Dosimetric comparison in various stereotactic radiosurgery modalities for trigeminal neuralgia treatment.

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Radiological Physics and Technology Pub Date : 2025-07-14 DOI:10.1007/s12194-025-00935-w

Mageshraja Kannan, Sathiyan Saminathan, C Prasobh, Aditya Gupta, Karuppusamy Arumugam, Nithin Bhaskar, Varatharaj Chandraraj, B Shwetha, K M Ganesh

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引用次数: 0

Abstract

Trigeminal neuralgia (TN) is characterized by severe facial pain and is treated with medications, surgery, percutaneous procedures, and stereotactic radiosurgery (SRS). The Gamma Knife (GK) has historically been the gold standard for SRS in TN, with alternatives such as the CyberKnife (CK) and standard linear accelerator (LA) having recently emerged. This study compared GK, CK, and LA treatments for TN via dosimetric analysis. Twenty patients (10 right- and 10 left-sided) with TN were planned in the three modalities. Dosimetric parameters, including D_Max, D_Min, D_Mean, D_98%, D_90%, D_50%, D_30%, and V_4Gy, were evaluated. The statistical significance was assessed using paired t tests. The CK and LA plans achieved a 60 Gy target coverage comparable to the GK plan. The GK plan exhibited superior brain stem sparing and lower V_4Gy compared with CK (p = 0.0013) and LA (p = 0.0001). Significant differences in D_Min, D_98%, D_90%, D_50%, and D_30% were observed between GK and CK (p < 0.05) and GK and LA (p < 0.05), but not for the CK-LA comparisons. The brain stem dose parameters (D_0.03 cc, D_1%, and D_2%) were significantly lower in the GK plan (p < 0.05). The GK exhibited better normal tissue sparing and brain stem dose distribution than CK and LA, attributable partly to its higher beam count. CK and LA require more intricate planning times. Despite the established efficacy of GK, CK and LA offer viable alternatives, underscoring the need for further research on the clinical outcomes of TN treatment in the respective modalities.

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不同立体定向放射手术治疗三叉神经痛的剂量学比较。

三叉神经痛（TN）以严重的面部疼痛为特征，可通过药物、手术、经皮手术和立体定向放射手术（SRS）治疗。伽玛刀（GK）历来是TN SRS的黄金标准，最近出现了射波刀（CK）和标准直线加速器（LA）等替代品。本研究通过剂量学分析比较了GK、CK和LA处理对TN的影响。20例患者（10例右侧和10例左侧）计划在三种模式下进行TN。评估剂量学参数，包括DMax、DMin、DMean、D98%、D90%、D50%、D30%和V4Gy。采用配对t检验评估统计学显著性。CK和LA计划实现了与GK计划相当的60 Gy目标覆盖率。与CK （p = 0.0013）和LA （p = 0.0001）相比，GK计划表现出更好的脑干节约和更低的V4Gy。GK组与CK组DMin、D98%、D90%、D50%和D30%差异显著（p < 0.03 cc）， D1%和D2%显著低于GK组（p < 0.05 cc）

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来源期刊

Radiological Physics and Technology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.00

自引率

12.50%

发文量

期刊介绍： The purpose of the journal Radiological Physics and Technology is to provide a forum for sharing new knowledge related to research and development in radiological science and technology, including medical physics and radiological technology in diagnostic radiology, nuclear medicine, and radiation therapy among many other radiological disciplines, as well as to contribute to progress and improvement in medical practice and patient health care.