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Figure 1: Avoidance volume (AV) and comparative dose distribution of FSRS (30 Gy/5 fractions) with Dynamic Conformal Arc (DCA) and Rapid Arc (RA). (a): T2-weighted MRI of a patient of GBM showing resection cavity (black). White line represents Avoidance Volume (AV) for reradiation with FSRS and is encompassed by 50 Gy isodose line from previous radiation with IMRT. (b): Planning CT scan of the same patient at the time of recurrence with 50 Gy Isodose line (gray) from previous radiation superimposed on planning CT Scan (AV). FSRS dose distribution with "DCA" (black-30 Gy, gray-20 Gy, white-15 Gy) with mean dose of 6.9 Gy to AV. (c): FSRS dose distribution of the same patient with "Rapid Arc". Note - considerable constriction of all the isodose curves resulting in significant dose reduction to 'AV' (mean dose 5.7 Gy, 19.2% less than DCA)

Figure 1: Avoidance volume (AV) and comparative dose distribution of FSRS (30 Gy/5 fractions) with Dynamic Conformal Arc (DCA) and Rapid Arc (RA). (a): T2-weighted MRI of a patient of GBM showing resection cavity (black). White line represents Avoidance Volume (AV) for reradiation with FSRS and is encompassed by 50 Gy isodose line from previous radiation with IMRT. (b): Planning CT scan of the same patient at the time of recurrence with 50 Gy Isodose line (gray) from previous radiation superimposed on planning CT Scan (AV). FSRS dose distribution with