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case1170292131.pdf (1.69 MB)
ETD Abstract Container
Abstract Header
A New Gamma Knife Radiosurgery Paradigm: Tomosurgery
Author Info
Hu, Xiaoliang
Permalink:
http://rave.ohiolink.edu/etdc/view?acc_num=case1170292131
Abstract Details
Year and Degree
2007, Doctor of Philosophy, Case Western Reserve University, Biomedical Engineering.
Abstract
The Leksell (Elekta, Stockholm, Sweden) Gamma Knife™ (LGK) is the worldwide standard-of-care for the radiosurgical treatment of a wide variety of intracranial lesions. The current LGK utilizes a step-and-shoot dose delivery mechanism where the centroid of each conformal radiation dose (i.e., the shot isocenter) requires repositioning the patient outside of the irradiation field. Perhaps the greatest challenge the LGK treatment team faces is planning the treatment of large and/or complexly shaped lesions that may be in close proximity to critical neural or vascular structures. The standard manual treatment planning approach is a time consuming procedure where additional time spent does not guarantee the identification of an increasingly optimal treatment plan. I propose a new radiosurgery paradigm which I refer to as “Tomosurgery”. The Tomosurgery paradigm begins with the division of the target volume into a series of adjacent treatment slices, each with a carefully determined optimal thickness. The use of a continuously moving disk-shaped radiation shot that moves through the lesion in a raster-scanning pattern is expected to improve overall radiation dose conformality and homogeneity. The Tomosurgery treatment planning algorithm recruits a two-stage optimization strategy, which first plans each treatment slice as a simplified 2D problem and secondly optimally assembles the 2D treatment plans into the final 3D treatment plan. Tested on 11 clinical LGK cases, the automated inversely-generated Tomosurgery treatment plans performed as well or better than the neurosurgeon’s manually created treatment plans across all criteria: (a) dose volume histograms, (b) dose homogeneity, (c) dose conformality, and (d) critical structure damage, where applicable. LGK Tomosurgery inverse treatment planning required much less time than standard of care, manual (i.e., forward) LGK treatment planning procedures. These results suggest that Tomosurgery might provide an improvement over the current LGK radiosurgery treatment planning software. As regards treatment delivery, a Tomosurgery Investigational Platform (TIP) is proposed to perform the physical validation of radiation dose delivery. The TIP should facilitate translation of the Tomosurgery paradigm to several other radiosurgery and/or radiotherapy devices without the need for expensive modification of commercial devices until the feasibility of delivering Tomosurgical treatment plans has been well established.
Committee
David Dean (Advisor)
Pages
164 p.
Keywords
Radiosurgery
;
Brain Tumor
;
Cancer
;
Inverse Treatment Planning
;
Optimization
;
Dynamic Delivery
;
Step-and-shoot
;
IMRT
;
Dose Conformality
;
Dose Homogeneity
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Refworks
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Citations
Hu, X. (2007).
A New Gamma Knife Radiosurgery Paradigm: Tomosurgery
[Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1170292131
APA Style (7th edition)
Hu, Xiaoliang.
A New Gamma Knife Radiosurgery Paradigm: Tomosurgery.
2007. Case Western Reserve University, Doctoral dissertation.
OhioLINK Electronic Theses and Dissertations Center
, http://rave.ohiolink.edu/etdc/view?acc_num=case1170292131.
MLA Style (8th edition)
Hu, Xiaoliang. "A New Gamma Knife Radiosurgery Paradigm: Tomosurgery." Doctoral dissertation, Case Western Reserve University, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=case1170292131
Chicago Manual of Style (17th edition)
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Document number:
case1170292131
Download Count:
1,830
Copyright Info
© 2006, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.