OBJECTIVEThe authors developed a new, real-time interactive inverse planning approach, based on a fully convex framework, to be used for Gamma Knife radiosurgery.METHODSThe convex framework is based on the precomputation of a dictionary composed of the individual dose distributions of all possible shots, considering all their possible locations, sizes, and shapes inside the target volume. The convex problem is solved to determine the plan, i.e., which shots and with which weights, that will actually be used, considering a sparsity constraint on the shots to fulfill the constraints while minimizing the beam-on time. The system is called IntuitivePlan and allows data to be transferred from generated dose plans into the Gamma Knife treatment planning software for further dosimetry evaluation.RESULTSThe system has been very efficiently implemented, and an optimal plan is usually obtained in less than 1 to 2 minutes, depending on the complexity of the problem, on a desktop computer or in only a few minutes on a high-end laptop. Dosimetry data from 5 cases, 2 meningiomas and 3 vestibular schwannomas, were generated with IntuitivePlan. Results of evaluation of the dosimetry characteristics are very satisfactory and adequate in terms of conformity, selectivity, gradient, protection of organs at risk, and treatment time.CONCLUSIONSThe possibility of using optimal, interactive real-time inverse planning in conjunction with the Leksell Gamma Knife opens new perspectives in radiosurgery, especially considering the potential use of the full capabilities of the latest generations of the Leksell Gamma Knife. This approach gives new users the possibility of using the system for easier and quicker access to good-quality plans with a shorter technical training period and opens avenues for new planning strategies for expert users. The use of a convex optimization approach allows an optimal plan to be provided in a very short processing time. This way, innovative graphical user interfaces can be developed, allowing the user to interact directly with the planning system to graphically define the desired dose map and to modify on-the-fly the dose map by moving, in a very user-friendly manner, the isodose surfaces of an initial plan. Further independent quantitative prospective evaluation comparing inverse planned and forward planned cases is warranted to validate this novel and promising treatment planning approach.
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http://dx.doi.org/10.3171/2018.7.GKS181572 | DOI Listing |
Brachytherapy
January 2025
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Background: To determine outcomes of MRI-assisted radiosurgery (MARS) for salvage brachytherapy using the radioisotope Pd after various upfront treatments including surgery, external beam radiotherapy, and brachytherapy.
Methods: We retrospectively reviewed data for patients who underwent salvage MARS for intraprostatic lesions or prostate bed recurrences from 2016 to 2022. Biochemical recurrence, prostate cancer-specific, and overall survival, and the cumulative incidences of toxicities, were determined by Kaplan-Meier estimates.
World Neurosurg
January 2025
Department of Neurological Surgery, Columbia University Irving Medical Center, New York, NY, USA, 10032; Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA, 10032. Electronic address:
Background And Objectives: This article aims to report results of our facial nerve preservation approach to treating vestibular schwannomas (VS) at a single institution by a single surgeon performing both microsurgery (MS) and stereotactic radiosurgery (SRS).
Methods: We retrospectively reviewed 751 patients at our institution between 1998 and 2023 by intervention received: retrosigmoid microsurgery (MS, Group 1, 217 patients), gamma knife stereotactic radiosurgery (SRS, Group 2, 462 patients), MS then SRS (Group 3, 72 patients), SRS then MS (Group 4, 10 patients), and SRS then SRS (Group 5, 5 patients). No patients had MS followed by MS.
Eur J Radiol
December 2024
Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK; UCL Great Ormond Street Institute of Child Health, London, UK; Great Ormond Street Hospital NIHR Biomedical Research Centre, London, UK.
J Neurosurg Pediatr
January 2025
1Neurotology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and.
Objective: The objective of this study was to discuss the characteristics of intracranial extension in patients with juvenile nasopharyngeal angiofibroma (JNA) and propose and an algorithm for its management.
Methods: A retrospective chart review of all patients with JNA who underwent operations between January 2013 and January 2023 was done, and those cases with intracranial extension categorized as stage IIIb, IVa, and IVb according to the Andrews modification of the Fisch staging classification were included in the study. Data were collected about age at presentation, symptoms, radiological findings, routes of intracranial extension, therapeutic management, and follow-up.
PLoS One
January 2025
Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
This study aimed to identify radiotherapy dosimetric parameters related to local failure (LF)-free survival (LFFS) in patients with lung and liver oligometastases from colorectal cancer treated with stereotactic body radiotherapy (SBRT). We analyzed 75 oligometastatic lesions in 55 patients treated with SBRT between January 2014 and December 2021. There was no constraint or intentional increase in maximum dose.
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