By Mark H. Phillips Ph.D. (auth.), Mark H. Phillips Ph.D. (eds.)
When I first proposed this e-book, one of many hopes used to be that it'd be the degree upon which might be performed a quiet, good reasoned dialogue of some of the concepts of stereotactic radio surgical procedure. at the moment, there has been rather a lot of rancorous debate that tended to vague the medical and scientific advantages of every of the separate tools. today, i'm satisfied to document that the sector of stereotactic radiosurgery is way much less riven by way of such beside the point posturing. the sphere has taken many steps in the direction of adulthood, either technically and medically. during this mat uration procedure, there were many grandiose plans and speeches made on behalf of stereotactic radiosurgery. necessarily, the truth won't stay as much as the hype, yet such is the typical process devel opment in those kinds of issues. besides the fact that, although occasions won't fit our hopes, we must always consider the phrases of Herbert Parker. spotting that new modalities for the therapy of melanoma don't stand a lot likelihood of innovative luck, however, he fairly accurately mentioned that " . . . with any form of radiatiQn, the margin among good fortune and failure is small. If the opportunity of good fortune is a bit higher . . . thi~ may possibly good be classed as a good boost. " Mark H.
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On the other hand, the fact that CT images are reconstructed without magnification distortion and with very well defined distance scales in all three dimensions made things much simpler. The Leksell system, illustrated in Fig. 5, provides a clear demonstration of the most common method of obtaining stereotactic coordinates in CT systems. Parallel rods run along the CT scan axis, which we will call the Z axis. Diagonal rods join the opposite ends of pairs of the parallel rods, forming an "N". A CT slice containing the center of the target cuts this "N" at some value of Z, yielding an image of three collinear points.
In practice, an infinite number of beams is not required. The number of sources in the Gamma Knife design was dictated by the need to achieve a sufficient dose rate [61]. Linear accelerator arc methods use segments of anywhere from 5 to 11 great circles, as well as more innovative patterns [40, 96, 133]. Lateral scattering of the beam and overlap of adjacent and opposing beams limit the improvement achievable with larger numbers of beamports. Charged particle beams, with their Bragg peak and definite range, do not require such large numbers of beamports to achieve similar dose localization as with photons.
The type of radiobiological effect depends on the dose distribution of the radiation, the volume of tissue irradiated, the type of tissue irradiated, the radiation dose, the radiation quality, and the time course of the radiation. The purpose of this book is to describe exactly the physical characteristics of the radiation that can be delivered, and to relate them to the biological effects that can be achieved. In this chapter, the basic concepts will be introduced, starting with the most fundamental physical principles and proceeding to their practical application.