X-ray scalpel - a new device for targeted x-ray brachytherapy and stereotactic radiosurgery.

The basic design and performance of a novel x-ray scalpel device for interstitial radiosurgery are reported. The x-ray scalpel is comprised of a capillary optics collimator conjugated with a high brilliance microfocus x-ray tube and a thin hollow needle (tip) attached to the collimator. The device is capable of producing a high dose rate (about 140 Gy min(-1) in water-like absorber at the exit window), 0.7 mm diameter, quasi-parallel beam that can be delivered to a targeted site by a minimally invasive procedure. Contrary to insertable x-ray tubes or radionuclides used in brachytherapy and complying with the 1/r(2) radiation attenuation law, the dose rate for a quasi-parallel beam decreases with distance as mu exp(-mu r), where mu is the energy-dependent linear attenuation coefficient in the exposed medium. Moreover, the shape, energy and the dose attenuation curve of the x-ray beam can be adjusted. Two versions of the x-ray scalpel device (5.4 keV and 20.2 keV) are described. We present results from our first test of the x-ray scalpel as a controllable source of focal radiation for producing radiation necrosis in rat brain tissue. Irradiation was transdurally delivered to the rat cerebral cortex for 10 min at a dose rate of 20 Gy min(-1).