Technical Note: A spiral fluid‐attenuated inversion recovery MRI technique for stereotactic radiosurgery treatment planning for trigeminal neuralgia

2021 ◽  
Author(s):  
Zhiqiang Li ◽  
Shiv P. Srivastava ◽  
John P. Karis
Keyword(s):  
Trigeminal Neuralgia ◽  
Stereotactic Radiosurgery ◽  
Treatment Planning ◽  
Technical Note ◽  
Inversion Recovery ◽  
Fluid Attenuated Inversion Recovery

Linac-stereotactic radiosurgery (LSRS) in the management of trigeminal neuralgia

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18603-18603
Author(s):  
S. Gurley ◽  
R. Mark ◽  
P. J. Anderson ◽  
T. Neumann ◽  
M. Nair
Keyword(s):  
Trigeminal Neuralgia ◽  
Stereotactic Radiosurgery ◽  
Treatment Planning ◽  
Gamma Knife ◽  
Root Zone ◽  
Planning System ◽  
Response To Treatment ◽  
Treatment Planning System ◽  
Facial Numbness ◽  
Mri Scans

18603 Background: Stereotactic Radiosurgery (SRS) with the Gamma Knife (GK) has been used successfully in the treatment of Trigeminal Neuralgia (TN). Results have been comparable to open surgery. There have been few reports with the use of LSRS in the management of TN. We report our updated results with LSRS in the treatment of TN. Methods: Between 2000 and 2006, 37 patients with medically refractory TN were treated with LSRS. Prior neurosurgical intervention had been performed in 28 patients. Ten patients had one procedure, 10 patients two, and 3 patients three interventions. All patients had typical TN. LSRS was given to the cranial nerve V entry root zone into the brainstem. Targeting was defined by CT and MRI Scans, and CT Cisternogram, utilizing axial, coronal, and sagittal images. Treatment planning was accomplished thru the Radionics Treatment Planning System. The dose was 87 Gy to Dm, in one fraction using the 5 mm collimator and 6 arcs with the 20% Isodose line just touching the brainstem. This dosimetry is similar to Gamma Knife. The dose rate was 400 MU/min. Average Arc length was 130 degrees. Response to treatment was defined as excellent (no pain, off analgesics), good (no pain, with analgesics), and poor (continued pain despite analgesics). Results: With a median follow-up of 40 months (range 6–72 months), 73% (27/37) of patients have reported an excellent or good result after LSRS. One patient has sustained permanent ipsilateral facial numbness. Conclusions: LSRS offers comparable results to Gamma Knife SRS, with respect to both pain relief and complications, in the management of TN. No significant financial relationships to disclose.

Geometrical accuracy of the Novalis stereotactic radiosurgery system for trigeminal neuralgia

2004 ◽  
Vol 101 (Supplement3) ◽  
pp. 351-355 ◽  
Author(s):  
Javad Rahimian ◽  
Joseph C. Chen ◽  
Ajay A. Rao ◽  
Michael R. Girvigian ◽  
Michael J. Miller ◽  
...  
Keyword(s):  
Quality Assurance ◽  
Trigeminal Neuralgia ◽  
Image Fusion ◽  
Stereotactic Radiosurgery ◽  
Ct Images ◽  
Radiochromic Film ◽  
Quality Assurance Program ◽  
Content Type ◽  
Geometrical Accuracy ◽  
Fine Print

Object. Stringent geometrical accuracy and precision are required in the stereotactic radiosurgical treatment of patients. Accurate targeting is especially important when treating a patient in a single fraction of a very high radiation dose (90 Gy) to a small target such as that used in the treatment of trigeminal neuralgia (3 to 4—mm diameter). The purpose of this study was to determine the inaccuracies in each step of the procedure including imaging, fusion, treatment planning, and finally the treatment. The authors implemented a detailed quality-assurance program. Methods. Overall geometrical accuracy of the Novalis stereotactic system was evaluated using a Radionics Geometric Phantom Chamber. The phantom has several magnetic resonance (MR) and computerized tomography (CT) imaging—friendly objects of various shapes and sizes. Axial 1-mm-thick MR and CT images of the phantom were acquired using a T1-weighted three-dimensional spoiled gradient recalled pulse sequence and the CT scanning protocols used clinically in patients. The absolute errors due to MR image distortion, CT scan resolution, and the image fusion inaccuracies were measured knowing the exact physical dimensions of the objects in the phantom. The isocentric accuracy of the Novalis gantry and the patient support system was measured using the Winston—Lutz test. Because inaccuracies are cumulative, to calculate the system's overall spatial accuracy, the root mean square (RMS) of all the errors was calculated. To validate the accuracy of the technique, a 1.5-mm-diameter spherical marker taped on top of a radiochromic film was fixed parallel to the x–z plane of the stereotactic coordinate system inside the phantom. The marker was defined as a target on the CT images, and seven noncoplanar circular arcs were used to treat the target on the film. The calculated system RMS value was then correlated with the position of the target and the highest density on the radiochromic film. The mean spatial errors due to image fusion and MR imaging were 0.41 ± 0.3 and 0.22 ± 0.1 mm, respectively. Gantry and couch isocentricities were 0.3 ± 0.1 and 0.6 ± 0.15 mm, respectively. The system overall RMS values were 0.9 and 0.6 mm with and without the couch errors included, respectively (isocenter variations due to couch rotation are microadjusted between couch positions). The positional verification of the marker was within 0.7 ± 0.1 mm of the highest optical density on the radiochromic film, correlating well with the system's overall RMS value. The overall mean system deviation was 0.32 ± 0.42 mm. Conclusions. The highest spatial errors were caused by image fusion and gantry rotation. A comprehensive quality-assurance program was developed for the authors' stereotactic radiosurgery program that includes medical imaging, linear accelerator mechanical isocentricity, and treatment delivery. For a successful treatment of trigeminal neuralgia with a 4-mm cone, the overall RMS value of equal to or less than 1 mm must be guaranteed.

scholarly journals Technical Note: CT Calibration For Proton Treatment Planning By Cross‐Calibration With Proton CT Data

2020 ◽  
Author(s):  
Paolo Farace ◽  
Francesco Tommasino ◽  
Roberto Righetto ◽  
Francesco Fracchiolla ◽  
Monica Scaringella ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Technical Note ◽  
Proton Treatment ◽  
Ct Data ◽  
Cross Calibration

scholarly journals Fluid-Attenuated Inversion Recovery Images and Stroke Outcome After Thrombolysis

Stroke ◽  
2012 ◽  
Vol 43 (2) ◽  
pp. 539-542 ◽  
Author(s):  
Martin Ebinger ◽  
Anna Kufner ◽  
Ivana Galinovic ◽  
Peter Brunecker ◽  
Uwe Malzahn ◽  
...  
Keyword(s):  
Inversion Recovery ◽  
Stroke Outcome ◽  
Fluid Attenuated Inversion Recovery
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