A reusable and universal size polyethylene terephthalate glycol head fixation device for Gamma Knife Radiosurgery: a prospective comparative cohort study
Year: 2026
Type: article
Abstract: BACKGROUND: Accurate cranial fixation is fundamental to the precision and safety of Gamma Knife Radiosurgery (GKRS). Traditional invasive frames, while reliable, limit patient comfort and adaptability for multi-session procedures. This study introduces and validates a reusable, 3D-printed head fixation frame made from polyethylene terephthalate glycol (PETG), engineered to provide mechanical stability and compatibility with the Leksell Gamma Knife Icon®. METHODS: The PETG frame was modelled in SolidWorks® and analysed mechanically using ANSYS® 2022 to evaluate deformation, stress distribution, and safety factors under tightening forces from 50 N to 160 N. Phantom dosimetry was performed with a CC13 + F ionisation chamber to determine dose attenuation. Clinical validation included 15 patients undergoing hypofractionated GKRS. Cone-beam CT (CBCT) and High-Definition Motion Management (HDMM) were used for alignment and motion monitoring. Statistical comparison of motion parameters was performed using one-way ANOVA. RESULTS: Finite element analysis revealed a maximum von Mises stress of 10.36 MPa, well below PETG’s yield strength (53 MPa). Phantom testing showed a mean dose attenuation of 3.8%, confirming negligible influence on radiation accuracy. Clinical analysis demonstrated an average patient motion of 0.44 ± 0.22 mm, with only 40% of cases showing transient deviations beyond 1.5 mm. ANOVA indicated a significant difference in motion distribution among sessions (p = 0.041). Patients rated the frame as comfortable and non-intimidating, with no major skin reactions. CONCLUSION: The PETG frame offers a reusable, non-invasive, and cost-effective immobilization alternative for GKRS. Its proven mechanical reliability, radiological transparency, and compatibility with CBCT and HDMM systems establish it as a sustainable advancement in modern radiosurgical head fixation technology.
Source: BMC Neurology
Authors: Rafal Thamer Ibrahim, Moneer K. Faraj, Auns Q.H. Al-Neami
Institutions: University of Baghdad, Nahrain University
Language: English
Subfield: Radiation
Field: Physics and Astronomy
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7143028885