What Is Gamma Knife Radiosurgery?
Gamma Knife (a registered trademark of Elekta Radiosurgery of Atlanta, GA) Radiosurgery replaces the surgeon's scalpel with a single, high dose of gamma radiation. Like the surgeon's scalpel, the Gamma Knife eradicates the diseased area with a safe and effective approach. The patient wears a lightweight head frame that attaches to a helmet, through which 201 beams of gamma radiation precisely focus at a single target. Only the tissue being treated receives a very strong dose of radiation while the surrounding tissue remains unharmed.
The painless, bloodless procedure is usually performed under local anesthesia with mild sedation. Although the entire procedure takes several hours, the actual treatment takes just 15 minutes to one hour, depending on the size of the lesion being treated. If there are multiple tumors or if the tumor spreads to another area, radiosurgery can be repeated.
There is no risk of surgical complications like infection, hemorrhage or leakage of cerebral spinal fluid. Gamma knife radiosurgery has proven effective to over 100,000 candidates for brain surgery who have chosen this option over invasive neurological procedures.
Who Determines If Gamma Knife Radiosurgery Is Appropriate?
Medical necessity can be determined by a neurosurgeon, radiation oncologist or other medical specialist after evaluating a prospective patient's medical condition. Treatment options are then determined and discussed with the patient and family, so an informed decision can be made.
Does The Gamma Knife Center have A Medical Review Board?
At the Gamma Knife Center, a medical review board comprised of a team of neurosurgeons, radiation oncologists, medical physicists and a neurosurgical nurse meet bi-monthly to review and evaluate cases for treatment. For more information on how to have a case reviewed, please contact Lisa at: firstname.lastname@example.org.
Is The Gamma Knife Radiosurgery Effective?
Over 70,000 patients worldwide have chosen Gamma Knife Radiosurgery for treatment of benign tumors such as acoustic neuromas, meningiomas, pituitary adenomas, pineal tumors; malignant tumors like metastatic tumors, astrocytomas and glioblastomas. The Gamma Knife has also been used to eradicate arteriovenous malformations (AVM) and treatment protocols are under investigation for certain functional disorders such as epilepsy, chronic pain, trigeminal neuralgia, and Parkinson's disease.
Patients may be eligible for Gamma Knife Radiosurgery even if they have previously had open brain surgery, radiation therapy, chemotherapy, or in the case of AVM, embolization procedure. Results have proven to be superior or comparable to conventional neurosurgery, depending on the specific condition treated.
Is The Gamma Knife Procedure Safe?
Gamma Knife Radiosurgery is unique because no surgical incision is performed to "expose" the lesion. Consequently, the risk of surgical complication is greatly reduced. Patients are routinely administered a mild sedative, eliminating the side effects of general anesthesia.
What Is Involved In A Treatment?
On the day of the treatment, the Gamma Knife patient will have a lightweight frame attached to the head. Local anesthesia is used before the frame is secured in place. The frame is used in conjunction with an imaging procedure to accurately locate the diseased area.
With the frame in place, the patient has either an MRI or CT imaging study or, in the case of arteriovenous malformations, angiography, in order to precisely locate the diseased area to be treated.
Data from the imaging study is transferred to the Gamma Knife computer system. While the patient rests, the Gamma Knife Center team uses advanced software to determine the treatment plan. This takes one or two hours to complete depending on the complexity and location of the disease.
When the individualized treatment plan is completed, the patient is placed on the Gamma Knife couch and is precisely positioned. The patient is then moved automatically, head first into the Gamma Knife and treatment begins. Treatment typically lasts from 15 minutes to an hour, during which time the patient feels nothing unusual. At the completion of the treatment the patient is automatically moved out of the Gamma Knife and the head frame is removed. The patient remains in the hospital for observation, usually being discharged the following morning.
How Is Gamma Knife Radiosurgery Performed?
- After administering local anesthesia and intravenous sedation, a stereotactic frame is attached to the patient's head.
- Next the head is imaged using a CT or MRI scanner while the patient wears the stereotactic frame. For vascular malformations, an angiogram is obtained as well.
- The patient returns to the Gamma Knife Center while a treatment plan is made.
- A treatment plan is developed by computer using the brain images. This is done by the coordinated efforts of the neurosurgeon, radiation oncologist and radiation physicist.
- The completed plan outlines the gamma ray dose and location within the brain for each treatment.
- The patient lies on the treatment bed of the Gamma Knife unit while the frame is affixed to the appropriate collimator which determines the size of the treatment.
- The treatment table is moved into the Gamma Knife where the patient rests for a few minutes during each painless treatment.
- Usually more than one treatment is given to completely cover the abnormal brain tissue. Between each treatment the patient is moved out of the Gamma Knife so minor adjustments in the stereotactic frame and collimator can be made.
- After Gamma Knife surgery the head frame is removed and the patient returns home
- Your physician will arrange periodic follow-up examinations and brain imaging to follow the effects of treatment.
What Is The Average Time Period For Getting Better?
The effects of Gamma Knife Radiosurgery occur over a period of time that can range from days to several years, depending on the type of medical condition treated. Some abnormalities dissolve gradually, eventually disappearing. Others simply exhibit no further growth.
May I Speak With A Gamma Knife Patient?
The Gamma Knife Center of the Pacific has successfully treated patients with a wide range of brain diseases. Many of them are happy to share their experiences with patients considering Gamma Knife Radiosurgery. The Center is pleased to accommodate prospective patients' requests for such contact.
If you would like us to put you in touch with a recent Gamma Knife patient, either send us an e-mail, or call us at the number listed at the bottom of this page.
Is The Treatment Cost Effective?
Cost studies have shown Gamma Knife Radiosurgery to be less expensive than conventional neurosurgery because it eliminates lengthy post-surgical hospital stays, expensive medication and sometimes months of rehabilitation. Importantly, there are virtually no post-surgical disability and convalescent costs with this procedure. Gamma Knife Radiosurgery is reimbursed by most insurance companies, PPO's, HMO's, and Medicare.
What Disorders Can The Gamma Knife Treat?
• Tumors within the head from a primary site elsewhere in the body: metastatic tumors.
• Tumors originating within the brain itself or its coverings: pituitary tumors, acoustic neuromas, certain gliomas and meningiomas, etc.
• Abnormal blood vessels: arteriovenous malformations.
• Also specific centers within the brain can be destroyed to treat pain, tremors and other functional disturbances.
What Are The Results Of Gamma Knife Surgery?
The majority of brain tumors selected for treatment will disappear or stop growing over time.
After one year 40% of arteriovenous malformations are cured increasing to 80% two years after treatment. The risk of spontaneous bleeding during this time is not more than untreated malformations.
What Are The Advantages Of Gamma Knife Surgery?
• Gamma Knife surgery is different from conventional radiation therapy of the brain because it is only directed to the target and spares unnecessary treatment of adjacent, normal brain.
• It differs because only a one day treatment is required rather than many treatments over several weeks and can be repeated if needed.
• It can be used in conjunction with conventional surgery as a boost and can be used in previously inoperable cases.
• Gamma Knife surgery can replace brain surgery in some patients with brain tumors and vascular malformations . . . ask your doctor about these options.
• An individual who would be at high risk for complications by conventional surgery may be a candidate for Gamma Knife surgery.
• It can be used when prior surgery or radiation therapy has failed to control the disease process.
• It can be used in conjunction with conventional surgery as a boost and can be used in cases previously considered inoperable.
• Cost effective.
• Bloodless, virtually painless, no loss of hair with rapid return to activities of every day living.
• Established effectiveness after 25 years of world wide experience with no reported mortality and few complications.
Are There Any Complications From Receiving Gamma Knife Surgery?
• local pain and swelling in the scalp
• skin reddening and irritation
• local loss of hair in superficial lesions
• local brain swelling in treatment site
• local necrosis in the treatment site
• visual loss (dependent on diagnosis)
• deafness (dependent on diagnosis)
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