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The Impact of Treatment Dose Rate On Biologically Effective Dose in Gamma Knife Radiosurgery

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R Juh

R Juh1*, J Han1 , C Kim1 , C Oh1 , T Suh2 , (1) Seoul National University Bundang Hospital , Gyeonggi-do, (2) Catholic Univ Medical College, Seoul, SEOUL

Presentations

SU-I-GPD-I-13 (Sunday, July 30, 2017) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose: The median deviation found in clinical assessment of GKRS is compatible with its high rate of efficiency. Diffusion tensor imaging (DTI) parameters accurately detect the effects of focal radiosurgery on the trigeminal neuralgia, serving as an in vivo imaging tool. This study is a proof of principle for further assessment of DTI parameters to understand the pathophysiology of trigeminal neuralgia and treatment effects.

Methods: The median deviation found in clinical assessment of GKRS is compatible with its high rate of efficiency. Diffusion tensor imaging (DTI) parameters accurately detect the effects of focal radiosurgery on the trigeminal neuralgia, serving as an in vivo imaging tool. This study is a proof of principle for further assessment of DTI parameters to understand the pathophysiology of trigeminal neuralgia and treatment effects.

Results: After replacement of the cobalt-60 source, the functional GKRS dose rate rose from 1.54 to 3.7 Gy/min, treatment time fell, and estimated BED increased. Assuming the most biologically plausible parameters, source replacement resulted in an immediate relative BED increase of 11.7% for GKRS-based TN management with 80 Gy. Over the course of the 63-month lifespan of the cobalt-60 source, BED decreased annually by 2.2% for TN management. We estimated the impact of cobalt-60 source replacement on dose rate, treatment time, and BED by assuming a cobalt-60 lifespan of 1 half-life before replacement.

Conclusion: The median deviation found in clinical assessment of GKRS is compatible with its high rate of efficiency. Diffusion tensor imaging (DTI) parameters accurately detect the effects of focal radiosurgery on the trigeminal neuralgia, serving as an in vivo imaging tool. This study is a proof of principle for further assessment of DTI parameters to understand the pathophysiology of trigeminal neuralgia and treatment effects.


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