In this paper, we present the dosimetric characteristics of a commercially‐produced universal GRID block for spatially fractioned radiation therapy. The dosimetric properties of the GRID block were evaluated. Ionization chamber and film measurements using both Kodak EDR2 and Gafchromic EBT film were performed in a solid water phantom to determine the relative output of the GRID block as well as its spatial dosimetric characteristics. The surface dose under the block and at the openings was measured using ultra thin TLDs. After introducing the GRID block into the treatment planning system, a treatment plan was created using the GRID block and also by creating a GRID pattern using the multi‐leaf collimator. The percent depth doses measured with film showed that there is a shift of the normaldmax towards shallower depths for both energies (6 MV and 18 MV) under investigation. It was observed that the skin dose at the GRID openings was higher than the corresponding open field by a factor as high as 50% for both photon energies. The profiles showed the transmission under the block was in the order of 15–20% for 6 MV and 30% for 18 MV. The MUs calculated for a real patient using the block were about 80% less than the corresponding MUs for the same plan using the multileaf collimator to define the GRID. Based on this investigation, this brass GRID compensator is a viable alternative to other solid compensators or MLC‐based fields currently in use. Its ease of creation and use give it decided advantages. Its ability to be created once and used for multiple patients (by varying the collimation of the linear accelerator jaws) makes it attractive from a cost perspective. We believe this compensator can be put to clinical use, and will allow more centers to offer GRID therapy to their patients.PACS number: 87.53.Mr
MAPCHECK analysis demonstrates high passing rates with the stringent γ(2%/2 mm) and local normalization criteria combination. The geometry of the ARCCHECK array creates a stress test for the FFF TPS model because of the shallow depth of the entrance diodes and large air cavity. Hence, the ARCCHECK γ-analysis passing rates are lower than with the MAPCHECK, while still on par with TG-119.
A tissue equivalent head phantom was utilized in the stereotactic localization and dose verification of radiosurgery procedures with the Leksell Gamma Knife Unit at the University of Kentucky Medical Center. A radiation dose-dependent color-doped gel target was positioned within the head phantom and stereotactically localized using either angiography, CT, or MR techniques. Utilizing standard Gamma Knife treatment procedures, the head phantom was irradiated, which resulted in a color change of the gel tumor at the position of the treatment isocenter and thereby confirmed the localization procedure. Additionally, a radiation dosimeter (thermoluminescent dosimetry – TLD) was positioned within the head phantom and localized using an angiography frame and a standard radiation therapy simulator. The phantom skull measurements and the dosimeter coordinates were entered into the Leksell Gamma Knife dose planning computer (KULA) and an irradiation time for 40 Gy using the 18-mm collimator was determined. The TLD dose evaluations were relatively determined using a cobalt-60 calibration curve. The experimental dose verification results agreed well (±4%) with computer dose estimates.
Fifteen patients were treated in the Gamma Knife Unit and followed for 18 months or longer. Four patients had Cushing''s disease, 4 had acromegaly, 3 had Nelson''s syndrome and 3 had prolactinomas. One patient had no endocrinopathy. One of the patients with acromegaly and 2 of those with prolactinomas had been operated prior to Gamma Knife treatment. Radiological tumor localization was not an insuperable problem in this series. The effect of Gamma Knife treatment on the anterior pituitary neoplasia, as such, was consistently successful. All the tumors which received 10 Gy or more to the edge showed either a reduction in volume or at least cessation of growth. On the other hand, the effect of the treatment was less consistent in respect to the endocrinopathies. These results are discussed in respect of dose and tumor size. It is suggested that the role of the Gamma Knife in the treatment of pituitary adenomas requires further clarification, based on prospective studies.
Purpose: Multi‐leaf collimator (MLC) based intensity‐modulated radiosurgery (IMRS) often results in large number of monitor units (MU) for patients with multiple brain lesions. Compensator based IMRS, however, may dramatically reduce MU. The purpose of this study is to quantify the reduction of MU for IMRS of multiple brain lesions using solid tissue compensators. Method and Materials: Patients with multiple brain tumors were selected for our study. For each patient, Varian Eclipse TPS was used to generate an MLC based IMRS plan consisting of 10–11 coplanar beams. The prescription dose for a typical IMRS treatment is 1800–2000 cGy delivered in 1 fraction using a 6 MV photon beam. IMRS plans were generated on 2 patients. The optimal fluence maps from IMRS plan were exported to the compensator generating system to generate compensators for each field. The compensator files are imported back to Eclipse to calculate MUs for the compensator fields. Eclipse TPS was modified to allow compensator based planning and evaluation inside Eclipse. Finally, we compared MLC and compensator plans in terms of MUs and target and normal structure coverage. Results: Compensators offer superior resolution compared to MLCs and are easier and faster to plan. DVH analysis from both patients shows adequate target coverage for both IMRS and compensator plans. More sparing of normal tissues in compensator plan was observed sometimes. The MUs were reduced by factors of more than 3 compared to an MLC based IMRS plan. Conclusion: Compensator based IMRS can dramatically reduce the number of MU needed for multiple brain lesion radiosurgery as compared to an MLC based IMRS plan while preserve prescribed dose coverage. Conflict of Interest: This work is partially supported by .decimal Inc.
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