Gamma Knife Radiosurgery By Tou Hmong Khang Biomedical

Gamma Knife Radiosurgery By: Tou Hmong Khang Biomedical Engineering BME 281 Section 1

Background • Also known as Stereotactic Radiosurgery • Type of radiation treatment used commonly for brain tumors and other abnormalities of the head • Investigated in the 1950 s by Dr. Borje Larsson and Dr. Lars Leksell • First Gamma Knife device constructed in 1967 • Requires no incisions

Leksell Gamma Knife Perfexion

Device Operation • Focuses and delivers 192 beams to target tumor/lesion etc. • Collimator – 4 mm, 8 mm and 16 mm • Radiation only distorts and destroys abnormal cells • Long term affect

Collimator

What it looks likes

General Procedures • • Head Frame Imaging Treatment Planning Treat

Post Treatment • On average with in about a day • Back to normal activities • Receive Follow up appointments with Doctor

Case Study: Acoustic Neuroma • 75 -year-old woman • Left-sided tinnitus and progressive sensorineural hearing loss • MRI scans revealed 2. 7 cc left-sided enhancing mass • Acoustic Neuroma

Before and After Results • Treatment delivered in less than 1 hour • Returned to normal activities later that day • Semi-annual follow-up • Improvement of tinnitus, functional hearing in left ear • After three years, MRI reveals 0. 5 cc residual mass • Greater than 80% reduction in size

Cost of GKRS • GKRS vs Open Surgery • Across 3 years • Average 12 month cost of Open surgery – Brain metastases - $55, 938 – Acoustic Neuroma - $67, 538 – Arteriovenous Malformations (AVM) - $78, 332 • Average 12 month cost of GKRS – Brain metastases - $23, 069 – Acoustic Neuroma - $37, 840 – Arteriovenous Malformations (AVM) - $46, 293

Disadvantages • Small risk of advertise radiation affects(2 -4%) resulting in swelling • Common Early Complications • Rare Delayed Complications • Long term affects not ideal for immediate affects

Conclusion • Cost effective • Better alternative to open surgery • Possible whole body Gamma Knife Radiosurgery implementation

References • • • [1] Gamma Knife Overview. (2015, November 16). <http: //www. beaumontgammaknife. org/overview. html> [2] Gamma Knife Sugery: Pros and Cons. (2015, November 16). <http: //www. odec. ca/projects/2006/cham 6 m 2/prosandcons. html> [3] Caruso, JP, Moosa, S, Fezeu, F, Ramesh, A, Sheehan, JP. (2015, November 16). A cost comparative study of Gamma Knife radiosurgery versus open surgery for intracranial pathology. <http: //www. ncbi. nlm. nih. gov/pubmed/25444994> [4]Taban, A. (2015, November 14). A gamma knifre case study: Acoustic Neuroma. <http: //drashertaban. com/services -case-studies. php> [5] Gamma Knifre Radiosurgery. (2015, November 14). <http: //www. columbianeurosurgery. org/conditions/gammaknife-radiosurgery/> [6]Niranjan, A. (2015, November 14). Gamma Knife Radiosurgery: Current Technique. <http: //www. wfns. org/pages/read_the_reviews/97. php? rid=52> [7] The Gamma Knifre: A Technical Overview. (2015, November 14). <http: //www. medicine. virginia. edu/clinical/departments/neurosurgery/gammaknife/overview-page> [8] Mayo. Clinic: Brain Stereotactic radiosurgery. (2015, November 14). <http: //www. mayoclinic. org/testsprocedures/brain-stereotactic-radiosurgery/basics/definition/prc-20014760> [9] RWJ University Hospital. (2015, November 16). Gamma Knife. <http: //www. rwjuh. edu/gamma-knifecenter. aspx>