Gamma Knife® FAQs


This article presents an overview of the most frequently asked questions about Gamma Knife® radiosurgery, an innovative form of treatment for conditions in the brain and spine. This will be of use to anyone who is considering treatment with Gamma Knife®.

Contents

What is Gamma Knife®?

The Gamma Knife® is a machine designed to deliver radiation in a very precise manner by targeting hundreds of pinpointed beams of radiation directly at the tumour. This is a non-invasive and non-surgical treatment for brain conditions.

What is special about Gamma Knife®?

Gamma Knife® is an innovative treatment and, despite the name, does not involve surgery or knives. Although it is state-of-the-art technology it has stood the test of time since the late 1960s when the prototype was first used. Gamma Knife® allows the traditional beam radiation, which is delivered to patients with tumours, to be administered as a day case procedure. This is in contrast to conventional radiotherapy which involves radiation being administered in small doses over weeks.

What can Gamma Knife® treat?

Gamma Knife® can be used to treat the following conditions in the head and neck (please click on the links for more information). For radiosurgery below the neck alternatives include CyberKnife® or TrueBeam.

Please note that Gamma Knife® would not normally be used to treat tumours greater than 3.5cm in diameter or large vascular malformations. Primary brain tumours such as astrocytomas and glioblastoma multiforme are generally not suitable for primary treatment with radiosurgery but Gamma Knife® is sometimes used as a boost therapy after conventional treatment has been given.

What does a typical Gamma Knife® treatment consist of?

  • The day starts at 07:30 at St Barts Hospital, London in the MRI department. A consent form will be signed by the patient to allow us to proceed with the radiosurgery.
  • Local anaesthetic will be injected into the scalp to allow fixation of an aluminium frame to the skull using 4 titanium tipped screws. This provides a fixed reference to allow the computer software to determine the location of the target within the head with an accuracy of around 1mm.
  • An MRI scan is then taken with the frame in position to provide the dataset needed for the software dose planning
  • The patient is then taken to the Gamma Knife Centre and waits for the dose planning to be completed and checked before the treatment is given
  • The required total dose of radiation needed to treat the problem is selected and the treatment plan ‘signed off’. The Gamma Knife® surgery is given, in a treatment time determined by the size of the target and the total dose of radiation needed. Usually this involves less than one hour of treatment after which the frame is removed.
  • The patient is normally discharged within an hour of the end of treatment but some will be advised to stay in hospital overnight.

Following the treatment a follow-up is usually carried out by the referring doctor, who may be one of the treating clinicians. This usually involves a brief check after six weeks to ensure that there have been no undue side effects and then normally involves MRI scans at intervals to check on the results of treatment.

A medication that reduces sensation. Full medical glossary

An AVM or arteriovenous malformation forms when arteries connect directly to veins. This direct connection forms a high-pressure shunt or fistula. The veins are not able to handle the pressure of the blood coming directly from the arteries. The veins stretch and enlarge to create a “nidus”. Usually there are multiple feeding vessels in an AVM and many draining veins.

Full medical glossary

An AVM or arteriovenous malformation forms when arteries connect directly to veins. This direct connection forms a high-pressure shunt or fistula. The veins are not able to handle the pressure of the blood coming directly from the arteries. The veins stretch and enlarge to create a “nidus”. Usually there are multiple feeding vessels in an AVM and many draining veins.

Full medical glossary
Relating to the brain. Full medical glossary
The basic unit of genetic material carried on chromosomes. Full medical glossary
Normally fully termed Glioblastoma multiforme is a highly aggressive and malignant form of brain tumour that stems from the glial cells Full medical glossary
A large abdominal organ that has many important roles including the production of bile and clotting factors, detoxification, and the metabolism of proteins, carbohydrates and fats. Full medical glossary
Secondary tumours’ that result from the spread of a malignant tumour to other parts of the body. Full medical glossary
An abbreviation for magnetic resonance imaging, a technique for imaging the body that uses electromagnetic waves and a strong magnetic field. Full medical glossary
Pain caused by irritation of or damage to a nerve. Full medical glossary
Non-cancerous tumour of nerve tissues. Full medical glossary
Any test or technique that does not involve penetration of the skin. The term 'non-invasive' may also describe tumours that do not invade surrounding tissues. Full medical glossary
A craving to eat non-food substances such as earth or coal. Full medical glossary
A gland deep in the brain that produces several hormones controlling the production of other hormones throughout the body Full medical glossary
Energy in the form of waves or particles, including radio waves, X-rays and gamma rays. Full medical glossary
The treatment of disease using radiation. Full medical glossary
An abnormal swelling. Full medical glossary
Relating to blood vessels. Full medical glossary
Relating to the veins. Full medical glossary