We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Clinical implementation of Lightning for the Gamma Knife Icon.
- Authors
Grishchuk, Diana; Karanatsiou, Anna; Paddick, Ian
- Abstract
Introduction: Lightning is a new Inverse Planning module available for Leksell Gamma Plan version 11.3.1. Prior inverse planning was limited for GK because it couldn’t outperform experienced manual planners. This module allows automatic planning using coverage, OAR tolerance dose(s), low dose/beam on time priorities and also allows final manual adjustments after dose calculation such as add/move/delete shot(s) and/or re-normalising the plan. Clinical implementation of this module is a practicechanging event and needs thorough investigation. Methods and materials: The following tasks were chosen to assess the clinical implementation of the new module: 1. To investigate whether optimal parameters exist for Lightning plans, a series of benchmarking targets were planned with Low dose and Beam on Time weightings between 0.1 and 1.0 in 0.1 increments yielding a total of 100 plans per target. The optimisation algorithm has 100% reproducibility ie. It produces exactly the same plan for the same optimisation parameters. Beam on time, conformity and gradient were assessed for each plan with the aim of finding whether optimal weighting values exist. 2. Treatment planning methods used since the implementation of Lightning were captured for every patient. Each plan was allocated one of the following categories: Manual planning, “Single click” Lightning with default 50:50 weighting, Lightning with weighting adjustment and Lightning with manual shot modifications. Results: 1. Low Dose/Beam on Time weighting matrices revealed that there is no ‘sweet spot’ so parameters need to be varied by the user to achieve their idea of an optimal plan. 2. After the first two months of use around 50% of plans were created with Lightning. This proportion has not significantly changed after 10 months though the number of plans with manual adjustments has increased. The planning method used appears to depend on the target size and complexity. For single targets > 1cc Lightning becomes the preferable method of planning and this rises to >80% for targets >5cc. Summary: Lightning is a well design and intuitive module which achieves a clinically acceptable planning results in a short time. It is particularly useful for planning large single targets and for multiple targets. The available tools allow the user to optimise the plan in terms of OAR tolerance doses, target coverage, gradient index and treatment time, but a “final touch” by an experienced planner may be still useful in order to further improve the selectivity and conformity of the plan.
- Subjects
LIGHTNING; MATHEMATICAL optimization
- Publication
Journal of Radiosurgery & SBRT, 2022, Vol 8, p167
- ISSN
2156-4639
- Publication type
Product Review