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In the pursuit of perfect planning: comparison between Lightning Inverse Planning and GammaPlan Wizard for gamma knife radiosurgery
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In the pursuit of perfect planning: comparison between Lightning Inverse Planning and GammaPlan Wizard for gamma knife radiosurgery
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Journal Article
In the pursuit of perfect planning: comparison between Lightning Inverse Planning and GammaPlan Wizard for gamma knife radiosurgery
2025
Overview
The Lightning
software, was added to the Gamma Knife's Leksell GammaPlan
as a fully automated inverse planner, differently from the prior software, Wizard
. In this paper we compare their treatment planning capacity and quality.
Thirty-eight cases were compared under four different planning techniques. First, manual forward planning aided by the Wizard
optimization tool. Second, inverse planning with Wizard
. The third and fourth plans used Lightning
with and without consideration for organs at risk (OAR). They were analysed for: planning time, number of shots, coverage, selectivity, gradient index, bean-on time, and OAR dose. Comparison based on pathology was added due to their idiosyncrasies. For quality comparison, dose-volume histograms (DVH) were compared to plans developed under our treatment standards. Tumor's volume and time to plan were correlated with Pearson's coefficient.
Lightning
had better coverage (8%) and gradient index (15%) but had 12% decrease in selectivity. Planning and delivery times had a reduction of 57% and 5% respectively, despite having three times the number of shots. Only Lightning
with protection of OAR met the dose constrains in all plans. DVH showed similar plan qualities.
Lightning
allowed the planner to explore different optimization parameters to achieve a plan that suits the clinical problem at hand. It took less time to calculate shots placement, OAR protection and the ideal isodose line than the Wizard
. This can be useful to plan multiple and complex targets at a faster time, increase the patient's tolerance and, may have a radiobiological advantage by impacting intra-fraction repair.
Publisher
Sciendo,De Gruyter Brill Sp. z o.o., Paradigm Publishing Services
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