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It is therefore helpful to understand which parameters for optimization are available and how they affect the plan quality. This study aims to provide a\u00a0reference for designing multi-metastases treatment plans and to define quality endpoints for benchmarking the technique from a\u00a0scientific perspective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In all, 20\u00a0patients with a\u00a0total of 183 lesions were retrospectively planned according to four optimization scenarios. Plan quality was evaluated using common plan quality parameters such as conformity index, gradient index and dose to normal tissue. Therefore, different scenarios with combinations of optimization parameters were evaluated, while taking into account dependence on the number of treated lesions as well as influence of different beams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Different scenarios resulted in minor differences in plan quality. With increasing number of lesions, the number of monitor units increased, so did the dose to healthy tissue and the number of interlesional dose bridging in adjacent metastases. Highly modulated cases resulted in 4\u201310% higher V\n                      <jats:sub>10%<\/jats:sub>\n                      compared to less complex cases, while monitor units did not increase. Changing the energy to a\u00a0flattening filter free (FFF) beam resulted in lower local V\n                      <jats:sub>12Gy<\/jats:sub>\n                      (whole brain-PTV) and even though the number of monitor units increased by 13\u201315%, on average 46% shorter treatment times were achieved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although no clinically relevant differences in parameters where found, we identified some variation in the dose distributions of the different scenarios. Less complex scenarios generated visually more dose overlap; therefore, a\u00a0more complex scenario may be preferred although differences in the quality metrics appear minor.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-024-02249-z","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T12:02:34Z","timestamp":1720440154000},"page":"815-826","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of different optimization parameters in single isocenter multiple brain metastases radiosurgery"],"prefix":"10.1007","volume":"200","author":[{"given":"Angelika","family":"Altergot","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Ohlmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"N\u00fcsken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Palm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Dzierma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,8]]},"reference":[{"issue":"5","key":"2249_CR1","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1269\/jrr.08020","volume":"49","author":"JS Kim","year":"2008","unstructured":"Kim\u00a0JS, Lee\u00a0HJ, Kim\u00a0JC et\u00a0al (2008) Transient impairment of hippocampus-dependent learning and memory in relatively low-dose of acute radiation syndrome is associated with inhibition of hippocampal neurogenesis. 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