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Two-year experience with the commercial Gamma Knife Check software
Andy Yuanguang Xu1, Jagdish Bhatnagar, Greg Bednarz
1University of Pittsburgh Cancer Institute. andyxu55@gmail.com.
Journal of Applied Clinical Medical Physics
|July 26, 2016
Summary
The Gamma Knife Check software, an FDA-approved tool for Gamma Knife radiosurgery dose calculations, shows high accuracy and stability for independent dose verification. While generally precise, some peripheral targets and specific gamma angles may result in dose differences exceeding 5%.
Area of Science:
- Medical Physics
- Radiosurgery Technology
- Radiation Oncology
Background:
- Gamma Knife radiosurgery relies on accurate dose calculations for effective treatment.
- Independent verification systems are crucial for ensuring patient safety and treatment efficacy.
- The Gamma Knife Check software is an FDA-approved tool for secondary dose verification in Gamma Knife procedures.
Purpose of the Study:
- To evaluate the accuracy and stability of the Gamma Knife Check software (version 8.4) for independent dose verification.
- To assess the software's performance across different Leksell Gamma Knife units (Perfexion and 4C) and various clinical diagnoses.
- To identify factors influencing dose differences, such as target location, number of shots, and gamma angles.
Main Methods:
- Commissioning of Gamma Knife Check software (v8.4) on Leksell Gamma Knife Perfexion and 4C units.
- Independent dose verification for 319 (Perfexion) and 283 (4C) radiosurgery cases.
- Comparison of Gamma Knife Check doses against GammaPlan (v10) using the tissue maximum ratio (TMR 10) algorithm.
- Analysis of dose differences based on diagnosis, target-to-skull distance, shot count, and gamma angles.
Main Results:
- Averaged percent dose differences were generally low, ranging from 0.3% to 1.49% for Perfexion and 0.33% to 2.78% for 4C across various diagnoses.
- Dose differences tended to be larger for peripheral targets due to differing skull simulation methods.
- Dose differences exceeding 5% were observed for specific targets near the skull surface or in the lower brain, particularly with 70/110 gamma angles.
- The 5% dose difference criterion was not met for 40 out of 1065 treatment targets.
Conclusions:
- The Gamma Knife Check software demonstrates high accuracy and stability for independent dose verification in Gamma Knife radiosurgery.
- While generally reliable, potential discrepancies exist for peripheral targets and specific treatment configurations, necessitating careful review.
- The study highlights the importance of considering target location and treatment parameters when utilizing independent dose verification software.
