Effects of irradiation on the components of implantable pacemakers.

The purpose of this study was to examine the effects of irradiation on implantable pacemaker components. The pacemaker was divided into three components: lead wire and electrode, battery, and electrical circuit, and each component was irradiated by X-ray and electron beams, respectively. The pacemaker parameters were measured by both telemetry data of the programmer and directly measured data from the output terminal. The following results were obtained. For the lead wire and electrode, there was no effect on the pacemaker function due to irradiation by X-ray and electron beams. In the case of battery irradiation, there was no change in battery voltage or current up to 236Gy X-ray dose. In the electrical circuit, the pacemaker reverted to the regular beating rate (fixed-rate mode) immediately after the start of X-ray irradiation, and it continued in this mode during irradiation. In patients with their own heartbeat rhythm, changing to the fixed-rate mode may cause dangerous conditions such as ventricular fibrillation. When the accumulated irradiation dose is increased, another failure can be seen in the output voltage of the pacemaker. The pacing output voltage dropped rapidly by about 40 % at 30-88Gy. Decreasing the output voltage results in pacing disorders, and heart failure may occur. In the telemetry data of the programmer, no change in output voltage could be detected, highlighting the difference between telemetry data and actual pacing data.

[New method of verification of the position of target points in stereotactic radiosurgery by linear accelerator].

A method for quantitatively checking the position to be used for stereotactic radiosurgery was devised using a digital reconstruction radiogram (DRR) and electric portal images (EPI). On each image, the radiation field and head contour were extracted by binary-coded processing. The center of gravity position vector of the extracted image was calculated, and the vector from the head contour to the radiation field was obtained. By comparing the difference in DRR and EPI, an index was made of positional error. The error in the center of gravity position coordinate in changing 40~80 of 256 image tones in the binary operation was 0.5mm or less. The effect on the center of gravity position vector caused by the image distortion of EPI was within 0.5mm in the 200x200mm(2) region. Statistical processing was carried out on this index value, and a 95% confidence interval was estimated. The index value of the Z component of the lateral image became -1.43+/-0.66, and it shifted to the negative side. Error was evaluated by the verification method devised for the target point position. Results indicate the usefulness of the verification method using center of gravity for the target point position.