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To investigate potential improvement in external beam stereotactic radiation therapy plan quality for cranial cases using an optimized dynamic gantry and patient support couch motion trajectory, which could minimize exposure to sensitive healthy tissue.

Anonymized patient anatomy and treatment plans of cranial cancer patients were used to quantify the geometric overlap between planning target volumes and organs‐at‐risk (OARs) based on their two‐dimensional projection from source to a plane at isocenter as a function of gantry and couch angle. Published dose constraints were then used as weighting factors for the OARs to generate a map of couch‐gantry coordinate space, indicating degree of overlap at each point in space. A couch‐gantry collision space was generated by direct measurement on a linear accelerator and couch using an anthropomorphic solid‐water phantom. A dynamic …