Monte Carlo verification of output correction factors for a TrueBeam STx®.

The recent publication of the new code of practice IAEA/AAPM TRS-483 introduces output correction factors to correct detector response changes in relative dosimetry of small photon beams. In TRS-483, average correction factors are reported for several detectors in high-energy photon beams at 6 and 10 MV with and without flattening filter. These correction factors were determined by Monte Carlo simulation or experimental measurements using several linacs of different brands and vendors. The goal of this work was to validate the output correction factors reported in TRS-483 for 6 MV photon beams of a TrueBeam STx® linac. The validation was performed using Monte Carlo simulations of four radiation detectors employed in the dosimetry of small photon beams and whose output correction factors were determined using a different radiation source than TrueBeam STx®. The results show that Monte Carlo calculated output correction factors, and those reported in the code of practice TRS-483 fully agree within ∼1%. The use of generic correction factors for a TrueBeam STx® and the detectors studied in this work is suitable for small field dosimetry static beams within the uncertainties of Monte Carlo calculations and output correction factors reported in TRS-483.

Diffusion tensor imaging in radiosurgical callosotomy.

Callosotomy by radioneurosurgery induces slow and progressive axonal degeneration of white matter fibers, a key consequence of neuronal or axonal injury (radionecrosis). However, the acute effects are not apparent when using conventional MRI techniques. Diffusion tensor imaging (DTI) during the first week following radioneurosurgical callosotomy allowed evaluation of these microstructural changes. The present report details that the use of sequential DTI to evaluate axonal degeneration following radioneurosurgical callosotomy in a patient normalized with the data of six healthy subjects. We describe a 25-year old woman with symptomatic generalized epilepsy who underwent a radioneurosurgical callosotomy using LINAC (Novalis® BrainLAB). DTI was acquired at the baseline, 3 and 9 months and showed a progressive decrease of the fractional anisotropy values in the irradiated areas compared to the controls that could be interpreted as a progressive disconnection of callosal fibers related to the outcome.

Small photon beam measurements using radiochromic film and Monte Carlo simulations in a water phantom.

This work reports the use of both GafChromic EBT film immersed in a water phantom and Monte Carlo (MC) simulations for small photon beam stereotactic radiosurgery dosimetry. Circularly collimated photon beams with diameters in the 4-20 mm range of a dedicated 6 MV linear accelerator (Novalis, BrainLAB, Germany) were used to perform off-axis ratios, tissue maximum ratios and total scatter factors measurements, and MC simulations. GafChromic EBT film data show an excellent agreement with MC results (<2.7%) for all measured quantities.

A novel stereotactic device for spinal irradiation in rats designed for a linear accelerator.

OBJECTIVE: Our purpose was to report the design and positioning accuracy testing of a stereotactic device designed for a linear accelerator to perform spinal radiosurgery in rats. METHODS: To define the spatial and repositioning accuracy of the device, we measured the 3-dimensional (3D) translation of a paraspinal fiducial mark implanted by microsurgery in 5 Wistar rats during a sequence of setups and treatment simulations, thus obtaining final 3D translation vectors and maximum displacements. RESULTS: For spatial accuracy, the differential coordinate translations were 0.8 +/- 0.3, 0.6 +/- 0.2 and 0.5 +/- 0.1 mm in the x-, y- and z-directions, respectively. The median magnitude of the 3D vector was 1.3 mm (sigma = 0.2 mm), with a maximum error of 2.2 mm. The differential coordinate translation for the repositioning accuracy showed values of 1.4 +/- 0.3, 1.3 +/- 0.3 and 0.8 +/- 0.1 mm for the x-, y- and z-coordinates, resulting in a 3D displacement vector of 2.2 mm (sigma = 0.2 mm) and a maximum displacement error of 3.6 mm. CONCLUSIONS: Using a linear accelerator, our novel stereotactic device provides accurate immobilization and repositioning of paraspinal structures under experimental conditions in rats.