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

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

3. Leksell Gamma Knife Perfexion

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

5. Collimator

6. What it looks likes

7. General Procedures
Head Frame
Imaging
Treatment Planning
Treat

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

9. 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

10. 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

11. 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

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

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

14. References
[1] Gamma Knife Overview. (2015, November 16). <
[2] Gamma Knife Sugery: Pros and Cons. (2015, November 16). <
[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. <
[4]Taban, A. (2015, November 14). A gamma knifre case study: Acoustic Neuroma. <
[5] Gamma Knifre Radiosurgery. (2015, November 14). <
[6]Niranjan, A. (2015, November 14). Gamma Knife Radiosurgery: Current Technique. <
[7] The Gamma Knifre: A Technical Overview. (2015, November 14). <
[8] MayoClinic: Brain Stereotactic radiosurgery. (2015, November 14). <
[9] RWJ University Hospital. (2015, November 16). Gamma Knife. <