Monte Carlo calculated output factors of a Leksell Gamma Knife unit

The Leksell Gamma Knife is a standard radiosurgical tool for treating brain lesions by directing beams of gamma radiation to a specific region. The diameter of the gamma beams is confined by collimator systems and available collimator sizes are 4, 8, 14 and 18 mm. The reduction in dose rate for each collimator helmet is called the output factor (OPF). Experimental determination of OPFs is difficult due to the extremely narrow beams for which the dose is determined. In the present work, the PRESTA version of the EGS4 Monte Carlo code was used to obtain relative OPFs for the Leksell Gamma Knife for collimator sizes of 14, 8 and 4 mm (relative to that of the 18 mm collimator). A spherical probe with a radius of 1 mm was utilized in this computer experiment. Our Monte Carlo results gave OPFs of 0.974, 0.951 and 0.872 for the 14 mm, 8 mm and 4 mm collimators respectively, relative to the 18 mm collimator. Our calculated OPF for the 4 mm collimator helmet was more than 8% higher than the value currently used, but in good agreement with the average of experimental values obtained by various Gamma Knife centres throughout the world and with the value now recommended by the manufacturer, Elekta (Elekta Instrument AB, Skeppargatan 8, S-114 52 Stockholm, Sweden).