Effects on radiation oncology treatments involving various neuromodulation devices
Object: Where no society-based or manufacturer guidance on radiation limits to neuromodulation devices is available, this research provides the groundwork for neurosurgeons and radiation oncologists who rely on the computerized treatment plan clinically for cancer patients. The focus of the article...
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Published in | Journal of X-ray science and technology Vol. 19; no. 4; pp. 443 - 456 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London, England
SAGE Publications
2011
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Subjects | |
Online Access | Get full text |
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Summary: | Object: Where no society-based or manufacturer guidance on radiation
limits to neuromodulation devices is available, this research provides the
groundwork for neurosurgeons and radiation oncologists who rely on the
computerized treatment plan clinically for cancer patients. The focus of the
article is to characterize radiation parameters of attenuation and scatter when
an incident therapeutic x-ray beam is directed upon them. At the time of this
writing, manufacturers of Neuromodulation products do not recommend direct
exposure of the device in the beam nor provide guidance for the maximum dose
for these devices.
Methods: Ten neuromodulation models were chosen to
represent the finite class of devices marketed by Medtronic before 2011. CT
simulations permitted computer treatment modeling for dose distribution
analysis as used routinely in radiation oncology for patients. Phantom case
results were directly compared to actual clinical patient cases. Radiation
detection measurements were then correlated to computational results. Where the
x-ray beam passes through the device and is attenuated, dose reduction was
identified with Varian Eclipse computer modeling for these posterior locations.
Results: Although the computer algorithm did not identify physical
processes of side-scatter and back-scatter, these phenomena were proven by
radiation measurement to occur. In general, the computer results underestimated
the level of change seen by measurement.
Conclusions: For these
implantable neurostimulators, the spread in dose changes were found to be
−6.2% to −12.5% by attenuation, +1.7% to +3.8% by
side-scatter, and +1.1% to +3.1% by back-scatter at 6 MV. At 18 MV,
these findings were observed to be −1.4% to −7.0% by attenuation,
+1.8% to 5.7% by side-scatter, and 0.8% to 2.7% by back-scatter.
No pattern for the behavior of these phenomena was deduced to be a direct
consequence of device size. |
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ISSN: | 0895-3996 1095-9114 |
DOI: | 10.3233/XST-2011-030600306 |