% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Thomann:302836,
      author       = {B. Thomann$^*$ and T. Fechter$^*$ and J. Fischer and A.
                      Runz$^*$ and J. Roers and U. Ludwig and M. Grehn and M.
                      Grohmann and C. Ziemann and M. Judge and W. Baus and M.
                      Grahle and M. Walke and B. Bathen and J. Köhn and P.
                      Käthner and M. Shariff and R. Matthis and J. Fleckenstein
                      and S. Großmann and T. Streller and S. Howitz and M.
                      Priegnitz and R. Weigel and P. Winkler and O. Blanck and D.
                      Schmitt and J. Beck and M. Machein and E. Pappas and I.
                      Popp$^*$ and M. Reiner and C. Karger$^*$ and C. Moustakis
                      and M. Bock and A.-L. Grosu$^*$ and D. Baltas$^*$},
      title        = {{M}ulticenter multiplatform pattern-of-practice analysis of
                      single-isocenter multitarget stereotactic radiosurgery.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {201},
      number       = {9},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2025-01376},
      pages        = {953-962},
      year         = {2025},
      note         = {2025 Sep;201(9):953-962},
      abstract     = {Single-isocenter multitarget stereotactic radiosurgery
                      (SIMT SRS) offers enhanced clinical efficiency for treating
                      multiple brain metastases. However, it introduces additional
                      uncertainties, such as off-center dose and beam profile
                      inaccuracies, as well as quality assurance (QA) challenges,
                      complicating its implementation. This study aims to evaluate
                      different SIMT SRS approaches.We collected and analyzed SIMT
                      SRS protocol and infrastructure parameters from 23
                      radiotherapy centers across Germany, Austria, and
                      Switzerland, encompassing immobilization systems, computed
                      tomography (CT) protocols, linear accelerators, treatment
                      planning systems, beam configurations, imaging techniques,
                      and QA practices. Consensus, deviations, and compliance with
                      current guidelines were assessed. Subsequent studies will
                      include on-site measurements, evaluation of treatment plan
                      quality and delivery accuracy, and correlation of these
                      findings with the analyzed protocols to identify potential
                      links between protocol parameters and clinical
                      outcomes.There is consensus (at least $80\%$ agreement) for
                      a CT slice thickness of ≤ 1 mm, the need for
                      six-degree-of-freedom patient setup correction, and
                      noncoplanar treatment. There is notable variability for
                      intrafraction imaging (used by $70\%),$ minimum accepted
                      planning target volume diameter (ranging from 2-10 mm), SRS
                      QA, and general plan parameters, such as photon energy and
                      number of treatment fields. There is also high variability
                      in employed linear accelerator models and treatment planning
                      systems.These findings highlight a lack of standardization
                      in SIMT SRS practices. Combined with future measurements
                      correlating protocols to treatment quality, our study will
                      provide a foundation for recommendations to support the safe
                      and standardized implementation of SIMT SRS.},
      keywords     = {Anthropomorphic phantom (Other) / Brain metastases (Other)
                      / End-to-end test (Other) / Ring trial (Other) / SIMT SRS
                      (Other)},
      cin          = {FR01 / E040},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331 / I:(DE-He78)E040-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40637729},
      doi          = {10.1007/s00066-025-02424-w},
      url          = {https://inrepo02.dkfz.de/record/302836},
}