Purpose/Objective
To establish a novel preclinical model for stereotactic radiosurgery with combined mouse-like phantom quality assurance in the setting of brain metastases.
Material Methods
C57B6 mice underwent intracranial injection of B16-F10 melanoma cells. T1-post contrast MRI was performed on Day 11 after injection. The MRI images were fused with cone beam computed tomography (CBCT) images using the SARRP. Gross tumor volume (GTV) was contoured using the MRI. A single sagittal arc utilizing the 3×3 mm2 collimator was used to deliver 18 Gy prescribed to the isocenter. MRI was performed 7 days after radiation treatment and the dose delivered to the mice was confirmed using two mouse-like anthropomorphic phantoms: one in the axial and the other in the sagittal orientation. SARRP output was measured using a PTW Farmer type ionization chamber as per AAPM TG-61 and the H-D curve was generated up to a max dose of 30 Gy. Irradiated films were analyzed based on optical density distribution and H-D curve.
Results
The tumor volume at Day 11, before intervention, was 2.48±1.37 mm3 in the no SRS arm versus 3.75±1.19 mm3 in the SRS arm (NS). In the SRS arm, GTV Dose max (Dmax) and mean dose were 2048±207 and 1785±14 cGy. Using the mouse-like phantoms, the radiochromic film showed close precision as compared with projected isodose lines with a Dmax of 1903.4 and 1972.7 cGy, the axial and sagittal phantom respectively. Tumor volume 7 days post-treatment was 7.34±8.24 mm3 in the SRS arm and 60.20±40.4 mm3 in the no SRS arm (p=0.009). No mice in the control group survived more than 22 days after implantation with a median overall survival (mOS) of 19 days. mOS was not reached in the SRS group with one death noted.
Conclusion
Single fraction SRS of 18 Gy delivered in a single arc can be delivered accurately with MRI T1-post contrast based treatment planning. The mouse-like phantom allows for verification of dose delivery and accuracy.
Cheng-Chia Wu, Kunal R. Chaudhary, Yong Hum Na, David Welch, Paul J. Black, Adam M. Sonabend, Peter Canoll, Yvonne M. Saenger, Tony J.C. Wang, Cheng-Shie Wuu, Tom K. Hei, Simon K. Cheng’Correspondence information about the author Simon K. Cheng
