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  • 1
    In: Stereotactic and Functional Neurosurgery, S. Karger AG, Vol. 79, No. 2 ( 2002), p. 57-74
    Abstract: 〈 i 〉 Objective: 〈 /i 〉 To evaluate geometric and dosimetric inaccuracies in the irradiation of the rat brain with the Leksell Gamma Knife. 〈 i 〉 Materials and Methods: 〈 /i 〉 Altogether three types of dosimeters were employed for these measurements: (a) a thermoluminescent dosimeter, (b) a semiconductor detector and (c) a polymer gel dosimeter. The thermoluminescent dosimeter and the semiconductor detector were calibrated using an ion chamber and then implanted in the brain of a rat cadaver and used for absolute dose determination. A special glass phantom mimicking exactly the shape of the rat body filled with the polymer gel was used for measurements of the relative dose distribution and evaluation of geometric inaccuracies during the stereotactic irradiation in the rat brain. 〈 i 〉 Results: 〈 /i 〉 Both thermoluminescent and semiconductor detectors, due to their size, measured mean doses. The observed results demonstrated that the Leksell GammaPlan can be employed for the calculation of absorbed doses in irradiation of experimental animals. In our case, it was necessary to apply a correction factor of 1.078 for the absolute absorbed dose to obtain reliable results. A comparison of calculated dose profiles using the treatment planning system in all three axes with those measured by the polymer gel dosimeter demonstrated a very good geometric agreement with the mean deviation in profile position of 0.5 mm. 〈 i 〉 Conclusion: 〈 /i 〉 The results indicate that this technique can effectively check the geometric and dosimetric accuracy of stereotactic irradiation in the rat brain. The Leksell GammaPlan can be employed for the calculation of absorbed doses, but the correction factor of 1.078 had to be applied for the absolute dose calculations in our irradiation geometry.
    Type of Medium: Online Resource
    ISSN: 1011-6125 , 1423-0372
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2002
    detail.hit.zdb_id: 1483576-9
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  • 2
    Online Resource
    Online Resource
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2002
    In:  Journal of Neurosurgery Vol. 97 ( 2002-12), p. 556-562
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 97 ( 2002-12), p. 556-562
    Abstract: Object. The purpose of this study was to investigate the use of a polymer gel—based dosimeter for the evaluation of geometric and dosimetric inaccuracies during gamma knife radiosurgery and during the irradiation of an experimental animal. Methods. A polymer gel dosimeter, based on acrylic monomers, was used for experiments conducted in this study. The accuracy of the dosimeter was evaluated on a Siemens EXPERT 1-tesla scanner in the transmitter/receiver head coil with the use of a multiecho sequence with 16 echoes, TE 22.5 to 360 msec, TR 2000 msec, slice thickness 2 mm, field of view 255 mm, and a pixel size of 0.5 × 0.5 mm 2 . Two experiments were conducted. First, the head phantom containing the polymer gel dosimeter was irradiated using 4-, 8-, 14-, and 18-mm isocenters. Second, a specially designed rat phantom was irradiated by four 4-mm isocenters. The dose profiles in the x, y, and z axes were calculated in the treatment planning system and measured with the polymer gel dosimeter and the results were compared. There was good agreement between the measured and calculated dose profiles. The maximum deviation in the spatial position of the center of measured and calculated dose profiles was 0.5 mm in the head phantom and 1 mm in the rat phantom. The maximum deviation in the width of the selected reference isodose of measured profiles was 1.2 mm in the head phantom and 1.1 mm in the rat phantom. Conclusions. The use of the polymer gel—based dosimeter for the verification of stereotactic procedures has advantages compared with other dosimetric systems. The dosimeter itself is tissue equivalent. Three-dimensional dose distributions can be measured and the dosimeter allows simulation of the therapeutic procedures.
    Type of Medium: Online Resource
    ISSN: 0022-3085
    RVK:
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2002
    detail.hit.zdb_id: 2026156-1
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  • 3
    Online Resource
    Online Resource
    Wiley ; 2001
    In:  Medical Physics Vol. 28, No. 11 ( 2001-11), p. 2370-2378
    In: Medical Physics, Wiley, Vol. 28, No. 11 ( 2001-11), p. 2370-2378
    Abstract: The purpose of this study was to find a physical‐mathematical description capable to correct a polymer‐gel dosimeter relaxation rate ‐dose response for different temperatures. Four different modifications of polymer‐gel dosimeters were used in this study. Samples with polymer‐gel dosimeter in glass test vessels were homogeneously irradiated by gamma photons. A multi‐echo sequence with 16 equidistant echoes was used for evaluation of irradiated polymer‐gel dosimeters. The sequence parameters were as follows: TR 2000 ms, TE 22.5–360.0 ms, slice thickness 5 mm, FOV 255 mm, one acquisition. The proposed description recommends to subtract response of the nonirradiated dosimeter from the total ‐dose response. The relaxation rate for the irradiated dosimeter can be expressed as a function of temperature and dose. The temperature dependence has an exponential behavior in the measured range. The proposed description allows to correct the measured NMR ‐dose responses for different temperatures.
    Type of Medium: Online Resource
    ISSN: 0094-2405 , 2473-4209
    Language: English
    Publisher: Wiley
    Publication Date: 2001
    detail.hit.zdb_id: 1466421-5
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  • 4
    Online Resource
    Online Resource
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2005
    In:  Journal of Neurosurgery Vol. 102, No. Special_Supplement ( 2005-01), p. 8-13
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 102, No. Special_Supplement ( 2005-01), p. 8-13
    Abstract: Object. The authors sought to compare the accuracy of stereotactic target imaging using the Siemens 1T EXPERT and 1.5T SYMPHONY magnetic resonance (MR) units. Methods. A water-filled cylindrical Perspex phantom with axial and coronal inserts containing grids of glass rods was fixed in the Leksell stereotactic frame and subjected to MR imaging in Siemens 1T EXPERT and Siemens 1.5T SYMPHONY units. Identical sequences were used for each unit. The images were transferred to the GammaPlan treatment planning system. Deviations between stereotactic coordinates based on MR images and estimated real geometrical positions given by the construction of the phantom insert were evaluated for each study. The deviations were further investigated as a function of the MR unit used, MR sequence, the image orientation, and the spatial position of measured points in the investigated volume. Conclusions. Larger distortions were observed when using the SYMPHONY 1.5T unit than those with the EXPERT 1T unit. Typical average distortion in EXPERT 1T was not more than 0.6 mm and 0.9 mm for axial and coronal images, respectively. Typical mean distortion for SYMPHONY 1.5T was not more than 1 mm and 1.3 mm for axial and coronal images, respectively. The image sequence affected the distortions in both units. Coronal T 2 -weighted spin-echo images performed in subthalamic imaging produced the largest distortions of 2.6 mm and 3 mm in the EXPERT 1T and SYMPHONY 1.5T, respectively. Larger distortions were observed in coronal slices than in axial slices in both units, and this effect was more pronounced in SYMPHONY 1.5T. Noncentrally located slice positions in the investigated volume of the phantom were associated with larger distortions.
    Type of Medium: Online Resource
    ISSN: 0022-3085
    RVK:
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2005
    detail.hit.zdb_id: 2026156-1
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  • 5
    Online Resource
    Online Resource
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2005
    In:  Journal of Neurosurgery Vol. 102 ( 2005-01), p. 8-13
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 102 ( 2005-01), p. 8-13
    Abstract: Object. The authors sought to compare the accuracy of stereotactic target imaging using the Siemens 1T EXPERT and 1.5T SYMPHONY magnetic resonance (MR) units. Methods. A water-filled cylindrical Perspex phantom with axial and coronal inserts containing grids of glass rods was fixed in the Leksell stereotactic frame and subjected to MR imaging in Siemens 1T EXPERT and Siemens 1.5T SYMPHONY units. Identical sequences were used for each unit. The images were transferred to the GammaPlan treatment planning system. Deviations between stereotactic coordinates based on MR images and estimated real geometrical positions given by the construction of the phantom insert were evaluated for each study. The deviations were further investigated as a function of the MR unit used, MR sequence, the image orientation, and the spatial position of measured points in the investigated volume. Conclusions. Larger distortions were observed when using the SYMPHONY 1.5T unit than those with the EXPERT 1T unit. Typical average distortion in EXPERT 1T was not more than 0.6 mm and 0.9 mm for axial and coronal images, respectively. Typical mean distortion for SYMPHONY 1.5T was not more than 1 mm and 1.3 mm for axial and coronal images, respectively. The image sequence affected the distortions in both units. Coronal T 2 -weighted spin-echo images performed in subthalamic imaging produced the largest distortions of 2.6 mm and 3 mm in the EXPERT 1T and SYMPHONY 1.5T, respectively. Larger distortions were observed in coronal slices than in axial slices in both units, and this effect was more pronounced in SYMPHONY 1.5T. Noncentrally located slice positions in the investigated volume of the phantom were associated with larger distortions.
    Type of Medium: Online Resource
    ISSN: 0022-3085
    RVK:
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2005
    detail.hit.zdb_id: 2026156-1
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Obstetrical & Gynecological Survey Vol. 64, No. 11 ( 2009-11), p. 727-729
    In: Obstetrical & Gynecological Survey, Ovid Technologies (Wolters Kluwer Health), Vol. 64, No. 11 ( 2009-11), p. 727-729
    Type of Medium: Online Resource
    ISSN: 0029-7828
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
    detail.hit.zdb_id: 2043471-6
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  • 7
    In: Clinical Endocrinology, Wiley, Vol. 70, No. 5 ( 2009-05), p. 732-741
    Type of Medium: Online Resource
    ISSN: 0300-0664 , 1365-2265
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2009
    detail.hit.zdb_id: 2004597-9
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  • 8
    Online Resource
    Online Resource
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2014
    In:  Journal of Neurosurgery Vol. 121, No. Suppl_2 ( 2014-12), p. 198-202
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 121, No. Suppl_2 ( 2014-12), p. 198-202
    Abstract: Glomus tumors usually display indolent behavior, and the effectiveness of radiation in stopping their growth can be assessed after long-term follow-up. Currently only midterm results of radiosurgery are available, so the authors included patients treated by Gamma Knife at least 10 years ago in this study to obtain a perspective of long-term results. Methods During the period from 1992 to 2003, the Gamma Knife was used to treat 46 patients with glomus tumors. The age of the patients ranged from 21 to 79 years (median 56 years). Gamma Knife radiosurgery was the primary treatment in 17 patients (37%). Open surgery preceded radiosurgery in 46% of cases, embolization in 17%, and fractionated radiotherapy in 4%. The volume of the tumor ranged from 0.2 to 24.3 cm 3 (median 3.6 cm 3 ). The minimal dose to the tumor margin ranged between 10 and 30 Gy (median 20 Gy). Results One patient was lost for follow-up after radiosurgery. Clinical follow-up was available in 45 patients and 44 patients were followed with MRI in a follow-up period that ranged from 12 to 217 months (median 118 months). Neurological deficits improved in 19 (42%) of 45 patients and deteriorated in 2 patients (4%). Tumor size decreased in 34 (77%) of 44 patients with imaging follow-up, while an increase in volume was observed in 1 patient (2%) 182 months after radiosurgery and Gamma Knife treatment was repeated. One patient underwent another Gamma Knife treatment for secondary induced meningioma close to the glomus tumor 98 months after initial radiosurgical treatment. Seven patients died 22–96 months after radiosurgery (median 48 months), all for unrelated reasons. Conclusions Radiosurgery has proved to be a safe treatment with a low morbidity rate and a reliable long-term antiproliferative effect.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    RVK:
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2014
    detail.hit.zdb_id: 2026156-1
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  • 9
    Online Resource
    Online Resource
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2005
    In:  Journal of Neurosurgery Vol. 102, No. Special_Supplement ( 2005-01), p. 207-213
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 102, No. Special_Supplement ( 2005-01), p. 207-213
    Abstract: Object. The authors conducted a study to record more detailed information about the natural course and factors predictive of outcome following gamma knife surgery (GKS) for cavernous hemangiomas. Methods. One hundred twelve patients with brain cavernous hemangiomas underwent GKS between 1993 and 2000. The median prescription dose was 16 Gy. One hundred seven patients were followed for a median of 48 months (range 6–114 months). The rebleeding rate was 1.6%, which is not significantly different with that prior to radiosurgery (2%). An increase in volume was observed in 1.8% of cases and a decrease in 45%. Perilesional edema was detected in 27% of patients, which, together with the rebleeding, caused a transient morbidity rate of 20.5% and permanent morbidity rate of 4.5%. Before radiosurgery 39% of patients suffered from epilepsy and this improved in 45% of them. Two patients with brainstem cavernous hemangiomas died due to rebleeding. Rebleeding was more frequent in female middle-aged patients with a history of bleeding, a larger lesion volume, and a prescription dose below 13 Gy. Edema after GKS occurred more frequently in patients who had surgery, a larger lesion volume, and in those in whom the prescription dose was more than 13 Gy. Conclusions. Gamma knife surgery of cavernous hemangiomas can produce an acceptable rate of morbidity, which can be reduced by using a lower margin dose. Lesion regression was observed in many patients. Radiosurgery seems to remain a suitable treatment modality in carefully selected patients.
    Type of Medium: Online Resource
    ISSN: 0022-3085
    RVK:
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2005
    detail.hit.zdb_id: 2026156-1
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  • 10
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 129, No. Suppl1 ( 2018-12), p. 125-132
    Abstract: The aim of this study was to compare 3 different methods to assess the geometrical distortion of two 1.5-T and one 3-T magnetic resonance (MR) scanners and to evaluate co-registration accuracy. The overall uncertainty of each particular method was also evaluated. METHODS Three different MR phantoms were used: 2 commercial CIRS skull phantoms and PTGR known target phantom and 1 custom cylindrical Perspex phantom made in-house. All phantoms were fixed in the Leksell stereotactic frame and examined by a Siemens Somatom CT unit, two 1.5-T Siemens (Avanto and Symphony) MRI systems, and one 3-T Siemens (Skyra) MRI system. The images were evaluated using Leksell GammaPlan software, and geometrical deviation of the selected points from the reference values were determined. The deviations were further investigated for both definitions including fiducial-based and co-registration–based in the case of the CIRS phantom images. The same co-registration accuracy assessment was also performed for a clinical case. Patient stereotactic imaging was done on 3-T Skyra, 1.5-T Avanto, and CT scanners. RESULTS The accuracy of the CT scanner was determined as 0.10, 0.30, and 0.30 mm for X, Y, and Z coordinates, respectively. The total estimated uncertainty in distortion measurement in one coordinate was determined to be 0.32 mm and 0.14 mm, respectively, for methods using and not using CT as reference imaging. Slightly more significant distortions were observed when using the 3-T than either 1.5-T MR units. However, all scanners were comparable within the estimated measurement error. Observed deviation/distortion for individual X, Y, and Z stereotactic coordinates was typically within 0.50 mm for all 3 scanners and all 3 measurement methods employed. The total radial deviation/distortion was typically within 1.00 mm. Maximum total radial distortion was observed when the CIRS phantom was used; 1.08 ± 0.49 mm, 1.15 ± 0.48 mm, and 1.35 ± 0.49 mm for Symphony, Avanto, and Skyra, respectively. The co-registration process improved image stereotactic definition in a clinical case in which fiducial-based stereotactic definition was not accurate; this was demonstrated for 3-T stereotactic imaging in this study. The best results were shown for 3-T MR image co-registration with CT images improving image stereotactic definition by about 0.50 mm. The results obtained with patient data provided a similar trend of improvement in stereotactic definition by co-registration. CONCLUSIONS All 3 methods/phantoms used were evaluated as satisfactory for the image distortion measurement. The method using the PTGR phantom had the lowest uncertainty as no reference CT imaging was needed. Image co-registration can improve stereotactic image definition when fiducial-based definition is not accurate.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    RVK:
    RVK:
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2018
    detail.hit.zdb_id: 2026156-1
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