Single
isocenter multiple target stereotactic radiosurgery (SIMT-SRS) has potentially
emerged as a new pillar in radio-immune combination therapy for the management
of brain metastasis. Accuracy and efficiency are pushed to a higher level in the era of the linear accelerator-based SIMT-SRS. This short review focuseson patient selection, image preparation, patient
simulation, electronic portal imaging device (EPID)
QA, and the patient treatment process in the SIMT-SRS treatment only. Image-relevant recommendations and guidelines are presented
and contrast application, acquisition efficiency, and alignment accuracy of CT
and MRI images are explored. With guidance, the SIMT-SRS can be implemented with high precision and efficiency. 1mm or
0.5 mm and non-uniform PTV margin expansion for all targets would
become possible. It will enhance cancer killing effect in radio-immune
combination therapy. General routine daily, monthly, and annual linear
accelerator image quality assurancesare excluded.
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