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Stereotactic systems for setting exact coordinates in radiosurgery using gamma radiation sources.
1. Several clinical procedures, such as radio surgery, neurosurgery, microsurgery, and biopsies, should be able to a use stereotactic radiosurgical system, featuring a gamma knife.
2. The following features should be available in treatment planning systems: removable media archival storage or connection to central storage, a film scanner, a color monitor, a keyboard and mouse, and 3-D planning software with graphics, digital imaging and communications in medicine compatibility, as well as dose computation and analysis features.
3. The gamma navigation system's headframes should be constructed of non-ferromagnetic materials for use with magnetic resonance and should be compatible with all cross-sectional imaging modalities, such as: CT, DSA, MRI, PET, and X-ray. Headframes should be lightweight, around 1 kg.
4. In most gamma knife headframes, fixation uses 2 to 4 carbon fiber or titanium pins or screws but some headframes use alternative fixation methods.
5. Several target approaches should be allowed by the center-of-arc or target-centered arc system. These include lateral, parallel, posterior fossa, and hypophyseal.
6. Method of approach confirmation should be available and target access should have a vertical range of >=150 mm, a lateral range of >=160 mm, and an anterior-posterior range of >=170 mm.
7. In dedicated gamma radiosurgical systems, radiation sources should use more than 200 encapsulated 60Co sources.
8. The gamma knife system should have tungsten collimators ranging from 4 to 18 mm in diameter.
9. Systems that allow attachments can have up to 20 MV, but dedicated LINAC radio surgery systems should have 6 MV photon energies.
10. Treatment delivery assemblies should be floor-mounted or wall-mounted with an isocentric accuracy of 0.5 mm for dedicated LINACs. Those mounted onto the LINAC should have an isocentric accuracy of 1 mm.