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http://dx.doi.org/10.3340/jkns.2013.53.2.102

Clinical Application of Gamma Knife Dose Verification Method in Multiple Brain Tumors : Modified Variable Ellipsoid Modeling Technique  

Hur, Beong Ik (Department of Neurosurgery, School of Medicine, Pusan National University)
Lee, Jae Min (Department of Neurosurgery, School of Medicine, Pusan National University)
Cho, Won Ho (Department of Neurosurgery, School of Medicine, Pusan National University)
Kang, Dong Wan (Department of Neurosurgery, School of Medicine, Pusan National University)
Kim, Choong Rak (Department of Statistics, Pusan National University)
Choi, Byung Kwan (Department of Neurosurgery, School of Medicine, Pusan National University)
Publication Information
Journal of Korean Neurosurgical Society / v.53, no.2, 2013 , pp. 102-107 More about this Journal
Abstract
Objective : The Leksell Gamma Knife$^{(R)}$ (LGK) is based on a single-fraction high dose treatment strategy. Therefore, independent verification of the Leksell GammaPlan$^{(R)}$ (LGP) is important for ensuring patient safety and minimizing the risk of treatment errors. Although several verification techniques have been previously developed and reported, no method has ever been tested statistically on multiple LGK target treatments. The purpose of this study was to perform and to evaluate the accuracy of a verification method (modified variable ellipsoid modeling technique, MVEMT) for multiple target treatments. Methods : A total of 500 locations in 10 consecutive patients with multiple brain tumor targets were included in this study. We compared the data from an LGP planning system and MVEMT in terms of dose at random points, maximal dose points, and target volumes. All data was analyzed by t-test and the Bland-Altman plot, which are statistical methods used to compare two different measurement techniques. Results : No statistical difference in dose at the 500 random points was observed between LGP and MVEMT. Differences in maximal dose ranged from -2.4% to 6.1%. An average distance of 1.6 mm between the maximal dose points was observed when comparing the two methods. Conclusion : Statistical analyses demonstrated that MVEMT was in excellent agreement with LGP when planning for radiosurgery involving multiple target treatments. MVEMT is a useful, independent tool for planning multiple target treatment that provides statistically identical data to that produced by LGP. Findings from the present study indicate that MVEMT can be used as a reference dose verification system for multiple tumors.
Keywords
Brain tumor; Gamma Knife; Radiation dose; Radiosurgery;
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1 Arai Y, Kano H, Lunsford LD, Novotny J Jr, Niranjan A, Flickinger JC, et al. : Does the Gamma Knife dose rate affect outcomes in radiosurgery for trigeminal neuralgia? J Neurosurg 113 Suppl : 168-171, 2010
2 Aubuchon AC, Chan MD, Lovato JF, Balamucki CJ, Ellis TL, Tatter SB, et al. : Repeat gamma knife radiosurgery for trigeminal neuralgia. Int J Radiat Oncol Biol Phys 81 : 1059-1065, 2011   DOI
3 Bland JM, Altman DG : Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1 : 307-310, 1986
4 Brisman R : Gamma knife radiosurgery for primary management for trigeminal neuralgia. J Neurosurg 93 Suppl 3 : 159-161, 2000
5 Brisman R : Gamma knife surgery with a dose of 75 to 76.8 Gray for trigeminal neuralgia. J Neurosurg 100 : 848-854, 2004   DOI
6 Brisman R : Repeat gamma knife radiosurgery for trigeminal neuralgia. Stereotact Funct Neurosurg 81 : 43-49, 2003   DOI
7 Critchley LA, Critchley JA : A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput 15 : 85-91, 1999   DOI
8 Hanneman SK : Design, analysis, and interpretation of method-comparison studies. AACN Adv Crit Care 19 : 223-234, 2008   DOI
9 Hur BI, Choi BK, Sung SK, Cho WH, Cha SH, Choi CH : The variable ellipsoid modeling technique as a verification method for the treatment planning system of gamma knife radiosurgery. J Korean Neurosurg Soc 47 : 128-133, 2010   DOI
10 Ma L, Chin L, Sarfaraz M, Shepard D, Yu C : An investigation of eye lens dose for gamma knife treatments of trigeminal neuralgia. J Appl Clin Med Phys 1 : 116-119, 2000   DOI
11 Marcu SM, Wu QJ, Pillai K, Weinhous MS : GammaPlan-Leksell Gamma Knife radiosurgery treatment planning verification method. Med Phys 27 : 2146-2149, 2000   DOI
12 Shih YH, Pan DH : Management of supratentorial cavernous malformations : craniotomy versus gammaknife radiosurgery. Clin Neurol Neurosurg 107 : 108-112, 2005   DOI
13 Tsai JS, Engler MJ, Rivard MJ, Mahajan A, Borden JA, Zheng Z : A formalism for independent checking of Gamma Knife dose calculations. Med Phys 28 : 1842-1849, 2001   DOI
14 Zhang P, Dean D, Wu QJ, Sibata C. Fast verification of Gamma Knifetrade mark treatment plans. J Appl Clin Med Phys 1 : 158-164, 2000   DOI