Gondré Maude, Vallet Véronique, Bourhis Jean, Bochud François, Moeckli Raphael
Institute of Radiation Physics, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland.
Radio-Oncology Department, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland.
J Appl Clin Med Phys. 2025 Mar;26(3):e14585. doi: 10.1002/acm2.14585. Epub 2024 Dec 19.
Treatment planning for CyberKnife (CK) (Accuray, USA) can be performed with Precision (Accuray, USA) or RayStation (RS) (RaySearch Laboratories, Sweden) treatment planning systems (TPS). RaySearch recently released a new version of the CK module in RS 12A. The objective of the study was to compare plan quality between RS 12A and Precision.
Fifty nine plans were optimized with both TPS and compared; 39 were for brain metastases and 20 were for vertebral metastases. To avoid bias in plan comparison, Precision plans were recomputed in RS with the dose algorithm and beam model of RS, and then compared to RS plans. The comparison was divided into 3 parts in order to reflect the potential of RS and the differences with Precision, in terms of technical aspects of delivery efficiency and dose distribution. We compared the dose to the target and to the organs at risk (OAR), the conformity index (CI), the gradient, as well as the number of monitor units (MU), and the number of beams and nodes. Finally, a global plan quality index (PQI) was calculated.
RS plans showed an equivalent target coverage for brain metastases but worse for vertebrae. OAR sparing was improved in RS but with a lower CI compared to Precision. Using an appropriate planning methodology in RS, plans with comparable quality to Precision could be obtained, but at the cost of a longer optimization time. The PQI obtained with RS was better than Precision, except for some brain cases.
RS is an adequate alternative for CK planning as it is possible to obtain plan quality comparable to Precision. However, the optimization time is longer compared to Precision and more attention must be paid to the choice of the initial conditions in terms of the number of beams and nodes.
射波刀（CK，美国Accuray公司）的治疗计划可使用Precision（美国Accuray公司）或RayStation（RS，瑞典RaySearch Laboratories公司）治疗计划系统（TPS）来制定。RaySearch最近在RS 12A中发布了CK模块的新版本。本研究的目的是比较RS 12A和Precision之间的计划质量。
用这两种TPS对59个计划进行优化并比较；其中39个用于脑转移瘤，20个用于脊柱转移瘤。为避免计划比较中的偏差，在RS中使用RS的剂量算法和射束模型重新计算Precision计划，然后与RS计划进行比较。比较分为3部分，以便从剂量传递效率和剂量分布的技术方面反映RS的潜力以及与Precision的差异。我们比较了靶区和危及器官（OAR）的剂量、适形指数（CI）、梯度，以及监测单位（MU）数量、射束和节点数量。最后，计算了一个整体计划质量指数（PQI）。
RS计划对脑转移瘤显示出相当的靶区覆盖，但对脊柱转移瘤则较差。RS在保护OAR方面有所改善，但与Precision相比CI较低。在RS中使用适当的计划方法，可以获得与Precision质量相当的计划，但代价是优化时间更长。除了一些脑转移瘤病例外，RS获得的PQI优于Precision。
RS是CK计划的一个合适替代方案，因为可以获得与Precision相当的计划质量。然而，与Precision相比，优化时间更长，并且在射束和节点数量的初始条件选择方面必须更加注意。
