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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1495216

A Preliminary Study of linear accelerator-based spatially fractionated radiotherapy (SFRT)

Provisionally accepted
Young Kyu Lee Young Kyu Lee 1Yunji Seol Yunji Seol 1Byeong Jin Kim Byeong Jin Kim 1Kyu Hye Choi Kyu Hye Choi 1Ji Hyun Hong Ji Hyun Hong 1Chan-beom Park Chan-beom Park 2Sun Hwa Kim Sun Hwa Kim 2Hyeong Wook Park Hyeong Wook Park 3Wonjoong Cheon Wonjoong Cheon 1*Young-Nam Kang Young-Nam Kang 1*Byung Ock Choi Byung Ock Choi 1
  • 1 Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
  • 2 College of Medicine, Catholic University of Korea, Seoul, Seoul, Republic of Korea
  • 3 Department of Medical Physics, Kyonggi University, Suwon, Republic of Korea

The final, formatted version of the article will be published soon.

    Purpose: This study aimed to provide quantitative information for implementing Lattice radiotherapy (LRT) using a medical linear accelerator equipped with the Millennium 120 multileaf collimator (MLC). The research systematically evaluated the impact of varying vertex diameters and separations on dose distribution, peak-to-valley dose ratio (PVDR), and normal tissue dose.Methods: A cylindrical Virtual Water™ phantom was used to create LRT treatments using the Eclipse version 16.0 treatment planning system (Varian, Palo Alto, USA). The plans were optimized employing a 3 × 3 × 3 lattice structure with vertex diameters ranging from 0.5 to 2.0 cm and separations from 1.0 to 5.0 cm. The prescribed dose was 20.0 Gy to 50% of the vertex volume in a single fraction. Peak-to-valley dose ratio (PVDR) was calculated along three orthogonal axes, and normal tissue dose and monitor units (MU) were analyzed. Additionally, the modulation complexity score (MCS) was calculated for each plan to quantitatively assess treatment plan complexity.The PVDR analysis demonstrated heterogeneous dose distribution, with optimal values below 30% in all directions for 5.0 cm separation. PVDR in the superior-inferior direction was consistently lower than in other directions. Normal tissue dose analysis revealed increasing mean dose with larger diameters and separations, while the volume receiving high doses decreased. MU analysis showed significant contributions from collimator angles of 315.0° and 45.0°. MCS values ranged from 0.02 to 0.17 for 0.5 cm vertex diameter and 0.08 to 0.20 for larger diameters (1.0-2.0 cm) across different separations, respectively.This study demonstrates the technical feasibility of implementing LRT using a medical linear accelerator with Millennium 120 MLC. The findings provide insights into optimizing LRT treatment plans, offering a comprehensive quantitative reference for achieving desired dose heterogeneity while maintaining normal tissue protection.Spatially fractionated radiation therapy (SFRT), Lattice radiation therapy (LRT), multi-leaf collimator (MLC), Peak-to-valley dose ratio (PVDR), Monitor unit (MU) Analysis

    Keywords: Spatially Fractionated Radiation Therapy (SFRT), Lattice Radiation Therapy (LRT), Multi-leaf collimator (MLC), peak-to-valley dose ratio (PVDR), Monitor Unit (MU) Analysis

    Received: 12 Sep 2024; Accepted: 13 Dec 2024.

    Copyright: © 2024 Lee, Seol, Kim, Choi, Hong, Park, Kim, Park, Cheon, Kang and Choi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Wonjoong Cheon, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
    Young-Nam Kang, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea

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