"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2018.06.632"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1533033819871621"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.04.120"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.1.Jns182769"},{"issue":"3","key":"e_1_2_11_26_1","first-page":"a388","article-title":"Profile comparisons of small dose volumes between three radiosurgery systems","volume":"11","author":"Sorensen SP","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.1663"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12761"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.30654\/MJCS.10023"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12851"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14144"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(03)01579-7"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.061"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2024.101534"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T20:54:49Z","timestamp":1758228889000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":33,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1002\/acm2.70046"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70046","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"assertion":[{"value":"2024-11-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70046"}}