Dosimetry, see MAGIC; Polymer gel dosimetry. Fiducial tracking, see CyberKnife radiosurgery

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1 Subject Index Acoustic neuroma, neurofibromatosis type 2 complications 103, 105 hearing outcomes 103, 105 outcome measures 101 patient selection 105 study design 101 tumor control treatment options 100, 101 Acute complications, grading 42 incidence determination dose conformality effects 44 multivariate analysis 42, 43 patient characteristics 40, 41 treatment parameters 40, 41 side effect types 42 study design 39, 40, 44 patient education 44 Anosmia, see Meningioma Brain tumor metastases multiple tumor capabilities 72, 73 ten or more metastases and dose absorption brainstem 78, 80 dose planning 78, 80 optic apparatus 78, 80 study design 78 treatment planning, see Positron emission tomography tumor control probability, multiple tumor treatment prognosis normal tissue complication probability, effects on survival time 70, 74 study design 68, 69 survival time prediction 68 70, 73, 74 whole-brain irradiation 67, 72, 73 Cancer pain, see Pain Cavernous malformations brainstem lesion surgery 159 complications 157, 159 dose 155 hemorrhage rate 155, 158 indications 154 response 155 seizure outcomes 157, 158 study design 155 imaging 153, 154 natural history 158 Chordoma, see Skull base chordoma Cluster headache (CH) diagnostic criteria 192, 193 of trigeminal nerve complications 194, 195 outcomes 191, 192, 194, 195 study design 191 pathophysiology 190, treatment options 190, 191,

2 Complications, see Acute complications, Computed tomography (CT) cisternography for trigeminal neuralgia 182 gamma knife treatment planning accuracy 248, 249 image acquisition 250, 251 overview 247, 248 registration with other imaging techniques 249 validation of frameless positron emission tomography stereotactic irradiation device for cat studies 34, 36 Craniopharyngioma, see Sellar-parasellar CyberKnife fiducial and skull tracking accuracy, quality assurance importance 258, 259 monthly test for fiducial tracking accuracy 256 monthly test for skull tracking accuracy 256, 257 outcomes 258 principles 255 trigeminal neuralgia, see Trigeminal neuralgia Dosimetry, see MAGIC; Polymer gel dosimetry Fiducial tracking, see CyberKnife Gamma knife acoustic neuroma management, see Acoustic neuroma, neurofibromatosis type 2 brain tumor metastasis treatment, see Brain tumor metastases cavernous malformation management, see Cavernous malformations cluster headache management, see Cluster headache development 13 extracranial dose measurement with model C instrument cancer risks 198 distance influence analysis 205, 211 doses by tissue 199, 200, 210 integral dose influence analysis 204, 211 pathology influence analysis phantom data 209, 210 plug influence analysis 206, 208, 211 reference isodose volume influence analysis 204, 211 study design 198, 199 target maximum dose influence analysis 203, 204 treatment time influence analysis 204, 212 glioblastoma multiforme treatment, see Glioblastoma multiforme low-grade gliomas, see Glioma pain management, see Pain pituitary adenoma management, see Pituitary adenoma polymer gel dosimetry, see MAGIC; Polymer gel dosimetry principles 39, 197, 198 sellar-parasellar tumor treatment, see Sellar-parasellar treatment planning imaging, see Computed tomography; Magnetic resonance imaging; Positron emission tomography inverse treatment planning advantages 265 clinical evaluation 262, 264, 265 morphology-guided planning approach 261, 262 overview 260, 261 vestibular schwannoma management, see Vestibular schwannoma Gel dosimetry, see Polymer gel dosimetry Subject Index 281

3 Glioblastoma multiforme (GBM) morbidity 94, 96 patient characteristics 92 patient selection 96, 97 statistical analysis 93 survival outcomes 93, 94 technique 93 tumor progression management 97, 98 prognostic factors 92, 97 radiobiology 96 Glioma, see also Sellar-parasellar methionine uptake positron emission tomography, evaluation of low-grade gliomas after gamma knife surgery dosimetry effects on metabolic course 149 follow-up and data analysis 146 histology 143, 149 magnetic resonance imaging correlation metabolic activity evaluation 147, patient characteristics 144, , 146 optic nerve glioma microsurgery versus 10, 11 Hearing preservation acoustic neuroma gamma knife in neurofibromatosis type 2 103, 105 vestibular schwannoma management, see Vestibular schwannoma Hypophysectomy, see Pain Linac, see also CyberKnife Novalis system, treatment of meningiomas radiotherapy 116 complications 119, 120 intensity-modulated stereotactic /radiotherapy 121 neurological outcomes 118 patient selection 120 study design 116, 117 tumor control vision outcomes 120, 121 Novalis system, treatment of skull base chordomas radiotherapy 83 outcomes patient characteristics 83, 85 toxicity 88 treatment planning and delivery 85 principles 39 trigeminal neuralgia management, see Trigeminal neuralgia MAGIC advantages 214 composition and effects on dose response 214, 215, 218, 220, 222 magnetic resonance imaging of absorbed dose under varying conditions 215, 216, 218, 220 production in the clinic 214, 215, 223 temperature effects on dose response 220, 222, 223 Magnetic resonance imaging (MRI) brain tumor angiogenesis evaluation 52, 53, 61 correlation with methionine uptake positron emission tomography, low-grade gliomas gamma knife treatment planning accuracy 248, 249 image acquisition 250, 251 overview 247, 248 registration with other imaging techniques 249 validation of frameless positron emission tomography MAGIC gel absorbed dose 215, 216, 218, 220 perfusion evaluation of brain areas of interest analysis 53 hemodynamic parameters 60, 61 perfusion ratios in malignant versus benign 55, 56, 61 principles 268 radiation therapy effects Subject Index 282

4 study design 268 tumor progression group 275, 276 tumor regression group 275, 276 study design 53, 54 Magnetic resonance spectroscopy (MRS) brain tumor evaluation advantages 52 areas of interest analysis 53, 59, 60 grading of brain 58, 59 metabolite ratios in malignant versus benign 55 58, 61 principles 268 pulse sequences 60 radiation therapy effects metabolite ratios 268, 275 study design 268 tumor progression group 275, 276 tumor regression group 275, 276 study design 53, 54 pattern analysis 52 spatial resolution 60 Meningioma, see also Sellar-parasellar Novalis system treatment radiotherapy 116 complications 119, 120 intensity-modulated stereotactic /radiotherapy 121 neurological outcomes 118 patient selection 120 study design 116, 117 tumor control vision outcomes 120, 121 olfaction preservation in olfactory groove meningiomas, stereotactic anosmia impact on patients 124, 125, 128, 129 case reports , 130, 131 conventional surgery outcomes 129, 130 olfactory system anatomy 127, 128 rationale 124, 125 Microsurgery sellar-parasellar, see Sellarparasellar vestibular schwannoma, see Vestibular schwannoma Morphology-guided planning, see Gamma knife Neurofibromatosis type 2 acoustic neuroma, see Acoustic neuroma, neurofibromatosis type 2 vestibular schwannoma, see Vestibular schwannoma Normal tissue complication probability (NTCP) calculation 67, 69 multiple brain tumor metastases prognosis 70, 74 Novalis, see Linac Nuclear magnetic resonance (NMR), polymer gel absorbed dose 228, 229, 233 Olfaction, see Meningioma Olfactory groove meningioma, see Meningioma Pain gamma knife management cancer pain dose/energy calculations 165, 166 indications 163, 164 mechanisms of action overview , 164 thalamic pain syndrome 165, 166, 168, 169 hypophysectomy management of cancer pain 162, 163 mechanism of action 167 thalamic pain syndrome management 163 Pathology, see Radiosurgical pathology Pituitary adenoma, see also Sellar-parasellar fractionated radiotherapy 135 advantages 140, 141 endocrinological control 136, 139, 140 hypopituitarism 140 side effects 137, 139 study design 135, 136 Subject Index 283

5 Pituitary adenoma, see also Sellar-parasellar (continued) (continued) tumor control 136, 139 visual field changes 136, 137, 140 surgery risks 135 Polymer gel dosimetry, see also MAGIC applications 213, 226, 233, 234 gamma knife treatment plan evaluation calibration and irradiation dose distribution parameters 229, 233 gel preparation 226 nuclear magnetic resonance, absorbed dose 228, 229, 233 observed versus calculated values 231, 233, 234 gel types 214 Positron emission tomography (PET) brain metastasis utility 48, 49 fluorodeoxyglucose as tracer 47 gamma knife treatment planning accuracy 248, 249 image acquisition 250, 251 overview 247, 248 registration with other imaging techniques 249 validation of frameless imaging methionine uptake positron emission tomography, evaluation of low-grade gliomas after gamma knife surgery dosimetry effects on metabolic course 149 follow-up and data analysis 146 histology 143, 149 magnetic resonance imaging correlation metabolic activity evaluation 147, patient characteristics 144, , 146 principles 47 radiation necrosis imaging 50 study design 47 Quality assurance CyberKnife fiducial and skull tracking accuracy quality assurance importance 258, 259 monthly test for fiducial tracking accuracy 256 monthly test for skull tracking accuracy 256, 257 outcomes 258 overview 236, 237, 244 Quality assurance in / radiotherapy (QUASIR), see Stereotactic /radiotherapy analysis; Tomographic phantom analysis Radiation tolerance definition 22 spinal cord, see Spinal cord radiation tolerance Radiosurgical pathology degenerative and proliferative changes in 18 goals 14 historical perspective radiolesion characteristics rationale 19 Schwannoma, see Vestibular schwannoma Sellar-parasellar, microsurgery versus case characteristics 2 control rates by tumor type 3, 4, 9 craniopharyngioma 5, 9 dosimetry 2, 9 germinoma 10 meningioma 6, 10, 11 optic nerve glioma 10, 11 pilocytic astrocytoma case presentation 6, 8 pituitary adenoma 5, 6, 9 radiosensitivity of 9 efficacy evaluation 3 suprasellar germinoma case presentation 8 Skull base chordoma epidemiology 83 Novalis system treatment radiotherapy 83 outcomes patient characteristics 83, 85 Subject Index 284

6 toxicity 88 treatment planning and delivery 85 radiation tolerance 83 Spinal cord radiation tolerance injury signs 22 modeling 23 radiation parameters in injury 22, 23 treatment planning dose-volume effects study design 23, 24 tolerance dose 26, 27 Stereotactic irradiation (STI), experimental device for cat studies computed tomography 34, 36 device features 30 film dosimetry 33 phantom 30 stereotactic 31, 33 X-Knife software, comparison with film dosimetry 29, 33, 34, 36 Stereotactic radiation therapy (SRT) Novalis system, treatment of meningiomas radiotherapy 116 complications 119, 120 intensity-modulated stereotactic /radiotherapy 121 neurological outcomes 118 patient selection 120 study design 116, 117 tumor control vision outcomes 120, 121 Novalis system, treatment of skull base chordomas radiotherapy 83 outcomes patient characteristics 83, 85 toxicity 88 treatment planning and delivery 85 Stereotactic /radiotherapy analysis (STERAS) applications 244 goals 237 phantom, see Tomographic phantom analysis test routines L-test 242, 243 simulation patient 243 system test Thalamic pain syndrome, see Pain Tomographic phantom analysis (TOPAS) applications 244 film dosimetry 239, 240 goals 237 phantom 237, 238 Trigeminal nerve, see Cluster headache; Trigeminal neuralgia Trigeminal neuralgia CyberKnife computed tomographic cisternography 182 dose placement precision image-guided 183, 184 pain relief and temporal patterns 185, 186, 188 patient selection 182 side effects 185 treatment planning 183, 187, 188 epidemiology , 176, 177, 182 Linac complications 176 pain relapse 175, 176 patient selection 172 technique , 177, 178 response assessment 175 statistical analysis 175 medical therapy 172 Tumor control probability (TCP) formula 67 multiple brain tumor treatment prognosis normal tissue complication probability, effects on survival time 70, 74 study design 68, 69 survival time prediction 68 70, 73, 74 whole-brain irradiation 67, 72, 73 Vestibular schwannoma and microsurgery for hearing preservation Subject Index 285

7 Vestibular schwannoma and microsurgery for hearing preservation (continued) outcomes with and without microsurgery 109, 110, 112, 113 rationale 108 study design 108 large-tumor treatment 107, 108 Vision optic apparatus dose absorption, of multiple brain metastases 78, 80 pituitary adenoma gamma knife effects 136, 137, 140 preservation with meningioma treatment 120, 121 Whole-brain irradiation, multiple brain metastases 67, 72, 73 Subject Index 286

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