{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:48:54Z","timestamp":1784558934754,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,11,8]],"date-time":"2015-11-08T00:00:00Z","timestamp":1446940800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:p>The Leksell GammaPlan software version 10 introduces a CT image\u2010based segmentation tool for automatic skull definition and a convolution dose calculation algorithm for tissue inhomogeneity correction. The purpose of this work was to evaluate the impact of these new approaches on routine clinical Gamma Knife treatment planning. Sixty\u2010five patients who underwent CT image\u2010guided Gamma Knife radiosurgeries at the University of Pittsburgh Medical Center in recent years were retrospectively investigated. The diagnoses for these cases include trigeminal neuralgia, meningioma, acoustic neuroma, AVM, glioma, and benign and metastatic brain tumors. Dose calculations were performed for each patient with the same dose prescriptions and the same shot arrangements using three different approaches: 1) TMR 10 dose calculation with imaging skull definition; 2) convolution dose calculation with imaging skull definition; 3) TMR 10 dose calculation with conventional measurement\u2010based skull definition. For each treatment matrix, the total treatment time, the target coverage index, the selectivity index, the gradient index, and a set of dose statistics parameters were compared between the three calculations. The dose statistics parameters investigated include the prescription isodose volume, the 12 Gy isodose volume, the minimum, maximum and mean doses on the treatment targets, and the critical structures under consideration. The difference between the convolution and the TMR 10 dose calculations for the 104 treatment matrices were found to vary with the patient anatomy, location of the treatment shots, and the tissue inhomogeneities around the treatment target. An average difference of 8.4% was observed for the total treatment times between the convolution and the TMR algorithms. The maximum differences in the treatment times, the prescription isodose volumes, the 12 Gy isodose volumes, the target coverage indices, the selectivity indices, and the gradient indices from the convolution and the TMR 10 calculations are 14.9%, 16.4%, 11.1%, 16.8, 6.9%, and 11.4%, respectively. The maximum differences in the minimum and the mean target doses between the two calculation algorithms are 8.1% and 4.2% of the corresponding prescription doses. The maximum differences in the maximum and the mean doses for the critical structures between the two calculation algorithms are 1.3 Gy and 0.7 Gy. The results from the two skull definition methods with the TMR 10 algorithm agree either within  or 0.3 Gy for the dose values, except for a 4.9% difference in the treatment times for a lower cerebellar lesion. The imaging skull definition method does not affect Gamma Knife dose calculation considerably when compared to the conventional measurement\u2010based skull definition method, except in some extreme cases. Large differences were observed between the TMR 10 and the convolution calculation method for the same dose prescription and the same shot arrangements, indicating that the implementation of the convolution algorithm in routine clinical use might be desirable for optimal dose calculation results.<\/jats:p><jats:p>PACS numbers: 87.55.D, 87.55.kd<\/jats:p>","DOI":"10.1120\/jacmp.v16i6.5530","type":"journal-article","created":{"date-parts":[[2017,2,28]],"date-time":"2017-02-28T00:15:12Z","timestamp":1488240912000},"page":"119-129","source":"Crossref","is-referenced-by-count":13,"title":["Gamma Knife radiosurgery with CT image\u2010based dose calculation"],"prefix":"10.1002","volume":"16","author":[{"given":"Andy (Yuanguang)","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Pittsburgh Cancer Institute  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagdish","family":"Bhatnagar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Pittsburgh Cancer Institute  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Bednarz","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Pittsburgh Cancer Institute  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery New York University Medical Center  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Pittsburgh Cancer Institute  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery University of Pittsburgh Medical Center  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Saiful","family":"Huq","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Pittsburgh Cancer Institute  Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,8]]},"reference":[{"issue":"2","key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1227\/00006123-198902000-00001","article-title":"Stereotactic radiosurgery of the brain using the 1st United States 201\u2010cobalt\u201060 source Gamma\u2010Knife","volume":"24","author":"Lunsford LD","year":"1989","journal-title":"Neurosurgery."},{"key":"e_1_2_6_3_1","volume-title":"Progress in neurological surgery","author":"Maitz A","year":"1998"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v8i3.2377"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/43\/12\/009"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(98)00065-6"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/49\/21\/003"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/50\/23\/018"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1088\/1742-6596\/74\/1\/021023"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/02841860701697712"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3532824"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v15i2.4603"},{"key":"e_1_2_6_13_1","volume-title":"Leksell GammaPlan online reference manual","author":"Elekta Instrument AB."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.596856"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/44\/11\/201"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031-9155\/50\/4\/007"},{"key":"e_1_2_6_17_1","volume-title":"The convolution algorithm in Leksell GammaPlan 10 [white paper]","author":"Elekta Instrument AB."},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v15i5.4844"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(99)00513-1"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.07.980"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000093723"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3171\/sup.2006.105.7.194"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1120%2Fjacmp.v16i6.5530","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1120%2Fjacmp.v16i6.5530","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1120\/jacmp.v16i6.5530","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:14:09Z","timestamp":1745817249000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1120\/jacmp.v16i6.5530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.1120\/jacmp.v16i6.5530"],"URL":"https:\/\/doi.org\/10.1120\/jacmp.v16i6.5530","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]}}}