Quality of life of older adults with cancer in Korea

Park²,

Kim³

et al. 2022

Sci Rep

Augmented reality (AR) offers a new medical treatment approach. We aimed to evaluate frameless (mask) fixation navigation using a 3D-printed patient model with fixed-AR technology for gamma knife radiosurgery (GKRS). Fixed-AR navigation was developed using the inside-out method with visual inertial odometry algorithms, and the flexible Quick Response marker was created for object-feature recognition. Virtual 3D-patient models for AR-rendering were created via 3D-scanning utilizing TrueDepth and cone-beam computed tomography (CBCT) to generate a new GammaKnife Icon™ model. A 3D-printed patient model included fiducial markers, and virtual 3D-patient models were used to validate registration accuracy. Registration accuracy between initial frameless fixation and re-fixation navigated fixed-AR was validated through visualization and quantitative method. The quantitative method was validated through set-up errors, fiducial marker coordinates, and high-definition motion management (HDMM) values. A 3D-printed model and virtual models were correctly overlapped under frameless fixation. Virtual models from both 3D-scanning and CBCT were enough to tolerate the navigated frameless re-fixation. Although the CBCT virtual model consistently delivered more accurate results, 3D-scanning was sufficient. Frameless re-fixation accuracy navigated in virtual models had mean set-up errors within 1 mm and 1.5° in all axes. Mean fiducial marker differences from coordinates in virtual models were within 2.5 mm in all axes, and mean 3D errors were within 3 mm. Mean HDMM difference values in virtual models were within 1.5 mm of initial HDMM values. The variability from navigation fixed-AR is enough to consider repositioning frameless fixation without CBCT scanning for treating patients fractionated with large multiple metastases lesions (> 3 cm) who have difficulty enduring long beam-on time. This system could be applied to novel GKRS navigation for frameless fixation with reduced preparation time.

Section: Discussionmentioning

confidence: 98%

Navigation of frameless fixation for gamma knife radiosurgery using fixed augmented reality

Park²,

Kim³

et al. 2022

Sci Rep

“…In radiosurgery, all patients have various lesions including malignant or benign tumors, vascular disease, and functional diseases. In our country, demographic projections for older adults have increased, implying a consequent increase in cancer incidence and mortality in this population 29 . Radiosurgery delivered by highly focusing radiation with sharp dose fall-off is theoretically expected to reduce delayed neurotoxicity 28 .…”

Section: Discussionmentioning

confidence: 98%

Navigation of Frameless Fixation for Gammaknife Radiosurgery Using Fixed Augmented Reality

Park²,

Kim³

et al. 2021

Preprint

Augmented reality (AR) offers a new medical treatment approach. We aimed to evaluate frameless fixation navigation using a 3D-printed patient model with fixed-AR technology for gammaknife radiosurgery. Fixed-AR navigation was developed using the inside-out method with visual inertial odometry algorithms, and the flexible Quick Response (QR) marker was created for object-feature recognition. Virtual 3D-patient models for AR-rendering were created via 3D-scanning utilizing TrueDepth and cone-beam computed tomography (CBCT) to generate a new GammaKnife IconTM model. A 3D-printed patient model included fiducial markers, and virtual 3D-patient models were used to validate registration accuracy. Registration accuracy between initial frameless fixation and re-fixation navigated fixed-AR was validated through visualization. The quantitative method was validated through set-up errors, fiducial marker coordinates, and high-definition motion management (HDMM) values. 3D-printed models and virtual models were correctly overlapped under frameless fixation. Virtual models from both 3D-scanning and CBCT were enough to tolerate the navigated frameless re-fixation. Although the CBCT virtual model consistently delivered more accurate results, 3D-scanning was sufficient. Frameless re-fixation accuracy navigated in virtual models had mean set-up errors within 1 mm and 1.5° in all axes. Mean fiducial marker differences from coordinates in virtual models were within 2.5 mm in all axes, and mean 3D errors were within 3 mm. Mean HDMM difference values in virtual models were within 1.5 mm of initial HDMM values. The variability from navigation fixed-AR is enough to consider repositioning frameless fixation without CBCT scanning for treating patients fractionated with large multiple metastases lesions (>3 cm) who have difficulty enduring long beam-on time. This system could be applied to novel radiosurgery navigation for frameless fixation with reduced preparation time.

“…In the Republic of Korea, there has been an increase in the demographic projections for the older population, resulting in higher cancer incidence and mortality. 21 Accordingly, there is a surge in the number of cases requiring GKRS for brain metastases accompanied by eloquent areas or large lesions. Fractionated GKRS has become an effective treatment outcome owing to the introduction of the LGK Icon TM ; this method results in minimal toxicity for large brain metastases compared to single‐session GKRS.…”

Section: Discussionmentioning

confidence: 99%

“…In the Republic of Korea, there has been an increase in the demographic projections for the older population, resulting in higher cancer incidence and mortality 21 . Accordingly, there is a surge in the number of cases requiring GKRS for brain metastases accompanied by eloquent areas or large lesions.…”

Section: Discussionmentioning

confidence: 99%

Optimal mask fixation method for frameless radiosurgery with Leksell Gamma Knife Icon^TM

J Applied Clin Med Phys

Chung

Min

et al. 2023

The Leksell Gamma Knife (LGK) Icon TM is used for mask‐based and frame‐based fixation. The mask fixation provides a noninvasive method. However, an optimal mask fixation method is yet to be established. We evaluated the characteristics of three mask fixation methods (Plain, Folded, and Wide) for the LGK Icon TM . Force‐sensitive resistor sensors were attached to the forehead, supraorbital, zygoma, mandible, and occipital bone of the phantom, and digital humidity and temperature sensors were attached to both temporal lobes. Cone‐beam computed tomography (CBCT) and high‐definition motion management (HDMM) for each mask fixation method were used to evaluate the phantom motion during the initial application. Subsequently, the mask was removed and reapplied on the second (1st reapplication) and third days (2nd reapplication). In the initial application, forces acting on most portions of the phantom were stabilized within 1.5 h. The largest force acted on the occipital bone for the Plain and Wide methods and on the mandible for the Folded method. The temperature rapidly approaches the initial temperature, whereas the humidity gradually approached the initial humidity in all fixation methods. The Folded method exhibited a significantly lower translation along the Y‐axis of the Leksell coordinate system, and rotations along all axes were under 0.5°. The HDMM values remained at 0.1 mm for all fixation methods. In the reapplications, the force acting on the occipital bone was significantly greater than that during the initial application for all mask fixation methods; the temperature and humidity remained unchanged. All mask fixation methods in the 1st reapplication were not significantly different from those in the 2nd reapplication. The Folded method is recommended as an optimal mask fixation for patients who require tight fixation; the Wide method can be considered if patient comfort is a priority.