Radiosurgery

Gamma Knife radiosurgery allows for the destruction of a brain lesions without cutting the skin. By focusing many small beams of of radiation on abnormal brain tissue the abnormality can be destroyed while preserving the normal surrounding structures.

In order to precisely localize the abnormality, a stereotactic frame is fastened to the patients head. A set of localizing markers are attached to the frame.

With all of this in place, the patient undergoes a CT scan, and/or an MRI.

The neurosurgeon then uses the digitally transformed images from the CT/MRI to outline the tumor or lesion as well as the critical or eloquent structures of the surrounding brain. He then devises a unique and specific treatment plan to target the tumor. This involves using isocenters of various sizes to shape the lesion. The more complex the shape of the tumor, the more isocenters will be used. The treatment plan is then reviewed and refined with the radiation oncologist and physicist, who also decide the radiation dose to be delivered.

The Gamma Knife uses 201 narrow beam Cobalt 60 sources all aimed at a common focal point. When the intracranial abnormality is placed at this focal point it can be effectively destroyed.

The point where the radiation beams converge is spherical in shape and is referred to as the "isocenter". The abnormal brain tissue frequently has an irregular shape. The neurosurgeon uses one or a number of isocenters of varying size, intensity and location to properly cover the abnormality while sparing normal tissue.

Conditions treatable with Gamma Knife Radiosurgery include: metastatic brain tumors, arteriovenous malformations, acoustic neuromas, meningiomas, pituitary adenomas, and tic doulouroux (trigeminal neuralgia). Patients with malignant tumors, including gliomas and astrocytomas, may also be candidates for Gamma Knife treatment . Sometimes the Gamma Knife is used along with conventional surgery or as a boost in traditional radiotherapy. There are times when conventional surgery is preferred over Gamma Knife for these indications. The neurosurgeon will know the best form of management for each case.

The Gamma Knife is not an experimental procedure. More than 100,000 procedures have been performed and it is recognized by most insurance carriers including Medicare.

The Gamma Knife procedure is performed routinely on an outpatient basis. There is no need for an incision or general anesthesia. The procedure, including application of the frame, treatment planning and treatment takes anywhere from 2-4 hours. For the patient, much of this time is spent waiting after the CT/MRI while the dose plan is formulated.

The Gamma Knife was brought to Western New York largely through the efforts of the Director of Buffalo Neurosurgery Group, Douglas B. Moreland, MD in cooperation with Roswell Park Cancer Institute and other area physicians. Dr. Moreland performs procedures at the Gamma Knife Center where he is Program Director.

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