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https://www.readbyqxmd.com/read/28089836/delayed-csf-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#1
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate to the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy, is exceedingly rare. METHODS: Retrospective chart review and review of the literature RESULTS: We present two cases of delayed CSF leak following GKRS to treat pituitary adenoma...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28081463/analysis-of-the-results-of-recurrent-intracranial-meningiomas-treated-with-re-radiosurgery
#2
Moinay Kim, Do Hee Lee, Hyun Jung Kim Rn, Young Hyun Cho, Jeong Hoon Kim, Do Hoon Kwon
OBJECTS: Meningioma is the most common intracranial neoplasm, comprising approximately 30% of all primary intracranial tumors (Claus et al., 2005) [1]. Treatment options include observation, microsurgical resection, stereotactic radiosurgery (SRS), and whole brain radiation therapy (WBRT). Gamma knife radiosurgery (GKRS) is a very effective treatment for intracranial meningiomas; previous studies showed the tumor control rate at 5-10 years of follow-up as 84.3%-100% in all cases (Feigl et al...
December 29, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28078405/-radiosurgery-and-fractionated-stereotactic-radiotherapy-of-vestibular-schwannoma
#3
K Hamm, H-U Herold, G Surber, S Rosahl
Management of vestibular schwannoma (VS) should always be interdisciplinary and results better than the natural course. Particularly in small VS, either microsurgical resection or radiosurgery (RS) can be employed. RS is a special method (initially only possible stereotactically) for delivering high-precision radiation from many directions to the target point (the isocenter) in a single high dose. With the development of three different systems-Gamma Knife (Elekta, Stockholm, Sweden), special linear accelerators, and CyberKnife (Accuray, Sunnyvale, CA, USA)-the options were extended to 1-5 fractions for RS and multisession RS (msRS), and to up to 6 weeks of conventional fractionation as stereotactic radiotherapy (SRT)...
January 11, 2017: HNO
https://www.readbyqxmd.com/read/28074321/predictive-factors-of-early-distant-brain-failure-after-gamma-knife-radiosurgery-alone-in-patients-with-brain-metastases-of-non-small-cell-lung-cancer
#4
Young Cheol Na, Hyun Ho Jung, Hye Ryun Kim, Byoung Chul Cho, Jin Woo Chang, Yong Gou Park, Won Seok Chang
The objective of this study was to elucidate the predictive factors for early distant brain failure in patients with brain metastases of non-small-cell lung cancer (NSCLC) who were treated with gamma knife radiosurgery (GKRS) without previous whole-brain radiotherapy (WBRT) or surgery. We retrospectively reviewed clinical and imaging data of 459 patients with brain metastases of NSCLC who underwent GKRS from June 2008 to December 2013. The primary end-point was early distant brain failure, defined as the detection of newly developed metastatic lesions on magnetic resonance imaging (MRI) 3 months after GKRS...
January 10, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28061499/primary-intracranial-malignant-melanoma-with-extracranial-metastasis
#5
Kengo Hirota, Chika Yoshimura, Osami Kubo, Hidetoshi Kasuya
We report a case of primary intracranial malignant melanoma (PIMM) with extracranial metastases. The patient was an 82-year-old woman diagnosed with PIMM under the left cerebellar tentorium. We performed a tumor resection followed by gamma knife surgery. An magnetic resonance imaging at 11 months after surgery showed a local intracranial recurrence. At 12 months, vertebral metastasis was suspected, and 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) showed multiple extracranial metastases...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28061489/the-influence-of-biomarker-mutations-and-systemic-treatment-on-cerebral-metastases-from-nsclc-treated-with-radiosurgery
#6
Min Ho Lee, Doo-Sik Kong, Ho Jun Seol, Do-Hyun Nam, Jung-Il Lee
OBJECTIVE: The purpose of this study was to analyze outcomes and identify prognostic factors in patients with cerebral metastases from non-small cell lung cancer (NSCLC) treated with gamma knife radiosurgery (GKS) particularly, focusing on associations of biomarkers and systemic treatments. METHODS: We retrospectively reviewed the medical records of 134 patients who underwent GKS for brain metastases due to NSCLC between January 2002 and December 2012. Representative biomarkers including epidermal growth factor receptor (EGFR) mutation, K-ras mutation, and anaplastic lymphoma kinase (ALK) mutation status were investigated...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28058942/chronic-paroxysmal-headache-secondary-to-an-orbital-metastatic-leiomyosarcoma-a-case-report
#7
Hyun Ah Choi, Mi Ji Lee, Chin-Sang Chung
Background Intraorbital lesions associated with symptomatic trigeminal autonomic cephalalgias (TACs) are rarely reported. We present a case of orbital metastatic leiomyosarcoma, presenting with chronic paroxysmal hemicrania-like headache. Case report A 43-year-old man presented with a severe paroxysmal headache in his left periocular and frontal area for a year. The attacks occurred 10-12 times per day, lasting 10-15 minutes with ipsilateral lacrimation and conjunctival injection. Neurological examination and brain MRI without contrast were unremarkable...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28056412/toxicity-of-concurrent-stereotactic-radiotherapy-and-targeted-therapy-or-immunotherapy-a-systematic-review
#8
REVIEW
Stephanie G C Kroeze, Corinna Fritz, Morten Hoyer, Simon S Lo, Umberto Ricardi, Arjun Sahgal, Rolf Stahel, Roger Stupp, Matthias Guckenberger
BACKGROUND AND PURPOSE: Both stereotactic radiotherapy (SRT) and immune- or targeted therapy play an increasingly important role in personalized treatment of metastatic disease. Concurrent application of both therapies is rapidly expanding in daily clinical practice. In this systematic review we summarize severe toxicity observed after concurrent treatment. MATERIAL AND METHODS: PubMed and EMBASE databases were searched for English literature published up to April 2016 using keywords "radiosurgery", "local ablative therapy", "gamma knife" and "stereotactic", combined with "bevacizumab", "cetuximab", "crizotinib", "erlotinib", "gefitinib", "ipilimumab", "lapatinib", "sorafenib", "sunitinib", "trastuzumab", "vemurafenib", "PLX4032", "panitumumab", "nivolumab", "pembrolizumab", "alectinib", "ceritinib", "dabrafenib", "trametinib", "BRAF", "TKI", "MEK", "PD1", "EGFR", "CTLA-4" or "ALK"...
December 19, 2016: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28048840/su-f-j-208-prompt-gamma-imaging-based-prediction-of-bragg-peak-position-for-realistic-treatment-error-scenarios
#9
Y Xing, B Macq, G Janssens, L Bondar
PURPOSE: To quantify the accuracy in predicting the Bragg peak position using simulated in-room measurements of prompt gamma (PG) emissions for realistic treatment error scenarios that combine several sources of errors. METHODS: Prompt gamma measurements by a knife-edge slit camera were simulated using an experimentally validated analytical simulation tool. Simulations were performed, for 143 treatment error scenarios, on an anthropomorphic phantom and a pencil beam scanning plan for nasal cavity...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048565/th-ab-201-09
#10
L Mirzakhanian, H Benmakhlouf, J Seuntjens
PURPOSE: To determine the k_(Q_msr,Q)^(f_msr,f_ref) factor, introduced in the small field formalism for five common type chambers used in the calibration of Leksell Gamma-Knife Perfexion model over a range of different phantom electron densities. METHODS: Five chamber types including Exradin-A16, A14SL, A14, A1SL and IBA-CC04 are modeled in EGSnrc and PENELOPE Monte Carlo codes using the blueprints provided by the manufacturers. The chambers are placed in a previously proposed water-filled phantom and four 16-cm diameter spherical phantoms made of liquid water, Solid Water, ABS and polystyrene...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048533/su-c-201-06-small-field-correction-factors-for-the-microdiamond-detector-in-the-gamma-knife-model-c-derived-using-monte-carlo-methods
#11
J C Barrett, C Knill
PURPOSE: To determine small field correction factors for PTW's microDiamond detector in Elekta's Gamma Knife Model-C unit. These factors allow the microDiamond to be used in QA measurements of output factors in the Gamma Knife Model-C; additionally, the results also contribute to the discussion on the water equivalence of the relatively-new microDiamond detector and its overall effectiveness in small field applications. METHODS: The small field correction factors were calculated as k correction factors according to the Alfonso formalism...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048509/th-a-brc-03-aapm-tg218-measurement-methods-and-tolerance-levels-for-patient-specific-imrt-verification-qa
#12
M Miften
: AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. LEARNING OBJECTIVES: 1. Understand the progression of technology since the first TG publication 2...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048479/we-ab-207b-01-dose-tolerance-for-sbrt-sabr
#13
J Grimm
PURPOSE: Stereotactic body radiation therapy (SBRT) / stereotactic ablative body radiotherapy (SABR) is gaining popularity, but quantitative dose tolerance has still been lacking. To improve this, the April 2016 issue of Seminars in Radiation Oncology will have normal tissue complication probability (NTCP) models for 10 critical structures: optic pathway, cochlea, oral mucosa, esophagus, chestwall, aorta, bronchi, duodenum, small bowel, and spinal cord. METHODS: The project included more than 1500 treatments in 1-5 fractions using CyberKnife, Gamma Knife, or LINAC, with 60 authors from 15 institutions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048212/su-f-j-106-dose-adaptation-with-a-virtual-6d-couch-for-frameless-brain-radiosurgery-via-a-dedicated-gamma-ray-device
#14
J Cheung, S Braunstein, P Sneed, M McDermott, P Theodosopoulos, L Ma
PURPOSE: The couch for Gamma Knife Radiosurgery (GKSRS) is limited to translational movements. With frameless designs, patient positional rotations may become an important factor. Therefore, we investigated the effect of rotations for GKSRS and the ability to correct for these rotations with simple couch translations. METHODS: Seven previously treated GKSRS patients with different disease types (tumor volumes 0.01-12cc) were selected for this study. The planning MRI images were processed in order to digitally rotate the stereotactic frame (Leksell G-frame) to ±1, ±2, ±3, ±5, and ±10-degrees in the transverse plane from the nominal position...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048203/su-f-p-15-report-on-aapm-tg-178-gamma-knife-dosimetry-and-quality-assurance
#15
S Goetsch
PURPOSE: AAPM Task Group 178 Gamma Stereotactic Radiosurgery Dosimetry and Quality Assurance was formed in August, 2008. The Task Group has 12 medical physicists, two physicians and two consultants. METHODS: A round robin dosimetry intercomparison of proposed ionization chambers, electrometer and dosimetry phantoms was conducted over a 15 month period in 2011 and 2012 (Med Phys 42, 11, Nov, 2015). The data obtained at 9 institutions (with ten different Elekta Gamma Knife units) was analyzed by the lead author using several protocols...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048017/tu-d-207b-01-a-prediction-model-for-distinguishing-radiation-necrosis-from-tumor-progression-after-gamma-knife-radiosurgery-based-on-radiomics-features-from-mr-images
#16
Z Zhang, A Ho, X Wang, P Brown, N Guha-Thakurta, S Ferguson, X Fave, L Zhang, D Mackin, L Court, J Li, J Yang
PURPOSE: To develop and validate a prediction model using radiomics features extracted from MR images to distinguish radiation necrosis from tumor progression for brain metastases treated with Gamma knife radiosurgery. METHODS: The images used to develop the model were T1 post-contrast MR scans from 71 patients who had had pathologic confirmation of necrosis or progression; 1 lesion was identified per patient (17 necrosis and 54 progression). Radiomics features were extracted from 2 images at 2 time points per patient, both obtained prior to resection...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047835/su-f-t-603-safe-treatment-of-the-maximum-tolerable-brain-metastases-with-gamma-knife-in-single-patient-clinical-findings
#17
Y Chen, C Li, C Yang
PURPOSE: Safe treatment of the maximum tolerable brain metastases with GK in single patient-clinical findings METHODS: A patient diagnosed with stage IV NSCLC has received 6 courses of Gamma Knife radiosurgery (GKRS) treatments. The plans were generated with GammaPlan (version 10.1.1), six courses of treatment were administered in 2.5 years. A total of 53 metastases were treated with retreatment foci (n = 5) and planned on newly identified lesions (n = 48). Individual prescription dose varied from 12 Gy to 24 Gy...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047759/th-a-brc-00-new-task-groups-for-external-beam-qa-an-overview
#18
Sonja Dieterich
: AAPM TG-135U1 QA for Robotic Radiosurgery - Sonja Dieterich Since the publication of AAPM TG-135 in 2011, the technology of robotic radiosurgery has rapidly developed. AAPM TG-135U1 will provide recommendations on the clinical practice for using the IRIS collimator, fiducial-less real-time motion tracking, and Monte Carlo based treatment planning. In addition, it will summarize currently available literature about uncertainties. LEARNING OBJECTIVES: 1. Understand the progression of technology since the first TG publication 2...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047734/su-f-t-599-volume-independent-conformity-index-for-stereotactic-brain-tumors
#19
S Kim, H Kim, S Lee, M Awan, D Rangaraj, Y Zheng, J Monroe, R Partel, S Lo, M Machtay, A Sloan, J Sohn
PURPOSE: To develop a volume-independent metric called the Gaussian Weighted Conformity Index (GWCI) for assessing conformality of stereotactic radiosurgery plans for small brain tumors. METHODS: The GWCI calculates bi-directional distance by searching for corresponding points between the prescription isodose line and tumor contour, assigning different scoring weights to tumor coverage with a score of 1.0 being ideal assuming an idealized Gaussian distribution of dose around the tumor...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047718/su-f-t-445-effect-of-triaxial-cables-and-microdetectors-in-small-field-dosimetry
#20
I Das, A Andersen
PURPOSE: Advances in radiation treatment especially with smaller fields used in SRS, Gamma knife, Tomotherapy, Cyberknife, and IMRT, require a high degree of precision especially with microdetectors for small field dosimetry (Das et al, Med Ph, 35, 206, 2008; Alfonso et al, Med Phys, 35, 5179, 2008). Due to small signal, the triaxial cable becomes critical in terms of signal to noise ratio (SNR) which is studied with microdetectors. METHODS: Six high quality triaxial cables, 9...
June 2016: Medical Physics
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