Purpose/Objective(s):Stereotactic Radiosurgery (SRS) is an alternative treatment for patients with trigeminal neuralgia. We investigated the clinical accuracy of a linear accelerator (LINAC) based, non-invasive frameless stereotactic radiosurgery system, equipped with advanced image guided capabilities (IGRT) in the treatment of trigeminal neuralgia.Materials/Methods:We retrospectively reviewed all patients treated in our institution with SRS for trigeminal neuralgia using a linear accelerator. 14 patients received treatment between 2011 and 2013, and 11 had at least one post-procedure MRI. Patients were initially treated with a head frame, and we switched to a non-invasive frameless system after Dec 2012. Pre-procedure MRI was fused with simulation CT as part of treatment planning. We fused the post-procedure MRI with the pre-procedure MRI sequences. We contoured the trigeminal nerve as well as post-procedure enhancing area. Using the enhancing area as a clinical marker for high dose region, we calculated the linear distance between the planning isocenter and the center of the enhancement.Results:8 patients were treated with a head frame, and 6 patients were treated with a frameless system. 13 patients had at least a temporary or partial response to SRS. 9 patients (81.8%) developed contrast enhancement on post-procedure MRI. The distance between the planning isocenter and the center of the enhancement was 2.0 ± 0.7 mm for the head frame system, and 1.3 ± 0.7 mm for the frameless system (p=0.17). The enhancing area received a mean dose of 67.6 ± 12.7 Gy.Conclusions:LINAC based frameless SRS system in conjunction with advanced IGRT can provide accurate treatment for patients with trigeminal neuralgia.
Chen, Y,
Turian, J,
Diaz, A,
Clinical Accuracy of LINAC Based Frameless Stereotactic Radiosurgery System for Trigeminal Neuralgia. Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL.
http://archive.rsna.org/2014/14043399.html
