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Stereotactic Radiosurgery (SRS) is a form of radiation therapy that uses a targeted beam of radiation to treat tumors, other brain abnormalities, and other body parts. Unlike traditional invasive surgery and radiation therapy, the SRS method aims to deliver high doses of radiation to specific affected areas. This method of radiation is highly effective because it spares the surrounding tissues and only kills the infected tissues in the targeted area.

This procedure aims to destroy the affected cells or tumors while minimizing the damage caused to healthy tissue. It is achieved through advanced imaging technologies like CT, and MRI scans to locate the tumor and guide the radiation beam to the targeted area.

It is used to treat conditions like:

–      Both benign and malignant brain tumor

–      Spinal tumor

–      Arteriovenous malformations (AVMs) or abnormal blood vessels in the brain

–      Painful conditions that affect the trigeminal nerve

Effects of Stereotactic Radiosurgery

The effects of Stereotactic Radiosurgery are very straightforward and evident. However, like other procedures, this, too, has certain side effects. The side effects of SRS can vary depending on the tumor’s location or abnormality being treated, as well as other factors such as the patient’s age and overall health. However, some common side effects include:

–      Fatigue: Once the procedure is done, many patients experience fatigue that can last for several weeks

–      Headache: Some patients experience headaches after SRS, which can be managed with medication.

–      Nausea: It is a common side effect of Stereotactic Radiosurgery, which can also be managed with medication

–      Hair loss: Some patients may experience temporary hair loss at the radiation site.

–      Brian swelling: In some cases, where the treatment procedures are performed for longer hours, patients experience brain swelling, but it can be managed with medications.

It’s important to note that the side effects of SRS are typically temporary and subside within a few weeks or months.

Benefits of SRS

One of the main benefits of SRS is its precision. By delivering a high radiation dose to a specific area, SRS can effectively treat the tumor or abnormality while minimizing damage to surrounding healthy tissue. This is particularly important for tumors or abnormalities that are located in sensitive areas of the brain or spine.

The procedure has lower risks when compared to traditional invasive surgery methods. For example, SRS does not carry the risk of infection or bleeding associated with traditional surgery. It is also a good option for patients whose body does not support traditional surgical methods.

Conclusion

Stereotactic Radiosurgery is a highly precise and effective form of radiation therapy that can treat various conditions, including brain tumors, spinal tumors, AVMs, and trigeminal neuralgia. It offers many benefits over traditional surgery, with a lower risk of complications.

The Gamma Knife and the CyberKnife Surgery are two popular forms of stereotactic radiosurgery to treat abnormal growths and problems in the brain and the spine. Both these techniques are non-invasive methods to treat brain tumors, lesions, and other growths in the brain and spine. While they both use advanced technology to deliver high doses of radiation to the targeted area, there are key differences between the two treatments that patients should be aware of before making a decision.

This article will mention the critical differences between GammaKnife and CyberKnife procedures.

Procedure

Gamma knife uses a single, high-intensity radiation beam focused on the targeted areas that use a fixed frame attached to the patient’s head during the treatment.

The CyberKnife procedure uses multiple beams of radiation delivered from different angles. The high precision of the procedure demands an automated robotic arm that can adjust the patient’s movements, even during the procedure,

Treatment Duration

Gamma Knife treatment typically takes between one and four hours, depending on the size and location of the targeted area. However, CyberKnife treatment can take longer, with some treatments lasting up to five hours.

Side-effects

Both Gamma Knife and CyberKnife have relatively low rates of side effects, but the side effects that do occur can vary between the two treatments. Gamma Knife patients may experience swelling and discomfort at the site of the frame, while CyberKnife patients may experience fatigue and skin irritation at the radiation site.

These are the only possible side effects of the treatment. If a patient experiences any other side effects, they must contact their medical expert immediately.

Cost of treatment

The cost of Gamma Knife and CyberKnife will differ depending on several factors, including the location of the treatment center and the patient’s insurance coverage, and many more. Gamma Knife tends to be more expensive than CyberKnife, but this can vary depending on the individual case.

Accuracy of treatment

Gamma Knife and CyberKnife are highly accurate treatments that can precisely target tumors and other abnormalities. However, CyberKnife has been shown to have a slightly higher degree of accuracy than Gamma Knife due to its ability to adjust to the patient’s movements during treatment.

Recovery time

Gamma Knife and CyberKnife have relatively short recovery times, with most patients returning to normal activities within a few days. However, some patients may experience fatigue or other side effects that can affect their ability to perform certain tasks.

Treatment suitability

If the patient has smaller and well-defined abnormalities in the brain, it is best to choose the Gamma Knife procedure. But for patients with large and irregular tumors, the CyberKnife radiation procedure is preferred. CyberKnife may also be a good option for patients who cannot undergo traditional surgery due to medical conditions or other factors.

Bottom Line

Gamma Knife and CyberKnife are effective forms of non-invasive radiosurgery that can treat abnormalities and tumors in the brain and spine. While they share similarities, the key differences mentioned above should be considered to make an informed decision about the treatment procedures.

CyberKnife and Gamma Knife are advanced, state-of-the-art radiosurgery systems that treat cancerous and non-cancerous tumors. They also are effective treatments for vascular lesions and functional disorders, such as arteriovenous malformations (AVMs) and trigeminal neuralgia. There are multiple types of CyberKnife and Gamma Knife treatments, which we have discussed in this article, along with how it works.

How does Gamma Knife work?

The Gamma Knife delivers high-intensity beams of radiation to the brain. These beams target and kill cancer cells while minimizing damage to healthy tissues. The Gamma Knife is designed to treat multiple tumors and metastases simultaneously in a single session, making it the ideal solution for patients with brain cancer or other related brain conditions that require rapid resolution.

The gamma knife uses hundreds of beams to deliver a high dose of radiation to the targeted tumor. These beams are delivered to the target with extreme precision, using sub-millimeter accuracy. The machine’s streamlined design minimizes the chance of mechanical error resulting in side effects and other issues.

How does Gamma Knife Treatments Work?

You will go to a dedicated, private room in the hospital, where you’ll lie down on a sliding table. You will then be fitted with a special helmet called a collimator helmet, which has 201 holes that allow radiation beams to pass through it in a precise pattern. This allows the system to deliver high-dose radiation to your brain in a small, focused area and helps limit any side effects from the treatment.

To ensure that your brain receives the highest dose of radiation possible, your doctor will ensure you’re positioned in the best position for the gamma knife to reach your tumor. This can be accomplished through imaging that is done days or weeks before the gamma knife treatment.

During imaging, your doctor will use CT or MRI scans to create an accurate image of your brain tumor. This information will be used to map out your radiation plan so that the radiation can be directed to the correct location and the surrounding healthy tissue is spared.

Once inside the Gamma Knife, your head will be placed into a metal head frame bolted to your skull. You cannot move during the treatment, which can take up to several hours. You may hear a clicking sound as the helmet moves into place.

The Gamma knife uses a computer-controlled device to deliver multiple, focused radiation beams to your brain. Unlike other types of radiation, the Gamma knife is extremely precise. This technology also limits the amount of radiation that can reach normal tissue around your tumor, resulting in less risk of side effects and less pain after treatment.

How Gamma Knife Therapy Works?

Unlike other LINACs, the Gamma Knife treatment is completed on the same day as the imaging. This enables your doctors to keep your treatment plans up to date, so they can consider any changes in your condition since the last time you had imaging.

Symptoms of a brain tumor depend on the type and location of the tumor. Symptoms may develop suddenly or gradually over time. They can be caused by the tumor growing or increased pressure inside your skull. They also can be a sign of other health problems, such as an infection or blood clot.

Types of Brain Tumors

Primary brain tumors, such as meningiomas and gliomas, are benign (non-cancerous) and typically don’t spread to surrounding tissue. They tend to respond well to treatment.

Malignant brain tumors, such as glioblastomas and astrocytomas, are aggressive (malignant) and can be life-threatening. They often grow quickly and require more intensive treatment.

Secondary (metastatic) brain tumors occur when cancer cells that have started elsewhere in the body spread (metastasize) to the brain. These tumors are most common in adults and tend to occur in people with a cancer history.

Symptoms

The most common symptom of a brain tumor is headaches. They can range from mild to severe and may be accompanied by other neurological symptoms such as nausea or vomiting. They can also affect vision and cause loss of coordination or balance.

Usually, pain caused by a brain tumor is worse when you wake up or breathe in and out through your mouth. It can also be more severe when you cough or strain. Some brain tumors can also make you lose your sense of smell.

Some types of brain tumors can cause problems with your vision. These symptoms may include drooping eyelids, blurred or double vision, loss of peripheral (side) vision, and difficulty seeing objects clearly.

Often, these symptoms occur when the tumor is in the area of the brain that controls movement and balance. You may even have trouble speaking or walking.

Diagnosing process

If you have a brain tumor, visit your GP or call an ambulance immediately. They will check you for other possible causes of your symptoms and refer you to a specialist for a proper diagnosis. If you have a brain tumor and your doctor suspects it could be cancer, they will do a biopsy to look for any cancer cells in the tissue sample removed.

MRI or CT scan

These tests can show a tumor in detail. They use a special type of x-ray called magnetic resonance imaging (MRI) or a computerized tomography (CT) scan to map your brain and determine the exact position of the tumor. A contrast agent that makes the tumor easier to see is injected into a vein (intravenously) before the test.

Other tests

Your doctor will ask you to keep a diary of your symptoms and any other signs or changes suggesting you have a brain tumor. These notes can help your doctor determine the type, size, and location of the tumor, which is essential for treating it effectively.

Tumor markers

Brain tumors release certain substances that can be checked in a laboratory to confirm your diagnosis. These markers are often found in high concentrations in the tumor tissue.

Gamma Knife Treatment is a safe, effective radiation therapy to shrink and prevent the growth of tumors or other lesions. It uses high-energy gamma rays to precisely target cancerous and noncancerous brain and spinal cord lesions, avoiding the normal surrounding healthy tissue.

Your doctor will review your condition and determine whether or not you are a good candidate for Gamma Knife treatment. If you are, you will be scheduled for an appointment with a neurosurgeon and a radiation oncologist. Each physician will take your medical history, perform a physical exam and obtain your consent to treat you with the Gamma Knife.

The procedure of Gamma Knife Treatment

The Gamma Knife procedure involves the attachment of a lightweight frame to your head and using local anesthesia. The frame is secured to your head at four points with pins. The anesthesia reduces any discomfort.

Building treatment plan

Following the anesthesia, you will undergo imaging studies such as magnetic resonance imaging (MRI) scans or angiography to help the doctors locate your lesion and plan the radiosurgical procedure. The data from these studies are transferred to a computer program that will guide the entire Gamma Knife treatment.

Process of treatment

Once your treatment plan is completed, you will lie down on the treatment table. A special helmet called a collimator helmet may be fitted over your head. It has 201 holes that allow the beams of radiation to pass through it in a precise pattern determined by the computer.

After the helmet is in place, the treatment table will slide into the Gamma Knife unit. The machine will then start producing radiation beams targeting your brain lesion.

You will remain awake during the procedure and be able to communicate with the Gamma Knife team through an audio and video connection. Your care team will always monitor your vital signs and provide you with pain and sedative medications as needed.

Your treatment will last a few minutes to a few hours, depending on the size and location of your brain tumor or other lesions. Most patients return home after the procedure. Some patients stay in the hospital for observation overnight, but this is rare.

Follow up after the treatment

Follow-up is essential after Gamma Knife radiosurgery because the effects of treatment occur over weeks or months. This means you must regularly see your healthcare provider for follow-up imaging.

Side effects

For some patients, side effects are mild and transient. These include a headache, numbness in the scalp, or other minor swellings around the pin sites. The numbness and swelling will gradually disappear after a few weeks.

Some patients notice temporary numbness or tingling of the scalp after Gamma Knife treatment, but this is a normal and transient sensation that will disappear in a few days. The doctor will also prescribe medication for nausea or head pain if necessary.

Recovery time

The recovery time after Gamma Knife treatment is minimal compared to surgery or other radiosurgery. This is because the beams of radiation are tightly focused on your lesion, which causes little or no damage to the surrounding tissue.

Children with brain tumors face a variety of treatment options depending on the type, grade, size, and location of the tumor. Some brain tumors are treated with surgery, while others are cured by radiation or chemotherapy. Your child’s doctor will work closely with other physicians to develop a customized plan for your child’s unique situation.

Surgery

Surgery (extirpation) is often the best option for many children with brain tumors. This is especially true for a brain tumor located in a difficult place to access. At MD Anderson’s Children’s Cancer Hospital, neurosurgeons use leading-edge equipment to help remove as much of the tumor as possible without damaging other brain parts.

Surgical extirpation is a highly effective treatment for some types of childhood brain tumors, such as low-grade glioma and high-grade glioma. For other types, such as medulloblastoma, surgery can be combined with other therapies, including radiation and chemotherapy.

Radiation therapy

Radiation therapy is a treatment that uses radioactive material to kill cancer cells, especially those that have spread to other areas of the body. The radiation dose may be delivered in one treatment, called a single fraction, or across several treatments, called multifractions.

Side effects of radiation therapy are mild, and most go away after the treatment is finished. However, some long-term side effects of radiation therapy include memory and hormonal problems and cognitive changes, such as difficulty understanding complex tasks.

Chemotherapy

Chemotherapy is the use of drugs that destroy tumor cells or slow their growth and reproduction. The drugs are given with or after radiation and surgery to decrease the chances of a tumor returning.

Immunotherapy

Other medications are used to treat a brain tumor when it has spread or is not responding to radiation and chemotherapy, such as immunotherapy. This includes drugs like ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda).

Immunotherapy is a new treatment that uses medication to stimulate the immune system’s ability to fight off tumors. It boosts the body’s natural defenses, such as T-cells and macrophages.

Stereotactic radiosurgery

Stereotactic radiosurgery is a type of radiation therapy that uses beams to target only the tumor in the brain, minimizing the risk of damage to other parts of the body. It is recommended for people with 1 to 4 brain tumors that are causing symptoms.

Whole brain radiation therapy

Whole-brain radiation therapy is a type of treatment that can be given to the entire brain, or it may be an option if other types of radiation therapy aren’t successful. It is usually used for people with up to 4 brain metastases and is more common in people in relatively good health who have had surgery to remove the tumors.

To sum it up

Your child’s doctor will talk with you about the benefits and risks of different medications, which are continually being tested. It is also essential to know that some medications can interact with other medicines, herbs, and supplements. These interactions can cause unwanted side effects or reduce the effectiveness of the drug.

Gamma knife surgery is a non-intrusive, computer-guided procedure that uses high-focused beams of radiation to eliminate masseuses and lesions in the brain. It is one of the most modern techniques to deal with arteriovenous malfunctions, acoustic neuroma, trigeminal neuralgia, and different forms of brain tumors. The procedure is popularly called stereotactic radiosurgery.

Unlike the traditional invasive procedure, this does not require surgeons to make incisions in the brain and skull but uses radiation to kill abnormal tissues and tumors in the brain.

Gamma Knife surgery definition

The procedure does not include a knife to many skulls or skin incisions despite the name. Instead, it requires high beams of radiation focused at a particular point to burn the infected cells and tissues. Approximately 192 beamlets of radiation are used under the targeted brain region, sparing the normal tissues surrounding it. As mentioned above, the procedure can cure several brain abnormalities, including the following:

• Malignant and non-malignant brain tumors like meningiomas, chondrosarcomas, glial tumors, pituitary adenomas, metastases, and craniopharyngiomas
• Acoustic neuroma is a non-cancerous growth around the hearing and balancing neurons that connect the brain with the inner ear.
• Arteriovenous malformations, which are typically tangles of blood vessels
• Tremors from Parkinson’s disease, essential tremors, and more
• Different types of epilepsy
• Trigeminal neuralgia

It is one of the best procedures when traditional brain surgery methods are not feasible for a particular condition.

The procedure of Gamma Knife surgery

The process involves the following steps:

• Frame placement: The patient is given a head frame secured to the skull using pins and scores. Keeping the head in place is essential to target the radiation in the right area.
• Imaging: MRI and CT scans are performed to get a detailed image of the brain and the affected area. This helps in treatment planning.
• Treatment planning: Depending on the condition and type of disease, the medical team uses specialized software to plan a treatment procedure. In this step, professionals also determine the exact amount of radiation that needs to be targeted to the affected area.
• Treatment: Once the procedure is drafted, the patient is positioned under the Gamma knife machine, and the radiation beams are targeted to the specific area of the brain. Depending on the size and intensity of the tumor, it can take anywhere from a few minutes to a few houses.

Gamma Knife surgery risks

Although the procured is mostly considered safe, like other medical procedures, this too carries some risks:

• Swelling and bleeding in the brain
• Vomiting and nausea
• Hair loss
• Headache
• Seizures
• Cognitive changes
• Fatigue

Gamma Knife surgery outcome

The procedure’s outcome and success factor depend on the location and type of brain disorder under study. The procedure has a high success rate, especially in treating brain tumors and AVMs. Patients also experience minimal discomfort after the procedure, and many will return to normal activities a few days after the procedure. However, it is not a cure for all types of brain disorders, and follow-up will be required in most cases.

Contrary to the term Knife in Gamma Knife Surgery, it is a non-invasive procedure that is mainly performed on patients undergoing treatment for brain cancer. The tiny beam of radiation penetrates through the brain’s cells to destroy the affected cells, keeping healthy cells intact.

According to medical reports and success stories, the procedure has a success rate of 90% in shrinking tumor cells and stopping their growth. It is the best radiosurgery for:

• Brain cancer
• Benign brain tumors
• Metastatic brain tumors
• Arteriovenous Malformation or other brain abnormalities
• Facial pain

Destroying brain tumors using gamma knife surgery

Gamma Knife surgery, also called stereotactic surgery, uses one or more 3-D positioning tools to shoot radiation doses to the affected area. This kills the affected cells in the area without causing pain or discomfort to the patient.

This is done by fixing a frame over the patient’s head to pinpoint the exact location and keep their head in position. Then, by carefully examining the patient’s condition and the intensity of treatment needed, a team of radiation oncologists, neurosurgeons, and radiation physicists plan the amount of radiation needed to treat the lesion or decrease the shape of the tumor.

Once the amount of radiation is decided, the gamma knife machine aims hundreds of tiny radiation beams at the affected spot since each beam is weak to damage the affected cell by itself. Hence, hundreds of beams meet at a spot, and their combination helps in destroying diseased cells or tissues.

Since the procedure guaranty accuracy, it is recommended for patients to receive a full radiation dose in a single session. Although the procedure lasts for a couple of hours, the results of it will unfold after many months.

What conditions does the procedure treat?

Here is a list of conditions/diseases treated by the procedure:

• Brain cancer
• Astrocytomas
• Skull base tumors
• Metastatic brain tumor
• Acoustic neuromas
• Meningiomas
• Pituitary tumors
• Brain abnormalities
• Trigeminal neuralgia
• Dyskinesia
• Essential tremor
• Parkinson’s diseases

Oncologists also recommend gamma knife procedure for patients with one or more of the following conditions:

• Patients with brain tumors where it difficult to reach the affected area through traditional surgical methods.
• When the tumors are close to critical areas like the optic nerve or the brain stem
• Patients who are not healthy to have a brain surgery
• Patients who have a history of brain tumors and traditional surgery has not worked
• Patients already undergoing chemo or radiation therapy for cancer
• Patients whose cancer has recurred after previous radiations

Over the years, there has been a massive improvement in the medical industry with different equipment made with precision to treat dangerous diseases like cancers and complicated surgeries. One such treatment is the Gamma Knife radiation therapy, mainly used to treat brain abnormalities and tumors. This painless, non-invasive procedure does not require incision or hospitalization and is used to treat acoustic tremors, neuroma, trigeminal neuralgia, arteriovenous formations, and other serious tumors.

Treatment using gamma knife therapy

This treatment method mainly focuses on targeting abnormal brain cells and gradually destroying them with the help of solid beams of radiation. The therapy uses a radiation machine equipped with 201 different beams emitting gamma rays and is directly targeted to the area of the tumor from various angles. This method is exact, delivers high accuracy, and targets the problem-causing cells without damaging the other tissues surrounding it.

The procedure is done on an outpatient basis and typically requires a few hours. Although no medication is needed during the procedure, a local anesthetic might be given to numb the pain area. It is also called stereotactic radiosurgery or Gamma knife radiosurgery. A patient usually takes a nap or listens to music during the procedure.

After gamma knife surgery

Generally, after the treatment, the area subjected to radiation is cleaned with a chemical called hydrogen peroxide, followed by the application of an antibiotic where other bandages are applied to the area. However, some patients might experience nausea, which medication can treat. After the procedure, the patient is kept under observation for 30 minutes to an hour before discharge.

Most patients might experience some swelling or pressure within the head, which can be cured by placing the head in an elevated position for up to a week.

Benefits of gamma knife procedure

Compared to invasive surgeries, this procedure is followed by many benefits.

• Does not require an incision in the brain or on the scalp
• Targets all the lesions and tumors, even the ones located deep snide the brain, that traditional surgery methods can reach.
• Targets multiple tumors at the same time
• No risk of complications from surgery
• Does not damage the surrounding tissues and muscles
• No post-operative discomfort or other problems
• Patients can return to their everyday life in a day or two.

Aside from the benefits mentioned above, the procedure’s success rate depends on various factors like the type of tumor, its location, the patient’s medical history, and so on.

One of the primary aims of the procedure is to shrink the tumor site significantly or entirely and prevent it from reappearing in the body. However, the effects of this procedure can be seen after 2 – 6 months.

A brain tumor is a mass of abnormal cells that grows in the brain or spine. Brain tumors are most often found in adults, but they can also occur in children and teens. They’re usually managed by your primary care doctor, who will refer you to a specialist if necessary.

Types of Brain Tumors

There are two types of brain tumors: benign and malignant.

• Benign tumors grow slowly, do not spread to other body parts, and rarely cause death.
• Malignant tumors grow quickly, spread from the original site to other parts of the body through the blood or lymphatic system, and can be fatal.

Symptoms and Signs

Brain tumors can cause a variety of symptoms and signs. The most common are headaches, nausea and vomiting, numbness or weakness in the face, arms, or legs; difficulty speaking, seizures; personality changes; memory loss; problems with balance and walking.

Causes of Brain Tumors

Brain tumors develop because of the following factors:

Genetic factors. The cause of brain tumors is not well understood, but some types are associated with a family history of cancer.

Radiation. High doses of radiation can increase your risk for certain types of brain tumors, especially if you’re exposed to them during childhood or adolescence when the brain is still developing and growing rapidly.

Chemicals. Certain chemicals used in manufacturing and industrial processes have been linked to an increased risk for certain types of brain tumors; these include asbestos (used in insulation), vinyl chloride (used in plastics), arsenic and chromium compounds (used in metal production).

Diagnosis of Brain Tumors

CT scan: A CT scan is a type of X-ray, or imaging test, that uses a computer to create detailed pictures of the inside of your body.

MRI: An MRI uses magnetic fields and radio waves to make pictures of the brain and spinal cord. The images show soft tissues like tumors or cysts, blood vessel abnormalities (aneurysms), and other conditions that affect the nervous system.

PET scan: A positron emission tomography (PET) scan combines a special tracer injected into your vein with a scanner that detects its location within your body by following its path inside you over time for about 45 minutes after injection until the tracer reaches its highest concentration within any one organ system (for example, brain tissue) before being eliminated from circulation through urine excretion.

The Prognosis for Brain Tumor Patients

The prognosis for a patient with a brain tumor will depend on the type of tumor, as well as its location within the brain. Tumors that are slow growing and do not spread to other parts of the body generally have a better prognosis than tumors that grow quickly or are malignant (cancerous).

The prognosis for benign tumors: Benign tumors are more likely to be successfully treated with surgery alone. Patients who have had surgery for benign tumors may experience symptoms related to their condition after treatment, such as headaches or seizures.

Prognosis for malignant tumors: Malignant (cancerous) tumors require different care depending on where they occur in your body. If you need radiation therapy or chemotherapy after surgery, these treatments will help reduce your risk of recurrence (new growth).

Patients need to understand the symptoms of this condition so they can seek medical attention as soon as possible if they suspect something might be wrong with their brain or spinal cord.