The linear accelerator can perform radiosurgery on larger tumors in a single session or during multiple sessions, which is called fractionated stereotactic radiotherapy. The radiation therapist can observe the patient through a window or on a closed-circuit television and is able to communicate with the patient throughout the procedure.

Is there any special preparation needed for the procedure ?

Prior to the procedure, you may be given a special shampoo with which to wash your hair.
Stereotactic Radiosurgery In India At Low Price
What is stereotactic radiosurgery and how is it used ?

Stereotactic radiosurgery is a highly precise form of radiation therapy used primarily to treat tumors and other abnormalities of the brain. Unlike the Gamma Knife, which remains motionless during the procedure, part of the LINAC machine called a gantry rotates around the patient, delivering radiation beams from different angles. There is no pain or discomfort from the actual treatment. The radiation therapy nurse provides the patient with information about the treatment and possible adverse reactions. The bed you are lying on will move backward into the treatment area. Compared to the Gamma Knife, the LINAC is able to use a larger x-ray beam, which enables it to treat larger tumors more uniformly and with less repositioning.

Next, you will be taken to an imaging area where a computed tomography (CT) scan and/or magnetic resonance imaging (MRI) will be performed to show the exact location of the tumor in relation to the head frame.

During the next phase, you will be able to relax for an hour or two while your treatment team performs a computer-aided treatment plan that will optimally radiate the tumor.


What equipment is used ?

There are three basic forms of stereotactic radiosurgery, each of which uses different instruments Granulator Knife and sources of radiation: Gamma Knife, which uses 201 beams of highly focused gamma rays.

Next, you will lie down on the Gamma Knife bed where your physician will describe the number and length of treatments to expect. You will not be able to see, feel or hear the x-rays.
You are allergic to intravenous contrast material, shellfish, or iodine. An intravenous (IV) line may be inserted into your arm for any necessary medications. The total treatment may last two to four hours. Radiosurgery delivers radiation in single high doses that conform closely to the tumor shape, and fall off sharply at the edge of the tumor.


Radiosurgery versus Radiotherapy

Radiosurgery is a form of radiotherapy.

Stereotactic radiosurgery works in the same way as other forms of radiation treatment. Once your treatment is completed, your head frame will be removed. You may receive medications to help you relax and to prevent dehydration.

Who operates the equipment ?

The multidisciplinary team, including the radiation oncologist, medical physicist and dosimetrist, plan and prescribe the appropriate treatment dose and delivery. It does not actually remove the tumor; rather, it distorts the DNA of tumor cells.
You have a pacemaker, artificial heart valve, defibrillator, brain aneurysm clips, implanted pumps or chemotherapy ports, neurostimulators, eye or ear implants, stents, coils or filters. Additionally, radiosurgery is used to treat arteriovenous malformations (AVMs), a tangle of expanded blood vessels that disrupts normal blood flow in the brain and is the leading cause of stroke in young people. As the head frame is pinned to your skull, you will feel pressure or tightness that typically disappears within 15 minutes. Treatments can typically be done in a single session. You will be able to talk to your physician through a microphone in the helmet and a camera will allow the team to see you at all times. A highly trained radiation therapist positions the patient on the treatment table and operates the Pressure Bar machine.

Radiosurgery treatments are similar to having an x-ray. Despite its name, stereotactic radiosurgery is a non-surgical procedure that uses highly focused x-rays to treat certain types of tumors, inoperable lesions and as a post-operative treatment to eliminate any leftover tumor tissue or to obliterate abnormal blood vessels in congenital arteriovernous malformations. Multiple manufacturers make this type of machine, which have brand names such as Peacock, X-Knife, CyberKnife, Clinac. A dosimetrist, under the supervision of the physicist, calculates the exposures and beam configurations necessary to deliver the dose prescribed by the radiation oncologist. This is referred to as stereotactic radiotherapy. Before the neurosurgeon positions and attaches your head frame, you will be injected with a local anesthetic in the front and back of your head to numb your scalp.

Radiosurgery Using the Linear Accelerator

Linear accelerator (LINAC) radiosurgery is similar to the Gamma Knife procedure and its four phases: head frame placement, imaging, computerized dose planning and radiation delivery. You will need to have a family member or other support person accompany you, remain with you at the treatment facility, and drive you home afterward. If you experience pain for other reasons, such as back pain or discomfort from the head frame, you should let your doctor or nurse know. The radiation therapist is responsible for operating the radiosurgical equipment from a protected area nearby. You will be asked not to eat or drink anything after midnight on the night before your treatment. These shots are only slightly uncomfortable and will help to minimize the discomfort of the head frame. The radiation oncologist and neurosurgeon oversee treatment and interpret the results of radiosurgical procedures. As a result, these cells lose their ability to reproduce. Particle beam (proton) or cyclotronis in limited use in North America, though the number of centers offering proton therapy has increased dramatically in the last several years. For some patients with large tumors, the target is divided into smaller targets, each of which is treated with high doses in separate daily sessions.

In the first phase, a box-shaped head frame is attached to your skull using specially designed pins to keep your head from moving until the treatment session is finished.
Stereotactic radiosurgery was once limited to brain tumors, but today it may be used to treat other diseases and conditions, including : -


This lightweight aluminum head frame is a guiding device that makes sure the Gamma Knife beams are focused exactly where the treatment is needed. You may hear a chime at this point and a click as the helmet locks into the radiation source.

On treatment day, you will be asked to remove all jewelry, makeup (including nail polish) hairpieces, contact lenses, eyeglasses and dentures.


What will I feel during and after the procedure ?

A nurse will place a small needle in your hand or arm to give medications, if needed, and a contrast material. You may experience nausea and/or a headache and can ask for medication to help make you feel more comfortable. Malignant and metastatic tumors may shrink more rapidly, even within a couple of months.

Stereotactic radiosurgery is an important alternative to invasive surgery, especially for tumors and blood vessel abnormalities located deep within or close to vital areas of the brain. Your head frame will then be attached to a helmet that has several hundred holes in it to allow individual rays of radiation to target specific areas of the brain. Because of its incredible accuracy, the Gamma Knife is ideal for treating small to medium size lesions. However, be prepared to spend up to 16 hours in the hospital. Radiosurgery is used to treat many types of brain tumors, both benign or malignant and primary or metastatic.

When the head frame is removed, there may be some minor bleeding from the pin sites that will be bandaged. See the Linear Accelerator page for more information. Both deliver radiation but use different means and doses to minimize the risk of radiation damage to healthy tissue.

The treatment involves the delivery of a single high-dose-or sometimes smaller, multiple doses-of radiation beams that converge on the specific area of the brain where the tumor or other abnormality resides.

Linear accelerator (LINAC) machines, prevalent throughout the world, deliver high-energy x-ray photons or electrons in curving paths around the patient's head.

Standard radiotherapy delivers small daily doses of radiation in multiple treatment sessions over several weeks.

Stereotactic radiosurgery is usually performed on an outpatient basis.

The treatment team will then go to another room so that your treatment can begin.

Who will be involved in this procedure ?

The treatment team is comprised of a number of specialized medical professionals, typically including a radiation oncologist, neurosurgeon, medical radiation physicist, dosimetrist, radiation therapist, radiation therapy nurse, and neurologist or neuro-oncologist.
You should also tell your physician if any of the following apply to you : -

�You are taking medications by mouth or insulin to control diabetes.
�You suffer from claustrophobia.

Although stereotactic radiosurgery is often completed in a one-day session, physicians sometimes recommend a fractionated treatment, in which treatments are given over a period of days or weeks. When treated with radiosurgery, arteriovenous malformations (AVMs) begin to thicken and close off. You will be asked to change into a gown for your procedure. See the Gamma Knife page for more information. You should ask your physician what to do about taking any normal medications on the day of your treatment and bring those medications with you to the procedure. Following the treatment, benign tumors usually shrink over a period of 18 months to two years.


How is the procedure performed ?

Stereotactic Radiosurgery Using the Gamma Knife

Gamma Knife radiosurgery involves four phases: placement of the head frame, imaging of tumor location, computerized dose planning, and radiation delivery. Using a helmet-like device that keeps the head completely still and three-dimensional computer-aided planning software, stereotactic radiosurgery minimizes the amount of radiation to healthy brain tissue. When the treatment is complete, the bed will return to its original position.

The radiation oncologist, a specially trained physician who heads the treatment team, sets an individualized course of treatment with the help of the medical radiation physicist, who ensures the delivery of the precise radiation dose