Klinge, T; Modat, M; McClelland, JR; Dimitriadis, A; Paddick, I; Hopewell, JW; Walton, L; ... Ourselin, S; + view all Klinge, T; Modat, M; McClelland, JR; Dimitriadis, A; Paddick, I; Hopewell, JW; Walton, L; Rowe, J; Kitchen, N; Ourselin, S; - view fewer (2021) The impact of unscheduled gaps and iso-centre sequencing on the biologically effective dose in Gamma Knife radiosurgery. J Radiosurg SBRT , 7 (3) pp. 213-221.

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Abstract

PURPOSE: Establish the impact of iso-centre sequencing and unscheduled gaps in Gamma Knife® (GK) radiosurgery on the biologically effective dose (BED). METHODS: A BED model was used to study BED values on the prescription iso-surface of patients treated with GK Perfexion™ (Vestibular Schwannoma). The effect of a 15 min gap, simulated at varying points in the treatment delivery, and adjustments to the sequencing of iso-centre delivery, based on average dose-rate, was quantified in terms of the impact on BED. RESULTS: Depending on the position of the gap and the average dose-rate profiles, the mean BED values were decreased by 0.1% to 9.9% of the value in the original plan. A heuristic approach to iso-centre sequencing showed variations in BED of up to 14.2%, relative to the mean BED of the original sequence. CONCLUSIONS: The treatment variables, like the iso-centre sequence and unscheduled gaps, should be considered during GK radiosurgery treatments.

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