ABSTRACT
BACKGROUND: Dose distribution can be obtained from total energy released per unit mass (TERMA) and inhomogeneous energy deposition kernel (EDK) convolution. Since inhomogeneous EDK data is location-dependent, it is calculated by employing the density scaling method rather than Monte Carlo based user code EDKnrc. OBJECTIVE: The present study aimed at investigating EDK scaling formula accuracy in the presence of lung and bone inhomogeneities. MATERIAL AND METHODS: In this theoretical-practical study, six EDKs datasets with lung and bone inhomogeneity in different radii were generated using EDKnrc user code and density scaling formula. Then the scaling method data and corresponding EDKnrc-generated ones were compared to enhance the calculations, and some correction factors for error reduction were also derived to create more consistency between these data. RESULTS: The study has shown that the errors in the theoretical method for calculating inhomogeneous EDKs were significantly reduced based on the attenuation coefficient and ρα rel parameter, with α equal to 1.2 and 0.8 for bone and lung voxels, respectively. CONCLUSION: Although the density scaling method has acceptable accuracy, the error values are significant at the location of lung or bone voxels. By using the mentioned correction factors, the calculation inaccuracy of heterogeneous EDKs can be reduced down to 5%. However, the lung heterogeneity results corrected by the method are not as good as the bone cases.
ABSTRACT
BACKGROUND: Stereotactic radiosurgery (SRS) method has been considered the first-line treatment option to treat patients involved with pre-optic nerve tumors. However, studies have shown that using fractionated SRS, normal tissue sparing and tumor dose can be strongly increased simultaneously. Our main goal was to illustrate the effects of fractionated SRS approach in optic nerve tumor treatment and its adjacent sensitive structures. MATERIALS AND METHODS: 19 patients involved in optic nerve tumor with clinical symptoms of vision loss were treated with Gamma Knife radiosurgery in three sessions with 12 hours intervals between them. The prescribed dose was about 6.0 ± 1.2 Gy. Patient-related parameters including pre-treatment and after-treatment tumor size, visual acuity and visual field were evaluated using the Snell chart and MRI imaging. Patients were followed for about 14 months. RESULT: The overall result showed vision improvement for patients with low and moderate visual loss. However, there was no significant improvement in patients with severe visual loss. Relative improvement was observed in blind patients, although poorly. There was no evidence of growth, recurrence, or new tumor after treatment in patients. CONCLUSION: Fractionated gamma knife radiosurgery offers a safe and effective alternative for benign lesions adjacent to the optic nerve.
ABSTRACT
BACKGROUND AND OBJECTIVE: In small radiation fields used in stereotactic radiosurgery penumbra is an important portion of the field size especially when critical organs at risk are located near the treatment sites. This study was aimed to reduce penumbra width (90%-50% isodose lines) of Gamma Knife (GK) machine by investigating of source to diaphragm distance (SDD) and designing compensating filter. METHODS: Compensating filters at the end of the helmet collimators with the aim of reducing penumbra as well as reducing hot spots appeared near the edge of beam were modeled using Monte Carlo simulation code. Moreover, the SDD parameter was increased as one of the effective factors on penumbra width. RESULTS: Results showed that single beam penumbra width using optimal design of filters was decreased by 59.49%, 42.50%, 39.02% and 34.44% with attenuation of 30.53%, 13.67%, 11.43% and 9.82% for 4, 8, 14 and 18 mm field sizes, respectively. CONCLUSIONS: The designed filters lead to considerable reductions in single beams penumbra width as well as a noticeable reduction in maximum dose emerged near the beam edge due to the curved lateral surface of filters.
