Radiosurgery and Pathological Fundamentals

G T Szeifert, D Kondziolka, M Levivier, L D Lunsford1-4051-1435-0

Table of contents :
Co-Editors……Page 6
List of Contributors……Page 7
Contents……Page 10
In Memoriam Prof. Lars Leksell (1907–1986)……Page 16
Acknowledgement……Page 17
Foreword……Page 18
Preface……Page 19
Prologue: Gamma Knife – The Early Story: Memoirs of a Privileged Man……Page 22
Snapshots……Page 26
(1) The Attachment……Page 27
(2) Individual Adjustments of Radiation Parameters……Page 28
(3) Treatment Nomogram……Page 30
Concluding Reflections……Page 31
References……Page 33
Abstract……Page 34
Historical Antecedents……Page 35
Pathological Fundamentals……Page 39
Conclusions……Page 44
Acknowledgement……Page 45
References……Page 46
Abstract……Page 49
The Effect of Dose Rate……Page 51
Experimental Laboratory Comparisons between Radiosurgery and Fractionation……Page 52
The Issue of Dose Homogeneity……Page 53
Benign Tumor Radiosurgery……Page 54
Vascular Effects……Page 55
Functional Radiosurgery……Page 56
Potential Pharmacologic Radioprotection for Radiosurgery……Page 57
References……Page 58
Basic Principles……Page 61
Treatment Planning and ‘Minimum’ Tumor Dose……Page 62
Early Dose-Volume Guidelines for Brain Tolerance……Page 63
Brain Tolerance Studies from AVM Radiosurgery……Page 65
Location Effects and AVM Radiosurgery Tolerance……Page 67
Cranial Nerve Tolerance to Radiosurgery……Page 68
The RTOG Phase I Maximum Tolerated Doses……Page 70
Target or Tumor Dose-Response Curves……Page 71
Functional Radiosurgery……Page 72
Arteriovenous Malformations……Page 73
References……Page 74
Abstract……Page 76
Ionizing Radiation……Page 77
Clinical Beams for Radiosurgery……Page 78
Radiosurgery Principles……Page 79
Dose-Volume Histograms and Indices……Page 81
References……Page 82
Gamma Knife Radiosurgery……Page 83
Charged-Particle Radiosurgery……Page 84
Gamma Knife (Models A, B, C, 4-C, and PFX®)……Page 85
Rotating Gamma System……Page 87
LINAC-Based Radiosurgery……Page 88
Charged Particle Radiosurgery……Page 89
Spinal and Body Radiosurgery……Page 90
Terms Used for Radiosurgery……Page 91
Radiosurgery Procedure……Page 92
Application of the Stereotactic Guiding Device……Page 93
Stereotactic MRI……Page 94
Stereotactic Angiography……Page 95
Techniques of Conformal Dose Planning……Page 96
Techniques of Stereotactic Radiation Delivery Using Gamma Knife……Page 97
References……Page 98
Abstract……Page 101
Materials and Methods……Page 102
Results……Page 104
Discussion……Page 106
References……Page 113
Abstract……Page 115
From Projections to Tomography……Page 116
Radiosurgery Treatment Planning……Page 117
Medical Data Managemen……Page 118
Radiosurgical Intervention Administration……Page 119
Treatment Data……Page 120
Statistics……Page 121
Conclusion……Page 122
References……Page 123
Abstract……Page 124
Patients and Methods……Page 125
Results……Page 126
Initial Studies……Page 132
Human Tissue Responses……Page 133
Human Tumors……Page 134
References……Page 135
Abstract……Page 139
What We Have Already Learned……Page 140
Detectability of Small METs on MR Images……Page 142
How Many Lesions Can Be Treated?……Page 143
Is GK Radiosurgery More Advantageous than WBRT?……Page 145
Can the Risk of Mental Changes Often Seen after WBRT Be Reduced?……Page 147
Radiosurgery as Postoperative Irradiation……Page 151
A Pitfall in Follow-Up after Radiosurgery……Page 152
Interpretation……Page 157
References……Page 159
The Swedish Experience……Page 162
The Pittsburgh Experience……Page 163
The Marseille Experience……Page 164
Hearing Preservation……Page 165
Nervus Intermedius Dysfunction……Page 166
Vestibular Symptoms……Page 167
Hydrocephalus……Page 168
Long-Term Complications……Page 169
Intracanalicular Schwannomas……Page 170
Cystic Ss……Page 171
Conclusion……Page 172
References……Page 173
Radiosurgery of Brain Tumors……Page 175
Radiosurgery Procedure……Page 176
Results……Page 178
Discussion……Page 180
References……Page 181
Abstract……Page 183
Materials and Methods……Page 184
Astrocytoma Grade 1……Page 185
Astrocytoma Grade 2……Page 186
Astrocytoma Grades 3 and 4……Page 187
Surgery……Page 191
Radiosurgery……Page 192
Treatment Outcomes……Page 194
References……Page 195
Abstract……Page 197
Patients and Methods……Page 198
Hormone-Producing Pituitary Adenomas……Page 199
Nonfunctional Pituitary Adenomas……Page 201
Discussion……Page 202
References……Page 203
Abstract……Page 205
Neuropathological Findings……Page 207
Discussion……Page 210
References……Page 211
Abstract……Page 213
Characteristics and Classification Based on Pathology……Page 214
Pathological Types……Page 215
A New Treatment Strategy……Page 217
Pathological Changes after Radiation Therapy……Page 221
Conclusion……Page 222
References……Page 223
Abstract……Page 225
The Role of the Gamma Knife……Page 226
Intraoperative Stereotactic Radiosurgical Imaging Techniques……Page 227
Nonacoustic Schwannomas……Page 228
Craniopharyngioma……Page 230
Hemangiomas……Page 231
Hemangioblastoma……Page 232
Chordoma and Chondrosarcoma……Page 233
Invasive Skull Base Cancers……Page 235
References……Page 236
Abstract……Page 239
Results……Page 240
Discussion……Page 241
Conclusions……Page 243
References……Page 244
Abstract……Page 245
Results……Page 246
Discussion……Page 249
References……Page 251
Abstract……Page 253
Radiosurgical Technique……Page 254
Follow-up……Page 256
Postradiosurgery Hemorrhage Rates……Page 257
Morbidity of Radiosurgery……Page 258
The Goal of Radiosurgery: Reduction in Hemorrhage Risk……Page 259
The Radiobiological Effect of Radiosurgery……Page 260
References……Page 261
Case History……Page 264
Pathological Findings……Page 265
References……Page 267
Abstract……Page 268
Historical Background of Radiosurgery for TN……Page 269
Radiosurgical Procedure……Page 270
Prognostic Factors of Pain Control……Page 271
Prognostic Factors of Pain Relief……Page 273
Future Improvement in Radiosurgery for TN……Page 274
References……Page 275
Abstract……Page 277
Case Report and Pathological Findings……Page 278
References……Page 280
Abstract……Page 282
The Gamma Knife and Dose Selection……Page 283
MRI and Target Planning……Page 284
Targeting the VIM Nucleus of the Thalamus……Page 285
Targeting the Globus Pallidus, Subthalamic, Caudate and VL Nuclei……Page 286
VIM Radiosurgical Thalamotomy……Page 287
Radiosurgical GPi Pallidotomy……Page 291
Radiosurgery for Torsion Spasm……Page 294
Discussion……Page 295
References……Page 297
The Marseille Historical Experience……Page 300
What Is the Target ? The Key Role of the Entorhinal Cortex……Page 305
Conclusion……Page 307
References……Page 308
Abstract……Page 312
Results……Page 313
Discussion……Page 317
References……Page 320
Abstract……Page 322
Neuroophthalmological Results……Page 323
Survival Periods……Page 325
Discussion……Page 327
References……Page 328
Abstract……Page 330
Results……Page 332
References……Page 334
Abstract……Page 336
Methods……Page 337
Results……Page 338
Discussion……Page 340
Conclusion……Page 342
References……Page 343
Abstract……Page 345
Patients and Methods……Page 347
Results……Page 348
Discussion……Page 352
References……Page 354
Abstract……Page 357
Method……Page 358
Uveal Melanomas……Page 361
Glaucoma……Page 364
Age-Related Macular Degeneration……Page 366
Rare Indications for Ophthalmic Radiosurgery……Page 368
Conclusion……Page 369
References……Page 370
Radiotherapy for Spinal Lesions……Page 373
Spinal Radiosurgery……Page 374
The CyberKnife System……Page 375
Indications for Spinal Radiosurgery……Page 378
Overview of the CyberKnife Treatment……Page 380
Face Mask and Fiducial Placement……Page 381
Treatment Planning……Page 383
Dose Prescriptions……Page 384
Treatment Delivery……Page 387
Conclusions……Page 389
References……Page 390
Abstract……Page 392
Investigations Seeking to Explore Focused Radiation as a Neurosurgical Tool……Page 393
Investigations into Effects of Dose and Time Latency of Normal Brain Radiosurgery……Page 394
Radiation Protection and Repair……Page 397
Radiation Potentiation……Page 399
Hippocampal Radiosurgery……Page 400
Trigeminal Neuralgia……Page 402
References……Page 404
Abstract……Page 408
Irradiation Procedure……Page 409
Maximal Potassium Response……Page 410
Potassium Dose Response Studies……Page 411
Pathological Observations……Page 412
Human AVM Tissue Cultures……Page 414
Discussion……Page 415
References……Page 418
Epilogue: The Future of Radiosurgery……Page 421
Author Index……Page 425
A……Page 426
C……Page 427
G……Page 428
M……Page 429
P……Page 430
T……Page 431
Y……Page 432