Quantifying superficial tissue doses in Gamma Knife radiosurgeryKeywords: gamma knife, dose planning, dose delivery, skin, radiosurgeryInteractive Manuscript
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What is the background behind your study?
Many groups have reported on radiation-induced meningioma following cranial irradiation. In radiosurgery, the dose to superficial tissues is typically low but can vary significantly depending on target location.
What is the purpose of your study?
The objective of this study is to validate the accuracy of superficial tissue doses in Gamma Knife (GK) radiosurgery, calculated by the Gamma Plan treatment planning system.
Describe your patient group.
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Describe what you did.
A CT scan was acquired of an anthropomorphic head phantom immobilized in a stereotactic frame. A patient treatment plan was projected onto the phantom CT scan by placing all shots in the patient plan in corresponding locations within the phantom using a single transformation matrix. MOSFET detectors, previously calibrated in the GK unit using a spherical dosimetry phantom, were placed on several locations on the head phantom under 3-mm thick pieces of bolus. The projected plan was then delivered to the phantom. Similarly, superficial dose measurements were obtained from EBT2 Gafchromic films. The films were placed on the same measurement sites of the MOSFETS. The EBT2 measurements were analyzed using a dose calibration curve for a 6 MV beam, as EBT2 film dose measurements are independent of beam energy. The measured superficial doses were compared with those predicted by Gamma Plan.
Describe your main findings.
The MOSFET and film dose measurements ranged from 4 to 53 cGy for a plan scaled to deliver 6 Gy to the 50% isodose line (approximately half the clinical dose). The surface dose varied by location and was sufficiently high (100-200 cGy) for accurate measurement with both MOSFET detectors and EBT2 films. The mean difference between absolute values of the MOSFET and Gamma Plan measurements was 8 ± 12 cGy. The EBT2 measurements showed a better agreement with the Gamma Plan doses with a mean difference of 4 ± 6 cGy. Maximum differences from the Gamma Plan measurements of 29 cGy and 14 cGy were observed for the MOSFETS and EBT2 film, respectively.
Describe the main limitation of this study.
The data obtained were from a limited data set.
Describe your main conclusion.
We have demonstrated a viable technique for quantifying superficial tissue doses in Gamma Knife radiosurgery, utilizing MOSFETS and EBT2 Gafchromic films.
Describe the importance of your findings and how they can be used by others.
Superficial tissue doses may be relevant for dose planning. Clinical research is required.
Many groups have reported on radiation-induced meningioma following cranial irradiation. In radiosurgery, the dose to superficial tissues is typically low but can vary significantly depending on target location.
The objective of this study is to validate the accuracy of superficial tissue doses in Gamma Knife (GK) radiosurgery, calculated by the Gamma Plan treatment planning system.
A CT scan was acquired of an anthropomorphic head phantom immobilized in a stereotactic frame. A patient treatment plan was projected onto the phantom CT scan by placing all shots in the patient plan in corresponding locations within the phantom using a single transformation matrix. MOSFET detectors, previously calibrated in the GK unit using a spherical dosimetry phantom, were placed on several locations on the head phantom under 3-mm thick pieces of bolus. The projected plan was then delivered to the phantom. Similarly, superficial dose measurements were obtained from EBT2 Gafchromic films. The films were placed on the same measurement sites of the MOSFETS. The EBT2 measurements were analyzed using a dose calibration curve for a 6 MV beam, as EBT2 film dose measurements are independent of beam energy. The measured superficial doses were compared with those predicted by Gamma Plan.
The MOSFET and film dose measurements ranged from 4 to 53 cGy for a plan scaled to deliver 6 Gy to the 50% isodose line (approximately half the clinical dose). The surface dose varied by location and was sufficiently high (100-200 cGy) for accurate measurement with both MOSFET detectors and EBT2 films. The mean difference between absolute values of the MOSFET and Gamma Plan measurements was 8 ± 12 cGy. The EBT2 measurements showed a better agreement with the Gamma Plan doses with a mean difference of 4 ± 6 cGy. Maximum differences from the Gamma Plan measurements of 29 cGy and 14 cGy were observed for the MOSFETS and EBT2 film, respectively.
The data obtained were from a limited data set.
We have demonstrated a viable technique for quantifying superficial tissue doses in Gamma Knife radiosurgery, utilizing MOSFETS and EBT2 Gafchromic films.
Superficial tissue doses may be relevant for dose planning. Clinical research is required.
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