Gamma Knife® is a treatment method that uses radiation and computer-guided planning to treat brain tumors, vascular malformations and other abnormalities in the brain. Despite its name, this procedure does not involve any incisions, not even a skin incision. The Gamma Knife is actually a treatment that delivers intense doses of radiation to the targeted area while sparing surrounding tissue. About 192 "beams" of radiation are collected and precisely focused on the targeted area of the brain.
Gamma knife surgery is also known as stereotactic radiosurgery, gamma knife radiosurgery and gamma knife treatment.
Each gamma knife treatment can treat several brain diseases including: brain tumors including brain metastases, pituitary adenomas, pinealomas, craniopharyngiomas, meningiomas, chordomas, chondrosarcomas, and glial tumors.
The Gamma Knife may be useful if you have a brain lesion or tumor that cannot be reached by traditional surgical techniques, or if you cannot undergo surgery due to your condition or age. It can also be combined with traditional surgery.
Gamma knife treatment involves several steps.
The initial steps are different if the Gamma Knife system uses an external rigid head frame or uses a frameless mask. If it uses a head frame:
First, a box-shaped head frame is placed on your head. The head frame is made of aluminum and weighs less than two pounds. The head frame acts as a "frame of reference" when planning your treatment and is essential for keeping the target perfectly aligned during precision treatment. The neurosurgeon positions the frame.
You will receive four injections with local anesthesia, one on each side of the forehead and two in the back of the head. These are the areas where special pins are placed to secure the head frame to your skull. You may feel pressure while the pins are being tightened, but this usually only lasts a few minutes. Once the head frame is positioned, a radiation therapist will take measurements of your head. Usually an imaging scan, such as a CT or MRI scan, is done with the head frame in place. These measurements and scans are used to plan your treatment.
Gamma Knife frameless systems use a thermoplastic mask that is placed over your face. The mask is then attached to an existing frame on the Gamma Knife table. Your head is completely still.
You may have an intravenesone source inserted into your arm. This allows a contrast agent to be delivered for your computed tomography (CT) and/or magnetic resonance imaging (MRI) scan. These scans and staining determine the exact location, size, and shape of the tumor or lesion to be treated. The scan usually takes about 30 minutes.
The source can also be used to deliver a small amount of sedation to help you relax (if needed). Most patients are awake but under light sedation during the procedure. General anesthesia is used in certain circumstances (usually in children).
Based on the scan results and other information, your neurosurgeon, radiation oncologist, and other team members plan your treatment on a computer. They will determine the area(s) to treat, the radiation dose, and how to direct the beam for best results.
Your head frame or frameless mask is secured to the table frame with a gamma knife that you lie on so that your head does not move during treatment. The Gamma Knife table is slowly moved into the machine that delivers the radiation. The treatment team will be immediately outside the room while you are being treated, but you will be constantly monitored by cameras. There is a microphone near your head so you will be able to easily talk to the staff during treatment.
Most treatments take 30 minutes to three hours, depending on the size, shape and location of the lesion and the number of radiation doses.
Depending on the type and size of the tumor or lesion, more than one treatment session may be needed.
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