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Gamma Knife Radiosurgery pp 9–23Cite as

High Precision Radiosurgery and Technical Standards

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Part of the Acta Neurochirurgica Supplements book series (NEUROCHIRURGICA,volume 91)

Summary

Background. A high degree of precision and accuracy in radiosurgery is a fundamental requirement for therapeutic success. Small radiation fields and steep dose gradients are clinically applied thus necessitating a dedicated quality assurance program in order to guarantee dosimetric and geometric accuracy.

Material and methods. A detailed analysis of the course of treatm ent independent of the irradiation technique used results in the so-called chain of uncertainties in radiosurgery (immobilisatio n, imaging, treat ment planning system, definition of regions of interest, mechanical accuracy, dose plann ing, dose verificatio n). Each link in this chain is analysed for accuracy and the established quality assurance procedu res are discussed. A “System Test” was used to check the whole chain of uncertainties simultaneously.

Results. The tests described are compatible with published reports on quality assurance in radiosurgery. In terms of accuracy the weakest link in the chain of uncert aint ies is stereotactic MR imaging. Geometric overall accuracy measured in the “System Test” is less than 0.7 mm.

Conclusion. The established quality assurance routin es have clinically been validated. MR imaging dominates geometric overa ll accuracy in radiosurgery, which can be limited to less than 1 mm by an adequate quality assurance protocol.

Keywords

  • Radiosurgery
  • gamma knife
  • quality assurance
  • System Test

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Author information

Authors and Affiliations

  1. Department of Medical Radiation Physics, Klinik Im Park, Zurich, Switzerland

    S. G. Scheib Ph.D, S. Gianolini & N. J. Lomax

  2. Gamma Knife Centre Frankfurt, Frankfurt, Germany

    A. Mack

Authors
  1. S. G. Scheib Ph.D
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  2. S. Gianolini
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  3. N. J. Lomax
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  4. A. Mack
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Corresponding author

Correspondence to S. G. Scheib Ph.D .

Editor information

Editors and Affiliations

  1. German Gamma Knife Centre, Munich, Germany

    PD. Dr. B. Wowra & Dr. A. Muacevic & 

  2. Neurochirurgische Klinik und Poliklinik, Klinikum Großhadern, Munich, Germany

    Prof. Dr. J.-C. Tonn

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© 2004 Springer-Verlag Wien

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Scheib, S.G., Gianolini, S., Lomax, N.J., Mack, A. (2004). High Precision Radiosurgery and Technical Standards. In: Wowra, B., Muacevic, A., Tonn, JC. (eds) Gamma Knife Radiosurgery. Acta Neurochirurgica Supplements, vol 91. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0583-2_2

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  • DOI: https://doi.org/10.1007/978-3-7091-0583-2_2

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