Evidence map›Paper›PMID 41906097›Full record

ArticleBMC neurology2026

A reusable and universal size polyethylene terephthalate glycol head fixation device for Gamma Knife Radiosurgery: a prospective comparative cohort study.

Rafal Thamer Ibrahim, Moneer K Faraj, Auns Q H Al-Neami

Abstract readComparative StudyValidation StudyComparative Study
In one paragraph

Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Rafal Thamer IbrahimDepartment of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq.
Moneer K FarajDepartment of Surgery, College of Medicine, University of Baghdad, Baghdad, Iraq. drmkfaraj@uob.edu.iq.
Auns Q H Al-NeamiCollege of Biomedical Engineering, Al-Nahrain University, Baghdad, Iraq.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurate 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®.

methodsThe 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.

resultsFinite 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.

conclusionThe 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.

Indexed as

HeadImmobilizationPatient ComfortRadiosurgeryAdultAgedCone-Beam Computed TomographyCost-Effectiveness AnalysisEquipment DesignEquipment ReuseFemaleHumansMaleMiddle AgedPhantoms, ImagingPolyethylene GlycolsPolyethylene Glycolspolyethylene terephthalate glycolPolyethylene TerephthalatesGamma Knife radiosurgeryHead fixationImmobilization devicePolyethylene Terephthalate GlycolStereotactic radiosurgery

Identifiers

PMID41906097
PMCPMC13151238

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.