Mednet Logo

In the modern IMRT/SBRT era, what should be the appropriate definition for the term "hot spot" in evaluating a plan?

Do people use it interchangeably with DMax or use the 2cmx2cm definition? I often get pushback from the dosimetrists for plans where the DMax is higher than desired (>110% etc.) and their argument to me is that this is merely a point dose and according to Khan textbook, a "hot spot" is considered clinically significant only if it is outside of the target and more than 2cmx2cm. However, I do not recall seeing this requirement in the recent RTOG protocols (they are mostly max/min dose or % of volume receiving Dose X etc.)
1 Answer
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on

The dose heterogeneity with IMRT has improved significantly over last 15 years. In past it was not unsual to see point hot spot (.03 cc) of 120% in PTV with a significant volume of PTV getting 110% or more.In modern planning with improved software and hardware usally point hotspot in majority of cas...

Join for free or sign in to see the full answer