TITLE:
Use of High Definition Multileaf Colimator for the Treatment of Trigeminal Neuralgia
AUTHORS:
Eduardo Cabello Murillo, Ana Milanés Gaillet, Gustavo Pozo Rodriguez, Ángel Gaitán Simón, Pedro Adaimi Hernández, Marta Manzano Rodríguez, Alejandro Ferrando Sánchez, Raúl Díaz Fuentes
KEYWORDS:
Trigeminal Neuralgia, Radiosurgery, Brainstem, Brainstem-Optimized Technique (BO), Virtual Cone (VC)
JOURNAL NAME:
International Journal of Medical Physics, Clinical Engineering and Radiation Oncology,
Vol.11 No.3,
August
22,
2022
ABSTRACT: In the present work, a treatment technique for trigeminal neuralgia (TN)
using LINAC radiosurgery is shown. The technique is based on the optimization
of ten static arcs in such a way as to minimize the overlapping of the
treatment fields with the brainstem. We will call this technique
brainstem-optimized (BO). The results are compared with another technique
described in the literature known as a virtual cone (VC). The
comparison of dosimetry results that have been carried out essentially shows that the doses in the brainstem V12Gy-brainstem, D0.5cm3-brainstem and
D0.035 cm3-brainstem are lower in the BO versus VC technique, and
with the parameters V50% (whole brain) and V12Gy-cerebrum higher in BO versus
VC. Our goal is to keep the dose to the brainstem as low as possible and, if
possible, at most between 12 Gy and 15 Gy. The BO technique meets our purposes
and is considered clinically acceptable at our institution.