• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.13-22
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• 2021

Objective : High precision and accuracy are expected in gamma knife radiosurgery treatment. Because of the requirement of clinically applying complex radiation and dose gradients together with a rapid radiation decline, a dedicated quality assurance program is required to maintain the radiation dosimetry and geometric accuracy and to reduce all associated risk factors. This study investigates the validity of Leksell Gamma plan (LGP)10.1.1 system of 5th generation Gamma Knife Perfexion as modified variable ellipsoid modeling technique (VEMT) method. Methods : To verify LGP10.1.1 system, we compare the treatment plan program system of the Gamma Knife Perfexion, that is, the LGP, with the calculated value of the proposed modified VEMT program. To verify a modified VEMT method, we compare the distributions of the dose of Gamma Knife Perfexion measured by Gafchromic EBT3 and EBT-XD films. For verification, the center of an 80 mm radius solid water phantom is placed in the center of all sectors positioned at 16 mm, 4 mm and 8 mm; that is, the dose distribution is similar to the method used in the x, y, and z directions by the VEMT. The dose distribution in the axial direction is compared and analyzed based on Full-Width-of-Half-Maximum (FWHM) evaluation. Results : The dose profile distribution was evaluated by FWHM, and it showed an average difference of 0.104 mm for the LGP value and 0.130 mm for the EBT-XD film. Conclusion : The modified VEMT yielded consistent results in the two processes. The use of the modified VEMT as a verification tool can enable the system to stably test and operate the Gamma Knife Perfexion treatment planning system.

• Journal of the Korean Physical Society
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• v.73 no.12
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• pp.1814-1820
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• 2018

With the publication of TRS-483 in late 2017 the IAEA has established an international code of practice for reference dosimetry in small and non-standard fields based on a formalism first suggested by Alfonso et al. in 2008. However, data on beam quality correction factors ($k^{f_{msr},f_{ref}}_{Q_{msr},Q_0}$) for the Leksell Gamma $Knife^{(R)}$ $Perfexion^{TM}$ is scarce and what little data is available was obtained under conditions not necessarily in accordance with the IAEA's recommendations. This study constitutes the first systematic attempt to calculate those correction factors by applying the new code of practice to Monte Carlo simulation using the GEANT4 toolkit. $k^{f_{msr},f_{ref}}_{Q_{msr},Q_0}$ values were determined for three common ionization chamber detectors and five different phantom materials, with results indicating that in most phantom materials, all chambers were well suited for reference dosimetry with the Gamma $Knife^{(R)}$. Similarities and differences between the results of this study and previous ones were also analyzed and it was found that the results obtained herein were generally in good agreement with earlier PENELOPE and EGSnrc studies.

• Nuclear Engineering and Technology
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• v.52 no.10
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• pp.2334-2338
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• 2020

In recent years, 3D printing technology has received significant research attention. Additionally, 3D printing technology is being applied to study radiation dosimeters of various materials. In this study, a plastic scintillator for 3D printing was developed in a laboratory and used to manufacture a plastic scintillation dosimeter (PSD) with a shape identical to that of the ionization chamber PTW31010. The 16-mm beam of Gamma Knife® Perfexion™ was irradiated to derive the absorbed dose rates of the PSD and PTW31010; they were subsequently compared with the dose rates of the treatment plan. The differences in the dose rates of the Gamma Knife treatment plan and the absorbed dose rates of PTW31010 were within 0.87%. The difference between the dose rates of the Gamma Knife treatment plan and the absorbed dose rates of the PSD were within 4.1%. A linear fit of the absorbed dose rates of four shots involving different dose rates and irradiation angles yielded an adjusted R-square value exceeding 0.9999. A total of 10 repeated measurements were conducted for the same shot to confirm its reproducibility, with a relative error of 0.56%.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.203-209
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• 2020

The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

• Journal of the Korean Society of Radiology
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• v.11 no.6
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• pp.509-515
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• 2017

The purpose of this study is to measure the 3 dimensional dose distribution of Gamma knife $Perfection^{TM}$, make a comparative analysis of the result and establish the measurement method for the procedures using EBT3 film. The dose distributions of the Gamma knife $Perfection^{TM}$ installed in two hospitals were evaluated in accuracy and precision. For accuracy, the difference between the mechanical center axis and the dose center axis was assessed on a 4 mm collimator. The allowed difference in accuracy is within 0.3 mm and it was measured as 0.098 mm, 0.195 mm for A hospital and 0.229 mm, and 0.223 mm for B hospital. For precision the difference between the FWHM(Full Width at Half Maximum) of Gamma Plan and measurement in the 4, 8, and 16 mm collimators was calculated. The allowed difference in precision is less than ${\pm}1mm$. The value of the hospital A was -0.283 ~ 0.583 mm, and the hospital B was -0.857 ~ 0.810 mm. When analyzing the dose distributions using the image-j program, it is necessary to establish a clearer reference point of the measurement point, and it is considered that the comparison of the dose distribution should be performed in actual treatment irradiation dose with a high dose usable film.

• Nuclear Engineering and Technology
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• v.55 no.8
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• pp.2935-2940
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• 2023

A polystyrene phantom was developed following the guidance of the International Atomic Energy Association (IAEA) for gamma knife (GK) quality assurance. Its performance was assessed by measuring the absorbed dose rate to water and dose distributions. The phantom was made of polystyrene, which has an electron density (1.0156) similar to that of water. The phantom included one outer phantom and four inner phantoms. Two inner phantoms held PTW T31010 and Exradin A16 ion chambers. One inner phantom held a film in the XY plane of the Leksell coordinate system, and another inner phantom held a film in the YZ or ZX planes. The absorbed dose rate to water and beam profiles of the machine-specific reference (msr) field, namely, the 16 mm collimator field of a GK Perfexion^TM or Icon^TM, were measured at seven GK sites. The measured results were compared to those of an IAEA-recommended solid water (SW) phantom. The radius of the polystyrene phantom was determined to be 7.88 cm by converting the electron density of the plastic, considering a water depth of 8 g/cm². The absorbed dose rates to water measured in both phantoms differed from the treatment planning program by less than 1.1%. Before msr correction, the PTW T31010 dose rates (PTW Freiberg GmbH, New York, NY, USA) in the polystyrene phantom were 0.70 (0.29)% higher on average than those in the SW phantom. The Exradin A16 (Standard Imaging, Middleton, WI, USA) dose rates were 0.76 (0.32)% higher in the polystyrene phantom. After msr correction factors were applied, there were no statistically significant differences in the A16 dose rates measured in the two phantoms; however, the T31010 dose rates were 0.72 (0.29)% higher in the polystyrene phantom. When the full widths at half maximum and penumbras of the msr field were compared, no significant differences between the two phantoms were observed, except for the penumbra in the Y-axis. However, the difference in the penumbra was smaller than variations among different sites. A polystyrene phantom developed for gamma knife dosimetry showed dosimetric performance comparable to that of a commercial SW phantom. In addition to its cost effectiveness, the polystyrene phantom removes air space around the detector. Additional simulations of the msr correction factors of the polystyrene phantom should be performed.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.9-17
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• 2017

A high degree of precision and accuracy in Gamma Knife Radiosurgery(GKRS) is a fundamental requirement for therapeutical success. Elaborate radiation delivery and dose gradients with the steep fall-off of radiation are clinically applied thus necessitating a dedicated Quality Assurance(QA) program in order to guarantee dosimetric and geometric accuracy and reduce all the risk factors that can occur in GKRS. In this study, as a part of QA we verified the accuracy of single-shot dose profiles used in the algorithm of Gamma Knife Perfexion(PFX) treatment planning system employing Variable Ellipsoid Modeling Technique(VEMT). We evaluated the dose distributions of single-shots in a spherical ABC phantom with diameter 160 mm on Gamma Knife PFX. The single-shots were directed to the center of ABC phantom. Collimating configurations of 4, 8, and 16 mm sizes along x, y, and z axes were studied. Gamma Knife PFX treatment planning system being used in GKRS is called Leksell GammaPlan(LGP) ver 10.1.1. From the verification like this, the accuracy of GKRS will be doubled. Then the clinical application must be finally performed based on precision and accuracy of GKRS. Specifically the width at the 50% isodose level, that is, Full-Width-of-Half-Maximum(FWHM) was verified under such conditions that a patient's head is simulated as a sphere with diameter 160mm. All the data about dose profiles along x, y, and z axes predicted through VEMT were excellently consistent with dose profiles from LGP within specifications(${\leq}1mm$ at 50% isodose level) except for a little difference of FWHM and PENUMBRA(isodose level: 20%~80%) along z axis for 4 mm and 8mm collimating configurations. The maximum discrepancy of FWHM was less than 2.3% at all collimating configurations. The maximum discrepancy of PENUMBRA was given for the 8 mm collimator along z axis. The difference of FWHM and PENUMBRA in the dose distributions obtained with VEMT and LGP is too small to give the clinical significance in GKRS. The results of this study are considered as a reference for medical physicists involved in GKRS in the whole world. Therefore we can work to confirm the validity of dose distributions for all collimating configurations determined through the regular preventative maintenance program using the independent verification method VEMT for the results of LGP and clinically assure the perfect treatment for patients of GKRS. Thus the use of VEMT is expected that it will be a part of QA that can verify and operate the system safely.