Fetal Dose Evaluation for Pregnant Patients on Leksell Gamma Knife Perfexion/Icon.

IF 1.9 4区医学 Q3 NEUROIMAGING

Stereotactic and Functional Neurosurgery Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI:10.1159/000535366

Lucie Hamáčková, Josef Novotný, Gabriela Šimonová, Roman Liščák, Tomáš Chytka

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引用次数: 0

Abstract

Introduction: It is a normal procedure to avoid the application of ionizing radiation during pregnancy. In very rare occasions, treatment can be performed, but doses to the fetus must be evaluated and reported, and the patient must sign informed consent. There can occur two types of damage caused by ionizing radiation - deterministic and stochastic effects. Deterministic effects may occur after reaching a certain threshold (100 mGy for this study); meanwhile, stochastic effects have no limit and their probability rises with dose. This study focuses on deterministic effects.

Case presentations: This study compares the dose measured on phantom for the area of the pelvis and the dose measured on 3 patients with dosimeters positioned on the pelvis irradiated on Leksell Gamma Knife Perfexion/Icon. The mean dose for measurement on phantom for the pelvis was 0.73 ± 0.76 mGy, and for the patients, it was 1.28 mGy, 0.493 mGy, and 0.549 mGy which is 80 times lower, 200 times lower, and 180 times lower than the threshold for deterministic effects, respectively.

Conclusion: The measurement carried on phantom served as the base for drafting informed consent and provided initial proof that treatment can be safely delivered. Measurements performed on patients only confirmed that irradiation of pregnant patients on Leksell Gamma Knife Perfexion/Icon is safe relative to the deterministic effects. Nevertheless, pregnant patients should be treated with ionizing radiation only in very extraordinary situations.

查看原文本刊更多论文

对使用 Leksell Gamma Knife Perfexion/Icon 的孕妇进行胎儿剂量评估。

导言正常情况下，怀孕期间应避免使用电离辐射。在极少数情况下，可以进行治疗，但必须对胎儿所受剂量进行评估和报告，患者必须签署知情同意书。电离辐射可造成两种损害--确定性效应和随机效应。确定性效应可能在达到一定阈值（本研究为 100 mGy）后发生；而随机效应则没有阈值限制，其概率随剂量增加而上升。本研究侧重于确定性效应：本研究比较了在模型上测量的骨盆区域的剂量，以及使用 Leksell Gamma Knife Perfexion/Icon 照射骨盆的 3 位患者的剂量。在模型上测量骨盆的平均剂量为 0.73 ± 0.76 mGy，而在患者身上测量的剂量分别为 1.28 mGy、0.493 mGy 和 0.549 mGy，分别比确定性效应阈值低 80 倍、200 倍和 180 倍：在人体模型上进行的测量是起草知情同意书的基础，并初步证明了治疗是可以安全进行的。在患者身上进行的测量仅证实，相对于确定性效应，用 Leksell Gamma Knife Perfexion/Icon 对怀孕患者进行照射是安全的。不过，只有在非常特殊的情况下，孕妇才能接受电离辐射治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Stereotactic and Functional Neurosurgery 医学-神经成像

CiteScore

3.80

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： ''Stereotactic and Functional Neurosurgery'' provides a single source for the reader to keep abreast of developments in the most rapidly advancing subspecialty within neurosurgery. Technological advances in computer-assisted surgery, robotics, imaging and neurophysiology are being applied to clinical problems with ever-increasing rapidity in stereotaxis more than any other field, providing opportunities for new approaches to surgical and radiotherapeutic management of diseases of the brain, spinal cord, and spine. Issues feature advances in the use of deep-brain stimulation, imaging-guided techniques in stereotactic biopsy and craniotomy, stereotactic radiosurgery, and stereotactically implanted and guided radiotherapeutics and biologicals in the treatment of functional and movement disorders, brain tumors, and other diseases of the brain. Background information from basic science laboratories related to such clinical advances provides the reader with an overall perspective of this field. Proceedings and abstracts from many of the key international meetings furnish an overview of this specialty available nowhere else. ''Stereotactic and Functional Neurosurgery'' meets the information needs of both investigators and clinicians in this rapidly advancing field.