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G Chierego

Publications and source records attributed to G Chierego.

18 recordsLinked to original sources
PubMed1991

Development of a second generation stereotactic apparatus for linear accelerator radiosurgery.

Linear accelerator radiosurgery technique is based on a multiple intersecting arc irradiations procedure. The coincidence of the axis of two rotation movements (of gantry and treatment couch) into the isocenter is critical for focusing irradiation. In October 1989, our linear accelerator was changed and the stereotactic apparatus had to be adapted to the new machine. After multiple mechanical tests of the new machine, the stereotactic head frame was fixed to the roller bearing allowing rotation of the couch. The new apparatus is described.

Humans↗
PubMed1990

Linear accelerator radiosurgery of three-dimensional irregular targets.

Current radiosurgical techniques allow concentration of radiation from external sources into spherical targets. Nonspherical target volumes require a modification of the irradiation technique. Moreover, isodose shaping is sometimes necessary to spare nearby important radiosensitive structures. To meet these prerequisites we have introduced some technical refinements: (1) computer-controlled rectilinear translations of the target in combination with different angular positions of the source and (2) computer-controlled rotations of the target around a vertical axis in combination with different angular positions of the source. The first solution has proven efficient for treating irregular targets, while the second one was employed for focusing the radiation dose inside volumes obtained by rotation of ellipses.

Brain Neoplasms↗
PubMed1990

[Inhomogeneity of electron beam dose distribution].

The radiation therapy employing high energy electron beams took place in superficial or near-superficial target volume treatments. The author describes the dose distribution in the patient whose body is not homogeneous for the presence of bone structures or air cavities that may involve localised perturbations of the dose distributions. Several methods have been developed to obtain the correct dose distribution including the influence of depth, field size and energy. The author describes how the dose distribution changes when the body contour at the beam entrance is bent and oblique. Artificial inhomogeneity like compensators, bolus and adjacent electron beam field may give unexpected small overdose areas.

Absorption↗
PubMed1989

Low-grade astrocytomas: treatment with unconventionally fractionated external beam stereotactic radiation therapy.

Fourteen patients with nonoperable low-grade astrocytomas were treated with unconventionally fractionated stereotactic radiation therapy. The target volume was defined with computed tomography (CT) performed under stereotactic conditions. The treatment was carried out with a technique producing multiple noncoplanar arc irradiation, with the center of the target volume placed at the isocenter of the linear accelerator. A total dose of 16-50 Gy was administered in either one fraction or two fractions 8 days apart. The concentration of dose within the target volume allowed reduction of dose absorbed by adjacent critical structures of the intact brain. Patients were followed up for 11-48 months. Twelve of 14 patients had a partial or complete response to treatment, as demonstrated by CT. Stereotactic radiation therapy appears to be effective in the control of small radioresistant cerebral neoplasms, without damaging surrounding healthy tissues.

Adolescent↗
PubMed1989

Linear accelerator radiosurgery of cerebral arteriovenous malformations.

A technique for linear accelerator radiosurgery has been used in clinical practice since 1982. The technique is based on multiple intersecting arc irradiations focused on a stereotactic target. From November 1984 to October 1988, 97 patients with cerebral arteriovenous malformations have been treated. Seventy-nine patients suffered one or more than one hemorrhage. Four patients had progressive neurological symptoms. In 14 patients, epilepsy was the principal complaint. Stereotactic localization was performed by stereotactic angiography. Lesion dimensions varied from 4 to 40 mm in diameter. Doses from 18.7 to 40 Gy were delivered in one or two sessions. Mean follow-up is 17.1 months (from 1 to 49). Four instances of minor rebleeding were observed after treatment; 3 patients complained of transient neurological deterioration. Of 56 patients who were followed longer than 1 year, 50 underwent 12-month follow-up angiography. In 26 patients complete obliteration of the malformation was demonstrated (52%), in 12 patients subtotal obliteration was obtained (24%), in 11 patients the obliteration was evident but not significant (22%), and in 1 patient the AVM was unchanged. Other angiographic features in incompletely obliterated cases were a significant reduction of flow velocity through the malformation together with a reduction in diameter of both feeding arteries and draining veins.

Adolescent↗
PubMed1988

Dosimetric considerations on multiple arc stereotaxic radiotherapy.

The aim of this paper is to present the physical and dosimetrical features of the stereotaxic radiosurgical method already published by the authors. This method concentrates the dose into the stereotaxic target volume, placed at the isocenter of a 4 MV X-ray beam. Computer calculations showed that: 9-17 arcs provide almost spherical dose distributions; the optimal photon beam quality is about 4-6 MV. The angle between adjacent rotation planes is 20-40 degrees and the arcs are 100-160 degrees wide. In this way the dose to healthy tissue is minimized. The dose distribution was experimentally verified both by ionometric and photodensitometric methods. The procedure for dose calculation at isocenter of fields as small as required by the radiotherapist, has been investigated.

Calibration↗
PubMed1987

New technique for three-dimensional linear accelerator radiosurgery.

A new method for external stereotactic focal irradiation of three-dimensional irregular target volumes is proposed. In this method the target is irradiated by a linear accelerator set in various angular positions around the isocenter. During the irradiation the target is translated in a direction perpendicular to the beam. By controlling the velocity of the translation it is possible to modify the configuration of therapeutic isodoses so as to make them follow the borders of the target.

Brain Diseases↗
PubMed1986

Radiosurgery using a 4MV linear accelerator. Technique and radiobiologic implications.

In the authors' technique, the stereotactically localized target is fixed to the isocenter of a 4 MV linear accelerator. The irradiation is carried out along 9-17 non-coplanar arcs distributed on a 160 degrees cylindrical sector. High doses (10-50 Gy) are delivered in one or two sessions. From 1982, 65 patients have been treated (shortest follow-up 6 months). The dose was chosen according to the pathology and to the volume of the lesion. Good clinical results have been obtained in low-grade gliomas, acoustic neuromas, arteriovenous malformations, and other selected types of intracranial lesions. Therapeutic effects in terms of clinical condition and size of the lesions have been plotted in relation to time elapsed and dose employed.

Adolescent↗
PubMed1985

Stereotactic radiosurgery utilizing a linear accelerator.

The authors have developed a radiosurgical technique based on multiple arc irradiations. The target is fixed to the rotational isocenter of a Varian 4 MV linear accelerator. The first irradiation is carried out while the radiating source is rotating on a 100-140 degrees arc. The patient is then rotated around a vertical axis passing through the target, and arc irradiations are repeated in different angular positions. By this technique it is possible to obtain very steep dose gradients at the borders of the target volume. High doses are usually delivered in two shots. 47 patients have been treated so far in a clinical trial that started in November 1982. The paper deals with the preliminary results (more than 6 months' follow-up) obtained in patients affected by nonresectable brain tumors and AVMs.

Adolescent↗
PubMed1985

External stereotactic irradiation by linear accelerator.

Stereotactic radiotherapy has two advantages: (a) the possibility of giving high radiation doses to small but spatially well-defined target volumes and (b) the presence of a stepped dose gradient between the target volume and the surrounding healthy tissues. To utilize these advantages, the authors built a new stereotactic head frame by which the intracranial target is fixed to the rotational isocenter of a 4-MV linear accelerator. The collimator openings are selected according to the volume and the three-dimensional configuration of the target, and the radiation dose is based on the radiosensitivity of the lesion. After the patient is fixed to the frame, the radiation source and the patient are rotated so that the target is irradiated through infinite portals distributed over the convexity of the skull. It is thereby possible to obtain very high radiation doses centered into the target with a stepped dose gradient. The preliminary radiodosimetric tests and the operative technique are described. The advantages of this technique compared to interstitial radiotherapy and Leksell's radiosurgery are emphasized. This noninvasive procedure has been used to treat a series of intracranial tumors.

Adolescent↗
PubMedDate not supplied

A retrospective analysis concerning physical aspects and clinical dosimetry in radiosurgery.

The authors have reviewed their experience with treatments of small intracranial lesions by unconventionally fractionated stereotactic radiotherapy using a 4 MV photon beam. Treatment is carried out by multiple non coplanar arc irradiation obtained rotating the target, while kept at the isocentre of a Linac, around a vertical axis. The outmost concentration of the dose within the target volume enables consistent reduction of the amount of the absorbed dose by critical structures of the intact brain. They analyse the dose distribution and the method to optimise the choice of the therapeutic dose. Finally, some radiobiological considerations are presented.

Humans↗
PubMedDate not supplied

Stereotactic radiosurgery of intracranial tumors in childhood.

The Authors have developed an original stereotactic technique by which the radiation dose erogated by a 4 MV linear accelerator is focused into the target volume with a steep dose gradient at its borders. The technique has been employed in a series of 30 patients affected by deep seated brain tumors and AVMs. The paper deals with the preliminary results obtained in a series of 10 patients in pediatric age.

Adolescent↗