{
  "abstract": "Background and purpose\n\nIntermediate-dose spillage is central to normal-brain sparing in stereotactic radiosurgery, yet fixed adverse-event and relative indices do not define achievable plan quality for single-target linear accelerator treatments. The aim was to derive a volume-dependent absolute benchmark for the 50% prescription isodose volume (V50%; equivalent to V10 Gy for 20 Gy plans) for brain metastases.Materials and methods\n\nIn total, 276 single-isocenter single-target plans were analyzed: 178 idealized model plans and 98 clinical plans. Power-law regression in log-log space modeled spillage against planning target volume (PTV, cm³). The volume-scaling exponents were 0.83 for the ideal references and 0.75 for the simplified clinical threshold. The clinical upper threshold was derived using q = 0.90 quantile regression. Threshold-exceeding plans were reviewed for anatomical or technical justification.Results\n\nIn the model cohort V50% value correlated strongly with PTV (r = 0.994, p < 0.001). The ideal mean model was V50% = 3.71 × PTV0.83, the conservative ideal-planning reference was V50% = 4.10 × PTV0.83, and the clinical upper threshold was V50% = 5.00 × PTV0.75. Ten of 98 clinical plans (10%) exceeded the threshold. Seven lacked anatomical justification and were replanned, reducing V50% by a median of 14% (range 7-29%) without compromising target coverage.Conclusions\n\nA volume-based V50% benchmark provided a complementary quality-assurance reference for single-target linear accelerator radiosurgery for brain metastases. It flagged plans that warranted structured review alongside target coverage, organs of interest, conformity, and gradient metrics.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, University Hospital Bonn, Venusberg-Campus 1, Bonn, Germany.",
    "University Clinic for Medical Radiation Physics, Medical Campus Pius Hospital, Carl von Ossietzky University, Oldenburg, Germany.",
    "Institute of Experimental Oncology, University Hospital Bonn, Bonn, Germany.",
    "Department of Radiation Physics, University Hospital Leipzig, Stephanstrasse 9a, Leipzig, Germany.",
    "Department of Radiation Oncology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Youness Nour"
    },
    {
      "affs": [
        0
      ],
      "name": "Shari Wiegreffe"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Tuba Tekin"
    },
    {
      "affs": [
        0
      ],
      "name": "Lara Caglayan"
    },
    {
      "affs": [
        0
      ],
      "name": "Christina Leitzen"
    },
    {
      "affs": [
        0
      ],
      "name": "Cas S Dejonckheere"
    },
    {
      "affs": [
        0
      ],
      "name": "Davide Scafa"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Julian P Layer"
    },
    {
      "affs": [
        0
      ],
      "name": "Victoria Volkenborn"
    },
    {
      "affs": [
        0
      ],
      "name": "Fabian Kugel"
    },
    {
      "affs": [
        0
      ],
      "name": "Stephan Garbe"
    },
    {
      "affs": [
        3
      ],
      "name": "Christos Moustakis"
    },
    {
      "affs": [
        4
      ],
      "name": "Dimos Baltas"
    },
    {
      "affs": [
        0
      ],
      "name": "Gustavo R Sarria"
    },
    {
      "affs": [
        4
      ],
      "name": "Anca-L Grosu"
    },
    {
      "affs": [
        0
      ],
      "name": "Eleni Gkika"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/adxgdjgx0dbgb.bib",
  "cited_by": 0,
  "doi": "10.1016/j.phro.2026.101105",
  "fulltext_url": "https://europepmc.org/articles/PMC13682193",
  "id": "adxgdjgx0dbgb",
  "issns": [
    "2405-6316"
  ],
  "landing_url": "https://europepmc.org/article/MED/42904134",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3108|Advanced Radiotherapy Techniques"
    ]
  ],
  "openalex": "W7221168679",
  "pdf_url": "https://europepmc.org/articles/PMC13682193?pdf=render",
  "pmcid": "PMC13682193",
  "pmid": "42904134",
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/adxgdjgx0dbgb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42904134",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42904134"
    }
  ],
  "subjects": [
    {
      "field": "physics",
      "origin": "openalex:3108|Advanced Radiotherapy Techniques",
      "subfield": "applied-instrumentation"
    }
  ],
  "title": "Benchmarking intermediate dose spillage in single target stereotactic radiosurgery for brain metastases.",
  "title_text": "Benchmarking intermediate dose spillage in single target stereotactic radiosurgery for brain metastases.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/adxgdjgx0dbgb",
  "venue": "Physics and imaging in radiation oncology",
  "versions": []
}