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Avoiding a Collision in Gamma Knife Radiosurgery : A Modified Mask Fixation Method.

Hyeong Cheol Moon1, Doheui Lee2, Byung Jun Min3

  • 1Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea.

Journal of Korean Neurosurgical Society
|November 29, 2022
PubMed
Summary

A modified mask fixation method for Leksell Gamma Knife Icon radiosurgery successfully resolved collision issues. This technique improved accuracy and clearance, making it a recommended solution for fractionated treatments.

Keywords:
CollisionGamma knife radiosurgeryHead cushionMeningiomaModified mask fixation method

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Medical Device Engineering

Background:

  • Leksell Gamma Knife Icon allows mask- and frame-based fixation for radiosurgery.
  • Mask fixation offers noninvasive immobilization for fractionated treatment but can experience collisions.
  • Collisions can compromise treatment accuracy and patient safety.

Purpose of the Study:

  • To investigate and address the collision problem associated with mask fixation in Leksell Gamma Knife Icon radiosurgery.
  • To evaluate the efficacy of a modified mask fixation technique in preventing collisions.

Main Methods:

  • A case study involving two frontal meningiomas with an occipital collision was used.
  • A modified mask fixation involved trimming the head cushion, removing polystyrene beads, stapling, and flattening.
  • Key parameters compared included shot coordinates, 3D error, clearance distance, and head cushion depth.

Main Results:

  • The modified fixation resulted in a +10.5 mm difference in y-axis shot coordinates.
  • A significant reduction in 3D error (approximately 18 mm) and clearance distance (-10.2 mm) was observed.
  • The head cushion was positioned approximately 8 mm deeper with the modified method.

Conclusions:

  • The modified mask fixation method effectively resolves collisions during Leksell Gamma Knife Icon radiosurgery.
  • This technique enhances treatment accuracy and safety for fractionated procedures.
  • It is recommended for cases experiencing mask fixation-related collisions.