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For more than 65 years localization of brain targets suitable for stereotactic radiosurgery has been performed after application of an intracranial guiding device to the cranial vault. After imaging and dose planning the same frame is used to secure the target at the focus of the intersection of the ionizing radiation beams that create the radiobiological effect. Non-invasive immobilization systems first proposed for linear accelerator or proton radiation technologies have now been developed for the Leksell Gamma Knife ICON radiosurgical system. The ICON technology adds a cone-beam computed tomography (CBCT) scan to the original Perfexion radiosurgical device in order to define the brain stereotactic space. Marketed since 2015, the ICON can be used for standard radiosurgical procedures, most of which remain frame based, but also coupled with a non-invasive thermoplastic mask for carefully selected patients who undergo standard single-session radiosurgical procedures, as well as multisession procedures using repeat mask fixation. Both at UPMC as well as worldwide, mask immobilization has to date been used for approximately 10% of patients with specific characteristics: relatively simple dose plans, short radiation delivery times, and non-anxious patients, most of whom have metastatic or primary brain cancers. In certain cases, multisession radiosurgery is also performed using the mask. The workflow of frame versus frameless procedures is often altered, and is reliant on high-definition imaging, mostly MRI, done prior to dose planning. Since each CBCT takes 10-12 min to set up and acquire, co-register, and review with the treatment plan, and two CBCT scans are necessary to initiate the treatment plan, this workflow must be added to the beam on time. Although frame-based immobilization remains the predominant method to secure target fixation for problems suitable for single-session radiosurgery, the advent of a mask immobilization technique has proven valuable for a select group of patients. It also provides a non-invasive method to perform multisession or fractionated radiation in patients for whom traditional single-session radiosurgery is not feasible.
This article was published in the following journal.
Name: Progress in neurological surgery
Frame-based stereotaxy is generally considered the gold standard for brain biopsies while frameless stereotaxy may expedite efficiency of clinical work flow. There are conflicting reports in the liter...
Leksell stereotactic radiosurgery has proven to be effective for less common tumors encountered in the brain, including hemangiomas of the orbit or cavernous sinus, recurrent hemangiopericytomas, and ...
Today, stereotactic radiosurgery is an effective therapy for a variety of intracranial pathology that were treated solely with open neurosurgery in the past. The technique was developed from the combi...
The outcome of patients with malignant gliomas has not substantially improved, even with advances in imaging, neurosurgery, molecular subtyping, and radiation, and newer oncologic options. Maximal saf...
Dose fall-off patterns with volumetric modulated arc therapy and three-dimensional conformal radiotherapy including the "organ at risk" effect. Experience of linear accelerator-based frameless radiosurgery from a single institution.
This study aimed to evaluate characteristics of dose fall-off pattern for linear accelerator based frameless stereotactic radiotherapy and radiosurgery using two different techniques, three-dimensiona...
The purpose of the present study is to compare the characteristics, i.e. efficacy, duration, safety and hospital stay, of a frameless fiducial-less brain biopsy method with those of the st...
The objective is to to compare 2 mm vs 0 mm PTV margins with respect to local PFS and risk of radionecrosis when treating intact brain metastases with LINAC-based frameless SRS
Stereotactic lesioning of thalamus and basal ganglia for treatment of tremor is a well-known procedure which, prior to the introduction of deep brain stimulation, or DBS, was usually achie...
This study is to establish a new, alternative stereotactic biopsy frame (AW frame) in the field of stereotactic neurosurgery.
RATIONALE: Stereotactic radiosurgery may be able to send x-rays directly to the tumor and cause less damage to normal tissue. Giving stereotactic radiosurgery after surgery may kill any tu...
A radiological stereotactic technique developed for cutting or destroying tissue by high doses of radiation in place of surgical incisions. It was originally developed for neurosurgery on structures in the brain and its use gradually spread to radiation surgery on extracranial structures as well. The usual rigid needles or probes of stereotactic surgery are replaced with beams of ionizing radiation directed toward a target so as to achieve local tissue destruction.
The time frame after a meal or FOOD INTAKE.
Producing a lesion in the posteroventral portion of the medial GLOBUS PALLIDUS to treat PARKINSON DISEASE and other extrapyramidal disorders. The placement of the lesion is aided by STEREOTACTIC TECHNIQUES and imaging procedures.
Therapy for MOVEMENT DISORDERS, especially PARKINSON DISEASE, that applies electricity via stereotactic implantation of ELECTRODES in specific areas of the BRAIN such as the THALAMUS. The electrodes are attached to a neurostimulator placed subcutaneously.
A pair of ophthalmic lenses in a frame or mounting which is supported by the nose and ears. The purpose is to aid or improve vision. It does not include goggles or nonprescription sun glasses for which EYE PROTECTIVE DEVICES is available.
Radiology is the branch of medicine that studies imaging of the body; X-ray (basic, angiography, barium swallows), ultrasound, MRI, CT and PET. These imaging techniques can be used to diagnose, but also to treat a range of conditions, by allowing visuali...