Dosimetric validation of the Gamma Knife Icon plan adaptation and high-definition motion management system with a motorized anthropomorphic head phantom.

Purpose: To perform dosimetric validation of the plan adaptation and high-definition motion management (HDMM) system of Gamma Knife® Icon in various clinical scenarios.

Methods And Materials: We built an assembly for a pitch-adjustable anthropomorphic head phantom. We then used films to measure dosimetric and positional accuracy in 13 clinical scenarios, including movement near HDMM thresholds, multiple plan adaptations, frequent coughing, and initial setup error.