Gamma knife, stereotactic linac radiosurgery, and micro multileaf collimator optimized treatment plan comparison

2002 ◽  
Author(s):  
Carine Kulik ◽  
Maximilien Vermandel ◽  
Jean Rousseau ◽  
D. Gibon ◽  
Salah Maouche
2015 ◽  
Vol 26 (3) ◽  
pp. 168
Author(s):  
Soon Sung Lee ◽  
Sang Hyoun Choi ◽  
Chul Kee Min ◽  
Woo Chul Kim ◽  
Young Hoon Ji ◽  
...  

2003 ◽  
Vol 48 (24) ◽  
pp. 4105-4110 ◽  
Author(s):  
Kenneth E Ekstrand ◽  
William H Hinson ◽  
J Daniel Bourland ◽  
Allan F deGuzman ◽  
Volker W Stieber ◽  
...  

2001 ◽  
Vol 94 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Roberto Spiegelmann ◽  
Zvi Lidar ◽  
Jana Gofman ◽  
Dror Alezra ◽  
Moshe Hadani ◽  
...  

Object. The use of radiosurgery in the treatment of acoustic neuromas has increased substantially during the last decade. Most published experience relates to the use of the gamma knife. In this report, the authors review the methods and results of linear accelerator (LINAC) radiosurgery in 44 patients with acoustic neuromas who were treated between 1993 and 1997. Methods. Computerized tomography scanning was selected as the stereotactic imaging modality for target definition. A single, conformally shaped isocenter was used in the treatment of 40 patients; two or three isocenters were used in four patients who harbored very irregular tumors. The radiation dose directed to the tumor border was the only parameter that changed during the study period: in the first 24 patients who were treated the dose was 15 to 20 Gy, whereas in the last 20 patients the dose was reduced to 11 to 14 Gy. After a mean follow-up period of 32 months (range 12–60 months), 98% of the tumors were controlled. The actuarial hearing preservation rate was 71%. New transient facial neuropathy developed in 24% of the patients and persisted to a mild degree in 8%. Radiation dose correlated significantly with the incidence of cranial neuropathy, particularly in large tumors (≥ 4 cm3). Conclusions. Single-isocenter LINAC radiosurgery proved to be an effective treatment for acoustic neuromas in this series, with results that were comparable with those reported for gamma knife radiosurgery and multiple isocenters.


2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 333-333
Author(s):  
Phillip M. Devlin

333 Background: This case is of a 70 yo Asian male who had suffered for many years from a painful eroding, oozing, bleeding lesion that started on the mons and over time had spread the full length of the penis and onto the anterior scrotum. A surface mold applicator fractionated computer-optimized high-dose rate (HDR) brachytherapy to 50Gy given in 2 Gy/day 5 days/week for 5 weeks. Methods: For the mons and the anterior scrotum a flat plate of aquaplast was molded with an aperture through which to pass the penis. For the penis a soft wrap, make of two layers of 5mm superflab was created with 15 truguide catheters embedded between. The wrapped penis was then supported with towels and tapes. Using radio-opaque dummy markers a CT was generated and an optimized treatment plan using Oncentra Brachytherapy. Because of the need for daily setups and the intrinsically elastic nature of the penis and scrotum, effort was made to keep the dwell times even so as to minimize any effect from day to day variation in set up. The prescription isodose line was manually adjusted so that where possible there was sparing of deep tissue of the urethra, bladder and testes. When QA was approved the patient began with daily treatments and successfully completed 25 without a treatment break. Results: Sustained local control was observed. Discussion: Surface mold applicator brachytherapy provides the most conformal of radiation therapy to complex superficial targets. For these targets it compares most favorably with all external beam approaches including electron, photon, IMRT and proton therapy. Conclusions: This modality optimally treated these lesions. The depth of the dose can be modulated. The treatment plan can be adapted to deal with swelling late in the course of therapy. The chance of a geographic miss of therapy is low because of the direct application to the affected area.


2007 ◽  
Vol 6 (2) ◽  
pp. 123-126 ◽  
Author(s):  
Kenneth E. Ekstrand ◽  
William H. Hinson ◽  
William Kearns ◽  
J. Daniel Bourland ◽  
Allan F. deGuzman ◽  
...  

2021 ◽  
Author(s):  
Humza Nusrat

This dissertation examines the extent to which radiobiological variations occur in photon radiotherapy, and then presents a novel methodology and detector prototype to measure this variation. In the first section, I examine the change in maximum RBE (RBEM) outside the primary field in open and composite 6 MV x-ray beams. This is done using Monte Carlo simulation and microdosimetric techniques. It was found that when comparing an open 10 10 cm2 6 MV beam to a composite 10 10 cm2 beam comprising one hundred 1x 1 cm2 beamlets, the out-of-field increase in RBE occurs much closer to the field edge in the composite case. This finding may have consequences for IMRT cases in which large amount of scattered radiation may be causing a higher than expected effective dose to organs at risk. In the second section, the maximum RBE variation is examined in the context of brachytherapy. The sources examined include 192Ir, 125I, and 169Yb. It was determined that maximum RBE of 125I relative to the source position did not vary significantly as distance from the source was increased, however, 192Ir and 169Yb were found to exhibit RBEM increases of 3.0% and 6.6% at a distance of 8 cm, respectively. Also, the impact of this variation on an HDR 192Ir prostate treatment plan was examined; it was found that RBEM hotspots of +3.6% occur at the treatment plan’s periphery. In the third part, the impact of lead doping on plastic scintillator response is quantified, a major step required for the development of the LET detector prototype. In this stage, 4 differently doped plastic scintillators were obtained, and measurements were conducted in low and medium LET beams. Using Geant4 Monte Carlo and the measured scintillator responses, the scintillator parameters: kB and L0 were determined as a function of dopant concentration and effective atomic number. Finally, the uniquely energy dependent scintillators were combined into a detector prototype used to measure the LET spectra produced by five low energy photon beams. These beams included four orthovoltage energies (100, 180, 250, and 300 kVp) along with an 192Ir HDR source. In this proof-of-principle work, the detector prototype and technique was found to accurately determine the LET spectra and the mean LET for all beams with the exception of the 100 kVp orthovoltage beam. Potential applications for the real-time LET detector prototype and technique described in this dissertation include LET measurement in radiotherapy, allowing for biologically optimized treatment plans improving patient care. This technique and prototype also has numerous applications in non-medical fields such as health physics, space travel dosimetry, and nuclear safety.


2018 ◽  
Vol 129 (Suppl1) ◽  
pp. 140-146
Author(s):  
Joshua Chiu ◽  
Steve Braunstein ◽  
Jean Nakamura ◽  
Philip Theodosopoulos ◽  
Penny Sneed ◽  
...  

OBJECTIVEInterfractional residual patient shifts are often observed during the delivery of hypofractionated brain radiosurgery. In this study, the authors developed a robustness treatment planning check procedure to assess the dosimetric effects of residual target shifts on hypofractionated Gamma Knife radiosurgery (GKRS).METHODSThe residual patient shifts were determined during the simulation process immediately after patient immobilization. To mimic incorporation of residual target shifts during treatment delivery, a quality assurance procedure was developed to sample and shift individual shots according to the residual uncertainties in the prescribed treatment plan. This procedure was tested and demonstrated for 10 hypofractionated GKRS cases.RESULTSThe maximum residual target shifts were less than 1 mm for the studied cases. When incorporating such shifts, the target coverage varied by 1.9% ± 2.2% (range 0.0%–7.1%) and selectivity varied by 3.6% ± 2.5% (range 1.1%–9.3%). Furthermore, when incorporating extra random shifts on the order of 0.5 mm, the target coverage decreased by as much as 7%, and nonisocentric variation in the dose distributions was noted for the studied cases.CONCLUSIONSA pretreatment robustness check procedure was developed and demonstrated for hypofractionated GKRS. Further studies are underway to implement this procedure to assess maximum tolerance levels for individual patient cases.


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