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Purpose <p>This study aimed to systematically evaluate the dosimetric performance of the Multi-Leaf Collimator (MLC) versus the fixed-diameter Circular Collimator (CC) for CyberKnife radiosurgery. The primary research question was to determine how tumor size, shape, and anatomical location (intracranial, hepatic, prostatic) influence plan quality, treatment efficiency, and Organ-at-Risk (OAR) sparing.</p> Methods <p>A comprehensive planning study was conducted. For intracranial targets, plans were generated on 15 patient CTs for simulated spherical PTVs of 1, 3, 5, and 7&#xa0;cm. For clinical validation, retrospective SBRT plans were created for 30 liver cancer and 30 prostate cancer patients. Key dosimetric parameters, including Conformity Index (CI), Homogeneity Index (HI), Gradient Index (GI), OAR doses, and treatment time, were compared between MLC and CC plans.</p> Results <p>For intracranial targets, the MLC significantly reduced normal brain dose spillage (mean V10Gy reduced by 17%, <i>P</i> &lt; 0.001) and improved dose homogeneity (mean HI: 1.15 vs. 1.29, <i>P</i> &lt; 0.001). In liver SBRT, MLC plans provided superior minimum dose coverage to the PTV (<i>P</i> &lt; 0.05). For prostate SBRT, the MLC significantly improved plan conformity (CI, <i>P</i> &lt; 0.05) and reduced rectal doses. Across all sites, the mean treatment time with MLC was significantly shorter than with CC (<i>P</i> &lt; 0.001).</p> Conclusion <p>The MLC significantly reduces treatment time while delivering favorable or comparable dose distributions for a wide range of target sizes and complexities. Its advantages in OAR sparing and plan quality are most pronounced for large targets and those with significant PTV-OAR interface, establishing it as a preferred modality for modern stereotactic radiotherapy.</p>

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Dosimetric Comparison of Multi-Leaf and Circular Collimator-based CyberKnife Radiosurgery for Targets of Varying Size and Complexity in Intracranial, Hepatic, and Prostatic Lesions: A Comprehensive Planning Study

  • 期刊论文

  • 发表日期：

    2025年10月16日

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  • Bo Tian,
  • Hui Xu,
  • Yunfei Bian,
  • Xiongfei Li,
  • Sha He,
  • Changwen Bo,
  • Zheng Zheng,
  • Zunhao Zhang

摘要

Purpose

This study aimed to systematically evaluate the dosimetric performance of the Multi-Leaf Collimator (MLC) versus the fixed-diameter Circular Collimator (CC) for CyberKnife radiosurgery. The primary research question was to determine how tumor size, shape, and anatomical location (intracranial, hepatic, prostatic) influence plan quality, treatment efficiency, and Organ-at-Risk (OAR) sparing.

Methods

A comprehensive planning study was conducted. For intracranial targets, plans were generated on 15 patient CTs for simulated spherical PTVs of 1, 3, 5, and 7 cm. For clinical validation, retrospective SBRT plans were created for 30 liver cancer and 30 prostate cancer patients. Key dosimetric parameters, including Conformity Index (CI), Homogeneity Index (HI), Gradient Index (GI), OAR doses, and treatment time, were compared between MLC and CC plans.

Results

For intracranial targets, the MLC significantly reduced normal brain dose spillage (mean V10Gy reduced by 17%, P < 0.001) and improved dose homogeneity (mean HI: 1.15 vs. 1.29, P < 0.001). In liver SBRT, MLC plans provided superior minimum dose coverage to the PTV (P < 0.05). For prostate SBRT, the MLC significantly improved plan conformity (CI, P < 0.05) and reduced rectal doses. Across all sites, the mean treatment time with MLC was significantly shorter than with CC (P < 0.001).

Conclusion

The MLC significantly reduces treatment time while delivering favorable or comparable dose distributions for a wide range of target sizes and complexities. Its advantages in OAR sparing and plan quality are most pronounced for large targets and those with significant PTV-OAR interface, establishing it as a preferred modality for modern stereotactic radiotherapy.