Gamma Knife Radiosurgery

This publication provides an excellent overview of Japan's 20-year experience with stereotactic radiosurgery using the Leksell Gamma Knife. Leading experts discuss their long-term results with gamma knife radiosurgery. Studies focusing on dose selection for optimal treatment results and avoidance of complications are also presented. In addition, gamma knife treatments of extracranial pathologies are reviewed.

This publication aims to give comprehensive information on the methods of gamma knife radiosurgery and the results of treatment of the most frequent diagnoses using radiosurgery. A summarisation of existing knowledge and results obtained in gamma knife radiosurgery world-wide is based on experience with treatment of more than 13,500 patients over 20 years at Na Homolce Hospital, Prague. Besides detailing the basic data of Leksell gamma knife radiosurgery, this book also provides thorough technical description of former and existing gamma knife models, basic physics principles of gamma knife radiosurgery, calibration and quality assurance as well as standardised treatment procedures. The book is primarily intended for physicians, who, together with the patient decide on the most appropriate methods of treatment for each diagnosis. The publication can be also helpful to medical physicists who are involved in gamma knife radiosurgery and responsible for its calibration and quality assurance. Finally, it is also intended for patients who are looking for, if necessary, more comprehensive information on the radiosurgical treatment method for tumours and other brain disorders.

Since its introduction 52 years ago, Leksell radiosurgery has become a widely applied technique for the management of a diverse group of vascular, neoplastic, and functional disorders. This publication presents an update on state-of-the-art radiosurgery technology, including outcomes, by the pioneers in the field. Experts have contributed chapters on various topics. They provide a history of the development of Leksell Gamma Knife and its evolution from frame-based to the inclusion of mask-based radiosurgery in the latest Gamma Knife model. For beginners, there is valuable information related to imaging, quality assurance, patient care, anesthesia, and regulatory requirements. Advance users will appreciate the summary of the long-term outcome of important indications. Additional chapters on cavernous malformation, orbital, uveal, and ocular disorders clarify the role of radiosurgery. This book is a concise overview for physicians interested in radiosurgery. It will be of great value to neurosurgeons, radiation oncologists, and medical physicists concerned with learning about the indications of radiosurgery.

Gamma knife radiosurgery is a minimally-invasive treatment alternative for intracranial disorders, including tumors, vascular malformations, facial pain and epilepsy. This book will allow the reader to learn when gamma knife radiosurgery is appropriate and what to expect as treatment results.

An excellent summary of more than 30 years of accumulated experience Clinical outcomes of brain vascular malformation have been greatly improved by advances in microsurgery, endovascular techniques and stereotactic radiosurgery. Radiosurgery has proven to be the least invasive technique and is associated with documented long-term success. The papers in this volume present the experience of leading brain vascular malformation specialists who describe the outcome of radiosurgery for arteriovenous malformations, cavernous malformations and dural arteriovenous fistulas. These reviews expand the knowledge of the role of stereotactic radiosurgery alone or in combination with other treatment modalities. Evidence-based guidelines are included in each section to provide a summary of the current management strategies. This unique publication includes additional data that will further define the long-term benefit and risks of radiosurgery for these often complex vascular disorders and makes valuable reading for neurosurgeons, neurologists and endovascular specialists interested in an excellent summary of more than 30 years of accumulated experience in the management of brain vascular malformations.

This book attempts to combine many different threads into a comprehensible whole. Since the subject is the Gamma Knife and the author is a neurosurgeon, the field of clinical interest is restricted to intracranial pathology. The discipline of radiosurgery now applies to patients who may reasonably be referred by internists, neurologists, otolaryngologists, endocrinologists and several others. Some of the topics, touched upon, such as stereotaxy and the construction of a radio surgical instrument are unfamiliar to the majority of medical men. Other topics, such as those pertaining to the reactions between radiation and living tissue, are not exactly unfamiliar and yet, for most of us, they are not comfortable areas of expertise: in that we have some basic knowledge but not enough to draw conclusions and interpret. In particular, it is not easy to answer the very sensible questions that patients ask, when being considered for this particular form of treatment. The author has attempted to describe the basic relevant phenomenology in terms that should be readily understandable to a non-specialist physician. To do this, he has been heavily dependent on the expertise of a number of mathematically sophisticated collaborators, who have checked his manuscript. They are named in the acknowledgments section. The relevance of the different sections of this book will naturally be assessed differently, according to the experience and interest of the reader. To simplifY access to the information that is required, the book is divided into three main sections.

Today, over 500,000 patients have been treated world wide in 250 Gamma Knife Centres in 37 countries each one treating between 150 and 700 patients a year. The current book serves as a textbook, training manual and reference book for those involved in Gamma Knife practice covering the theoretical background, the practical aspects of treatment, the social side of the method and necessary information not only for users but for those who refer to the Gamma Knife. It also covers some aspects of the hospital and social administration required for optimal use of the technology, also looking at the effect of the internet on specialist medical practice. It also presents the completely new Gamma Knife (Perfexion), a new technology which extends the range of the Gamma Knife and will be the treatment standard for the future.

Gamma knife radiosurgery has grown continually in importance in recent years. However, there was a lack of established clinical and physical quality standards and a good knowledge of the possibilities of radiosurgical treatment for brain lesions. This book fills the gap by giving an overview of the current status of European gamma knife radiosurgery. Leading european experts report on their specialities in this field which is a state-of-the-art summary of the possibilities and results of their current work. The book encompasses all important as well as the more rare indications. All relevant technical and clinical quality standards are addressed. Tailored planning strategies are described for different indications. All professionals who care for patients with neurosurgical disease, such as neurosurgeons, radiosurgeons, radiologists, radiation oncologists and neurologists will find the book highly useful for the management of patients with benign and malignant brain lesions in a multidisciplinary setting.