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无框架立体定向放射外科治疗中使用 Leksell Gamma Knife Icon 的最佳面罩固定方法。

Optimal mask fixation method for frameless radiosurgery with Leksell Gamma Knife Icon.

机构信息

Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Republic of Korea.

Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

J Appl Clin Med Phys. 2023 Apr;24(4):e13892. doi: 10.1002/acm2.13892. Epub 2023 Jan 7.

Abstract

The Leksell Gamma Knife (LGK) Icon is used for mask-based and frame-based fixation. The mask fixation provides a noninvasive method. However, an optimal mask fixation method is yet to be established. We evaluated the characteristics of three mask fixation methods (Plain, Folded, and Wide) for the LGK Icon . Force-sensitive resistor sensors were attached to the forehead, supraorbital, zygoma, mandible, and occipital bone of the phantom, and digital humidity and temperature sensors were attached to both temporal lobes. Cone-beam computed tomography (CBCT) and high-definition motion management (HDMM) for each mask fixation method were used to evaluate the phantom motion during the initial application. Subsequently, the mask was removed and reapplied on the second (1st reapplication) and third days (2nd reapplication). In the initial application, forces acting on most portions of the phantom were stabilized within 1.5 h. The largest force acted on the occipital bone for the Plain and Wide methods and on the mandible for the Folded method. The temperature rapidly approaches the initial temperature, whereas the humidity gradually approached the initial humidity in all fixation methods. The Folded method exhibited a significantly lower translation along the Y-axis of the Leksell coordinate system, and rotations along all axes were under 0.5°. The HDMM values remained at 0.1 mm for all fixation methods. In the reapplications, the force acting on the occipital bone was significantly greater than that during the initial application for all mask fixation methods; the temperature and humidity remained unchanged. All mask fixation methods in the 1st reapplication were not significantly different from those in the 2nd reapplication. The Folded method is recommended as an optimal mask fixation for patients who require tight fixation; the Wide method can be considered if patient comfort is a priority.

摘要

Leksell Gamma Knife(LGK)Icon 用于基于面罩和基于框架的固定。面罩固定提供了一种非侵入性的方法。然而,一种最佳的面罩固定方法尚未建立。我们评估了三种面罩固定方法(普通、折叠和宽)用于 LGK Icon 的特征。力敏电阻传感器附着在幻影的前额、眶上、颧骨、下颌骨和枕骨上,数字湿度和温度传感器附着在两个颞叶上。使用锥形束计算机断层扫描(CBCT)和高清运动管理(HDMM)来评估每种面罩固定方法下幻影在初始应用期间的运动。随后,移除面罩并在第二天(第 1 次重新应用)和第三天(第 2 次重新应用)重新应用。在初始应用中,作用于幻影大部分部位的力在 1.5 小时内稳定下来。对于普通和宽方法,最大的力作用于枕骨,对于折叠方法,最大的力作用于下颌骨。温度迅速接近初始温度,而湿度在所有固定方法中逐渐接近初始湿度。折叠方法在 Leksell 坐标系的 Y 轴上显示出明显较低的平移,并且所有轴上的旋转都小于 0.5°。HDMM 值在所有固定方法中均保持在 0.1 毫米。在重新应用中,对于所有面罩固定方法,作用于枕骨的力明显大于初始应用时的力;温度和湿度保持不变。在第 1 次重新应用中,所有面罩固定方法均与第 2 次重新应用中的方法没有显著差异。对于需要紧密固定的患者,建议使用折叠方法作为最佳面罩固定;如果患者舒适度是优先考虑的因素,可以考虑使用宽方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b6b/10113692/a6a1f2edf5a5/ACM2-24-e13892-g003.jpg

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