• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.243-248
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• 2023

This study aims to analyze the secondary carcinogenesis rate caused by exposure of organs at risk of damage using a glass dosimeter during radiosurgery in vestibular schwannoma disease. Using a pediatric phantom of human tissue equivalent material, the volume of the tumor was set to a total of three volumes: 0.506 cm³, 1.008 cm³, and 2.032 cm³, and a radiosurgery plan was established with an average dose of 18.4 ± 3.4 Gy. After mounting the human body phantom on the table of surgical equipment, glass dosimeters were placed on the right eye, left eye, thyroid gland, thymus, right lung, and left lung to measure the exposure dose, respectively. In this study, the incidence of secondary cancer due to exposure to damaged organs during gamma knife radiosurgery in vestibular schwannoma disease with the largest tumor volume of 2.032 cm³ was measured with a glass dosimeter. This study studies the risk of secondary radiation exposure dose that can occur during stereotactic radiosurgery, and it is considered that it will be used as basic data in the field of radiation damage related to the stochastic effect of radiation in the future.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.843-849
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• 2022

In this study, the probability of secondary carcinogenesis was analyzed by measuring the exposure dose of surrounding normal organs during radiosurgery using a gamma knife. A pediatric phantom (Model 706-G, CIRS, USA) composed of human tissue-equivalent material was set to four tumor volumes of 0.25 cm³, 0.51 cm³, 1.01 cm³, and 2.03 cm³, and the average dose was 18.4 ± 3.4 Gy. After installing the Rando phantom on the table of the gamma knife surgical equipment, the OSLD nanoDot dosimeters were placed in the right eye, left eye, thyroid, thymus gland, right lung, and left lung to measure each exposure dose. The probability of cancer occurrence due to radiation exposure of surrounding normal organs during gamma knife radiosurgery for acoustic schwannoma disease was 4.08 cancers per 100,000 at a tumor volume of 2.03 cm³. This study is expected to be used as useful data in relation to stochastic effects in the future by studying the risk of secondary radiation exposure that can occur during stereotactic radiosurgery.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.101-105
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• 1992

Authors performed a stereotactic radiosurgery with multiple noncoplanar convergent photon beams of linear accelerator (NELAC-1018 18 MeV, NEC) using a specially designed Yeungnam localization device for two patients with recurrent glioblastoma multiforme. One patient had 2 cm sized and the other 4 cm sized mass on the CT images. After single session of treatment with 15 and 20 Gy, headache was improved in a few days after radiosurgery with no remarkable untoward reactions. Our experience with these two patients were encouraging and we found that our localization device, which is easily adjustable and inexpensive, could be a valuable tool for stereotactic radiosurgery particularly in the treatment of recurrent brain tumor.

• Progress in Medical Physics
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• v.9 no.3
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• pp.175-184
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• 1998

The dose distribution evaluation program for the stereotactic radiosurgery treatment planning system using a gamma knife has been built in order to work on PC. And this custom-made dose distribution is compared with that of commercial treatment planning program. 201 source position of a radiation unit were determined manually using a gamma knife collimator draft and geometrical coordinates. Dose evaluation algorithm was modified for our purpose from the original KULA, a commercial treatment planning program. With the composed program, dose distribution at the center of a spherical phantom, 80 mm in diameter, was evaluated into axial, coronal and sagittal image per each collimator. Along with this evaluated data, the dose distribution at a arbitrary point of inside the phantom was compared with those from KULA. Radiochromic film was set up at the center of the phantom and was irradiated by gamma knife, for the verification of dose distribution. In result, the deviation of the dose distribution from that of KULA is less than ${\pm}$3%, which is equivalent to ${\pm}$0.3 mm in 50% isodose distribution for all examined coordinates and film verification. The custom-made program, GPl is proven to be a good tool for the stereotactic radiosurgery treatment planning program.

• Progress in Medical Physics
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• v.3 no.1
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• pp.53-62
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• 1992

Stereotactic implantation of intracranial lesions, and the development of stereotactic convergent irradiation, radiosurgery, techniques have to obtain the accurate coordinates of the tumor locations and that of critical organ. Computed tomography(CT) provides relatively precise imformations of tumor localization and surround the normal organs for conventional radiotherapy. This CT image use to extend for stereotactic radiosurgery procedures. Since the convergent irradiation technique in linear accelerator requires the target center coincident with gantry isocenter or radosurgery frame, the target coordinates must be described in accurately. We used the BRW stereotactic system for describing the target position in CT images This algorithm provides the coordinate conversions for orthogonal or non-orthogonal CT scan image. In this experiments, the target positions have shown the small discripancy within :to.3mm uncertanty in several known target positions in the phantom through the provided programs and it compared to that of BRW stereotactic systems.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.517-529
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• 1998

Purpose : Although many studies have investigated the dosimetric aspects of stereotactic radiosurgery in terms of target volume, the absorbed doses at extracranial sites: especially the lens or thyroid - which are sensitive to radiation for deterministic or stochastic effect -have infrequently been reported. The aim of this study is to evaluate what effects the parameters of radiosurgery have on the absorbed doses of the lens and thyroid in patients treated by stereotactic radiosurgery, using a systematic plan in a humanoid phantom. Materials and Methods : Six isocenters were selected and radiosurgery was planned using the stereotactic radiosurgery system which the Department of Therapeutic Radiology at Seoul National University College of Medicine developed. The experimental radiosurgery plan consisted of 6 arc planes per one isocenter, 100 degrees for each arc range and an accessory collimator diameter size of 2 cm. After 250 cGy of irradiation from each arc, the doses absorbed at the lens and thyroid were measured by thermoluminescence dosimetry. Results : The lens dose was 0.23$\pm$0.08$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the lens and was 0.76$\pm$0.12$\%$ of the maximum dose for each isocenter when the exit beam passed through the lens. The thyroid dose was 0.18$\pm$0.05$\%$ of the maximum dose for each isocenter when the exit beam did not pass through the thyroid and was 0.41$\pm$0.04$\%$ of the maximum dose for each isocenter when the exit beam Passed through the thyroid. The passing of the exit beam is the most significant factor of organ dose and the absorbed dose by an arc crossing organ decides 80$\%$ of the total dose. The absorbed doses of the lens and thyroid were larger as the isocenter sites and arc planes were closer to each organ. There were no differences in the doses at the surface and 5 mm depth from the surface in the eyelid and thyroid areas. Conclusion : As the isocenter and arc plane were placed closer to the lens and thyroid, the doses increased. Whether the exit beams passed through the lens or thyroid greatly influenced the lens and thyroid dose. The surface dose of the lens and thyroid consistently represent the tissue dose. Even when the exit beam passes through the lens and thyroid, the doses are less than 1$\%$ of the maximum dose and therefore, are too low to evoke late complications, but nevertheless, we should try to minimize the thyroid dose in children, whenever possible.

• Progress in Medical Physics
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• v.23 no.3
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• pp.169-176
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• 2012

Frameless method in brain radiosurgery has advantages relative to rigid head-frame method in terms of patient friendly and flexible application of multi-fractionation. However, it has also disadvantages and the most negative point is that it cannot control the patient motion during treatment as lowly as the level of the frame-based radiosurgery, which could affect to the treatment accuracy. In the present study, we analyzed the geometric uncertainty of the intra-fraction motion using the actual treatment records of 294-CyberKnife treatments for brain tumors. Based on the analysis, we statistically presented the magnitude of intra-fraction motion in frameless radiosurgy. The result could provide the quantitative information to determine the adequate treatment margins to compensate the intra-fraction movements.

• Progress in Medical Physics
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• v.18 no.1
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• pp.1-6
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• 2007

A system to non-invasively fix and monitor eye by a head mounted display (HMD) with a CCD camera for stereotactic radiotherapy (SRS) of uveal melanoma has been developed and implemented clinically. The eye fixing and monitoring system consists of a HMD showing patient a screen for fixing eyeball, a CCD camera monitoring patient's eyeball, and an immobilization mask. At flrst, patient's head was immobilized with a mask. Then, patient was Instructed to wear HMD, to which CCD camera was attached, on the mask and see the given reference point on its screen. While patient stared at the given point in order to fix eyeball, the camera monitored Its motion. Four volunteers and one patient of uveal melanoma for SRS came into this study. For the volunteers, setup errors and the motion of eyeball were analyzed. For the patient, CT scans were peformed, with patient's wearing HMD and fixing the eye to the given point. To treat patient under the same condition, daily CT scans were also peformed before every treatment and the motion of lens was compared to the planning CT Setup errors for four volunteers were within 1mm and the motion of eyeball was fixed within the clinically acceptable ranges. For the patient with uveal melanoma, the motion of lens was fixed within 2mm from daily CT scans. An eye fixing and monitoring system allowed Immobilizing patient as well as monitoring eyeball and was successfully implemented in the treatment of uveal melanoma for SRS.

• Journal of Radiation Protection and Research
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• v.33 no.2
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• pp.47-51
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• 2008

Objective: This study analyzed errors due to rotation or tilt of the magnetic resonance (MR) imaging indicator during image acquisition for a stereotactic radiosurgery. The error correction procedure of a commercially available stereotactic neurosurgery treatment planning program has been verified. Materials and Methods: Software virtual phantoms were built with stereotactic images generated by a commercial programming language, Interactive Data Language (version 5.5). The thickness of an image slice was 0.5 mm, pixel size was $0.5{\times}0.5mm$, field of view was 256 mm, and image resolution was $512{\times}512$. The images were generated under the DICOM 3.0 standard in order to be used with Leksell GammaPlan$^{(R)}$. For the verification of the rotation error correction function of Leksell GammaPlan$^{(R)}$, 45 measurement points were arranged in five axial planes. On each axial plane, there were nine measurement points along a square of length 100 mm. The center of the square was located on the z-axis and a measurement point was on the z-axis, too. Five axial planes were placed at z=-50.0, -30.0, 0.0, 30.0, 50.0 mm, respectively. The virtual phantom was rotated by $3^{\circ}$ around one of x, y, and z-axis. It was also rotated by $3^{\circ}$ around two axes of x, y, and z-axis, and rotated by $3^{\circ}$ along all three axes. The errors in the position of rotated measurement points were measured with Leksell GammaPlan$^{(R)}$ and the correction function was verified. Results: The image registration errors of the virtual phantom images was $0.1{\pm}0.1mm$ and it was within the requirement of stereotactic images. The maximum theoretical errors in position of measurement points were 2.6 mm for a rotation around one axis, 3.7 mm for a rotation around two axes, and 4.5 mm for a rotation around three axes. The measured errors in position was $0.1{\pm}0.1mm$ for a rotation around single axis, $0.2{\pm}0.2mm$ for double and triple axes. These small errors verified that the rotation error correction function of Leksell GammaPlan$^{(R)}$ is working fine. Conclusion: A virtual phantom was built to verify software functions of stereotactic neurosurgery treatment planning program. The error correction function of a commercial treatment planning program worked within nominal error range. The virtual phantom of this study can be applied in many other fields to verify various functions of treatment planning programs.

• Journal of the Korean Society of Radiology
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• v.8 no.7
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• pp.389-395
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• 2014

The research was carried out to develop a animal model of malignant brain tumor for the researches in glioblastoma multiform (GBM) diagnosis and therapy. C6 cells were transplanted into the right striatum of SD rat using stereotactic instrument for the development. The developed animal model was verified by MRI and H&E stain assay of anatomicohistological examination. The MRI observations showed that the tumor developed at the injection site at the 7 days after glioblastoma inoculation. At 14 days post inoculation, the tumor grew to a large volume occupying almost a half of the right cerebral hemisphere. It was confirmed that the expression of excessive mitosis and pleomorphism in anatomicohistological examination. The developed animal model must be necessary and useful tool for the in vivo level research in the development of the new modality for the diagnosis and therapy of brain cancer.