The clinical application of plugging patterns for the Leksell gamma knife.
OBJECTIVE
In this report the authors explore the use of standardized plugging templates in formulating stereotactic radiosurgery dose plans for the Leksell gamma knife.


METHODS
Unplugged gamma knife dose plans previously used in the treatment of patients with trigeminal neuralgia (TN) and vestibular schwannoma (VS) were studied. Standardized plugging templates were then superimposed on these plans, and their effects on the conformity index of tumors and the transposition of the radiation field from the brainstem to the cerebrospinal fluid spaces for the trigeminal cases were examined.


CONCLUSIONS
The standardized plugging templates significantly increased the conformity indices in cases of VS plans and for TN. Plugging significantly reduced the brainstem exposure to radiation while at the same time not altering the length of the trigeminal nerve being treated. Standardized plugging templates may therefore be a useful tool in optimizing dose plans.
Vaughan
Paul
P
National Centre for Stereotactic Radiosurgery, Royal Hallamshire Hospital, Sheffield, England. paul.vaughan@sth.nhs.uk
Hampshire
Anna
A
Soanes
Tracy
T
Kemeny
Andras
A
Radatz
Matthias
M
Rowe
Jeremy
J
Walton
Lee
L
D006801:Humans; D009464:Neuroma, Acoustic / Q000601:surgery*; D011829:Radiation Dosage; D016634:Radiosurgery / Q000379:methods*; D014277:Trigeminal Neuralgia / Q000601:surgery*