GAMMA KNIFE RADIOSURGERY Edited by David Mathieu Gamma Knife Radiosurgery Edited by David Mathieu Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. 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DepositPhotos First published December, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Gamma Knife Radiosurgery, Edited by David Mathieu p. cm. ISBN 978-953-307-888-5 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Neoplastic Disorders 1 Chapter 1 Outcomes Following Gamma Knife for Metastases 3 Henry S. Park, James B. Yu, Jonathan P.S. Knisely and Veronica L.S. Chiang Chapter 2 Gamma Knife Treatment for Patient Harboring Brain Metastases: How to Estimate Patient Eligibility and Survival? 29 José Lorenzoni, Adrián Zárate, Raúl de Ramón, Leonardo Badínez, Francisco Bova and Claudio Lühr Chapter 3 Radiosurgical Treatment of Intracranial Meningiomas: Update 2011. 45 M. Gerosa, R. Foroni, M. Longhi, A. De Simone, F. Alessandrini, P. Meneghelli, B. Bonetti, C. Ghimenton, T. Sava, S. Dall'Oglio, A. Talacchi, C. Cavedon, F. Sala, R. Damante, F. Pioli, S. Maluta and A. Nicolato Chapter 4 Gamma Knife Radiosurgery for the Vestibular Schwannomas, Technical Considerations and Hydrocephalus as a Complication 59 Sung Kyoo Hwang, Kisoo Park, Dong Hyun Lee, Seong Hyun Park, Jaechan Park and Jeong Hyun Hwang Chapter 5 Gamma Knife Radiosurgery in the Management of Unusual Grade I/II Primitive Neuroepithelial Tumours of the Brain 73 A. Nicolato, M. Longhi, R. Foroni, F. Alessandrini, A. De Simone, C. Ghimenton, A. De Carlo, P. Mirtuono and M. Gerosa VI Contents Part 2 Functional and Vascular Disorders 101 Chapter 6 Clinical, Anatomo-Radiological and Dosimetric Features Influencing Pain Outcome After Gamma Knife Treatment of Trigeminal Neuralgia 103 José Lorenzoni, Adrián Zárate, Raúl de Ramón, Leonardo Badínez, Francisco Bova and Claudio Lühr Chapter 7 Advanced Gamma Knife Treatment Planning of Epilepsy 123 Andrew Hwang and Lijun Ma Chapter 8 Hemorrhage from Arteriovenous Malformation Following Gamma Knife Radiosurgery: Pathophysiology of Rupture Early in the Latency Period 133 Juanita M. Celix, James G. Douglas and Robert Goodkin Part 3 Basic Science 155 Chapter 9 Applications of Gamma Knife Radiosurgery for Experimental Investigations in Small Animal Models 157 Gabriel Charest, Benoit Paquette and David Mathieu Preface In the past 25 years, gamma knife radiosurgery has evolved from a tool that was seen as a curiosity to a minimally-invasive neurosurgical treatment modality that is now a recognized alternative to conventional microsurgery or fractionated radiation therapy. Radiosurgery training is now implemented in most neurosurgical residency training program. The literature on the subjected has exploded in the past few years, with literally hundreds of papers being published annually on this topic. As physicians and patients become increasingly aware of the benefits of gamma knife radiosurgery, it is important that information is readily available when it is needed. That is the purpose of this book, which covers some of the most common indications for which gamma knife radiosurgery is performed. The first section of the book is dedicated to tumor radiosurgery. Brain metastases are now the most common tumors treated by gamma knife radiosurgery. Two chapters are devoted to this topic. Other chapters report the treatment results for meningiomas and vestibular schwannomas, the most frequent benign intracranial tumors treated by radiosurgery, and another is devoted to the treatment of rarer tumors. The second section covers benign non tumoral indications of radiosurgery, with chapters devoted to trigeminal neuralgia, epilepsy, and arteriovenous malformations. Finally, the last chapter reports on the use of the gamma knife as a tool for preclinical research. I hope that the information provided in the book will improve the knowledge on the many applications and uses of gamma knife radiosurgery, and allow more patients worldwide to benefit from this treatment modality when appropriate. David Mathieu, M.D., F.R.C.S.(C) University of Sherbrooke, Faculty of Medicine and Health Sciences, Department of Surgery, Division of Neurosurgery, Department of Nuclear Medicine and Radiobiology, Sherbrooke, Quebec, Canada [...]... (2008) Boost radiosurgery for treatment of brain metastases after surgical resections Surg Neurol, Vol 69, No 2, pp 181-186, ISSN 0090-3019 Jagannathan, J.; Yen, C.; Ray, D.; et al (2009) Gamma Knife radiosurgery to the surgical cavity following resection of brain metastases J Neurosurg, Vol 111, No 3, pp 431438, ISSN 0022-3085 Jawahar, A.; Willis, B.; Smith, D.; et al (2002) Gamma Knife radiosurgery. .. Clin Oncol, Vol 24, No 8, pp 1295-1304, ISSN 0732-183X Kim, C.; Im, Y.; Nam, D.; et al (2008) Gamma Knife radiosurgery for ten or more brain metastases J Korean Neurosurg Soc, Vol 44, No 6, pp 358-363, 1225-8245 Outcomes Following Gamma Knife for Metastases 23 Kim, P.; Ellis, T.; Stieber, V.; et al (2006) Gamma Knife surgery targeting the resection cavity of brain metastasis that has progressed after... of cerebral metastases from breast cancer with stereotactic radiosurgery Strahlenther Onkol, Vol 180,No 9, pp 590-596, ISSN 0179-7158 Outcomes Following Gamma Knife for Metastases 21 Datta, R.; Jawahar, A.; Ampil, F.; et al (2004) Survival in relation to radiotherapeutic modality for brain metastasis: whole brain irradiation vs Gamma Knife radiosurgery Am J Clin Oncol, Vol 27, No 4, pp 420-424, ISSN... Powell, J.; Chung, C.; Shah, H.; et al (2008) Gamma Knife surgery in the management of radioresistant brain metastases in high-risk patients with melanoma, renal cell carcinoma, and sarcoma J Neurosurg, Vol 109 (Supplement), pp 122-128, ISSN 0022-3085 26 Gamma Knife Radiosurgery Quigley, M.; Fuhrer, R.; Karlovits, S.; et al (2008) Single session stereotactic radiosurgery boost to the post-operative site... Kato, N.; et al (2007) Neurocognitive function of patients with brain metastasis who received either whole brain radiotherapy plus stereotactic radiosurgery or radiosurgery alone Int J Radiat Oncol Biol Phys, Vol 68, No 5, pp 1388-1395, ISSN 0360-3016 20 Gamma Knife Radiosurgery Armstrong, C.; Corn, B.; Ruffer, J.; et al (2000) Radiotherapeutic effects on brain function: double dissociation of memory systems... specialties resulted in the development of stereotactic radiosurgery (SRS), which is a method to deliver a single, highdose fraction of ionizing radiation treatment to a precisely defined focal target volume Gamma Knife radiosurgery (GK-SRS), initially developed by Lars Leksell and Borje Larsson (Leksell, 1951), delivers treatment using multiple gamma radiation beams from Cobalt-60 sources that simultaneously... Kreth, F.; Horstmann, G.; et al (1999) Surgery and radiotherapy compared with Gamma Knife radiosurgery in the treatment of solitary cerebral metastases of small diameter J Neurosurg, Vol 91, No 1, pp 35-43, ISSN 0022-3085 Muacevic, A.; Wowra, B.; Siefert, A.; et al (2008) Microsurgery plus whole brain irradiation versus Gamma Knife surgery alone for treatment of single metastases to the brain: a randomized... with brainstem metastases undergoing stereotactic radiosurgery Neurosurgery, Epub ahead of print (April 2011), ISSN 0148-396X Hoffman, R.; Sneed, P.; McDermott, M.; et al (2001) Radiosurgery for brain metastases from primary lung carcinoma Cancer J, Vol 7, No 2, pp 121-131, ISSN 1528-9117 Hwang, S.; Abozed, M.; Hale, A.; et al (2010) Adjuvant Gamma Knife radiosurgery following surgical resection of brain... stereotactic radiosurgery versus microsurgery in the treatment of single brain metastases Acta Neurochir, Vol 142, No 6, ISSN 0001-6268 Serizawa, T.; Iuchi, T.; Ono, J.; et al (2000) Gamma Knife treatment for multiple metastatic brain tumors compared with whole-brain radiation therapy J Neurosurg Vol 93, No 3 (Supplement), pp 32-36, ISSN 0022-3085 Serizawa, T., Hirai, T.; Nagano, O.; et al (2010) Gamma Knife. .. Oncol Biol Phys, Vol 39, No 1, pp 571-574, ISSN 0360-3016 Nam, T.; Lee, J.; Jung, Y.; et al (2005) Gamma Knife surgery for brain metastases in patients harboring four or more lesions: survival and prognostic factors J Neurosurg, Vol 102 (Supplement), pp 147-150, ISSN 0022-3085 Outcomes Following Gamma Knife for Metastases 25 Nieder, C.; Spanne, O.; Mehta, M.; et al (2010) Presentation, patterns of care, . which gamma knife radiosurgery is performed. The first section of the book is dedicated to tumor radiosurgery. Brain metastases are now the most common tumors treated by gamma knife radiosurgery. . GAMMA KNIFE RADIOSURGERY Edited by David Mathieu Gamma Knife Radiosurgery Edited by David Mathieu Published. use of the gamma knife as a tool for preclinical research. I hope that the information provided in the book will improve the knowledge on the many applications and uses of gamma knife radiosurgery,