A formalism for independent treatment verification has been developed for Gamma Knife radiosurgery in analogy to the second checks being performed routinely in the field of external beam radiotherapy. A verification algorithm is presented, and evaluated based on its agreement with treatment planning calculations for the first 40 Canadian Gamma Knife patients. The algorithm is used to calculate the irradiation time for each shot, and the value of the dose at the maximum dose point in each calculation matrix. Data entry consists of information included on the plan printout, and can be streamlined by using an optional plan import feature. Calculated shot times differed from those generated by the treatment planning software by an average of 0.3%, with a standard deviation of 1.4%. The agreement of dose maxima was comparable with an average of -0.2% and a standard deviation of 1.3%. Consistently accurate comparisons were observed for centrally located lesions treated with a small number of shots. Large discrepancies were almost all associated with dose plans utilizing a large number of collimator plugs, for which the simplifying approximations used by the program are known to break down.
The relative dose rate for the different Gamma Knife helmets (4, 8, 14, and 18 mm) is characterized by their respective helmet factors. Since the plateau of the dose profile for the 4 mm helmet is at most 1 mm wide, detector choices are limited. Traditionally helmet factors have been measured using 1 x 1 x 1 mm3 thermoluminescent dosimeters (TLDs). However, these are time-consuming, cumbersome measurements. This article investigates the use of metal-oxide-semiconductor field effect transistors (MOSFETs) (active area of 0.2 x 0.2 mm2) as a more accurate and convenient dosimeter. Their suitability for these measurements was confirmed by basic characterization measurements. Helmet factors were measured using both MOSFETs and the established TLD approach. A custom MOSFET cassette was designed in analogy to the Elekta TLD cassette (Elekta Instruments AB) for use with the Elekta dosimetry sphere. Although both dosimeters provided values within 3% of the manufacturer's suggestion, MOSFETs provided superior accuracy and precision, in a fraction of the time required for the TLD measurements. Thus, MOSFETs proved to be a reasonable alternative to TLDs for performing helmet factor measurements.
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