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RadiosurgeryThis page contains recent news articles, when available, and an overview of Radiosurgery but does not offer medical advice. You should contact your physician with regard to any health issues or concerns.News: Radiosurgery MarketWatch (press release)We have developed the first and only commercially available intelligent robotic radiosurgery system, the CyberKnife system, designed to treat solid tumors Alliance Imaging to Present at the UBS Global Healthcare Services ... - 06 Feb 2009 MarketWatch (press release)The Company also operated 18 radiation therapy centers and stereotactic radiosurgery facilities (two radiation therapy centers are in unconsolidated joint Ireland should market its healthcare - 06 Feb 2009 Irish Medical Times,...“At the time there was a new treatment called stereotactic radiosurgery, which they were experimenting with it in Sheffield, so I ended up going there. Neurosurgery Journal Issues Supplement Dedicated to CyberKnife ... - Jan 30, 2009 PR Newswire (press release),The supplement, titled "CyberKnife Stereotactic Robotic Radiosurgery" features 15 papers from seven different countries, focused on brain and spine Neurosurgery Journal Issues Supplement Dedicated to CyberKnife ... - Feb 1, 2009 dBusinessNews San Jose (press release),SUNNYVALE -- Accuray Incorporated , a global leader in the field of radiosurgery, announced today that Neurosurgery, the official journal of the Congress of Impact of collimator leaf width and treatment technique on ... - Jan 21, 2009 7thSpace Interactive (press release),For the brain and liver groups, both the radiosurgery MLC and the IMRT technique contributed to the dose sparing of organs-at-risk(OARs), as dose in the Accuray, Inc. F2Q09 (Qtr End 12/27/08) Earnings Call Transcript - Jan 29, 2009 Seeking Alpha,Moving onto our clinical programs, there continues to be tremendous interest from the medical community in CyberKnife radiosurgery treatments. Radical cyberknife radiosurgery with tumor tracking: an effective ... - Jan 16, 2009 7thSpace Interactive (press release),ObjectiveCurative surgery is not an option for many patients with clinical stage I non-small-cell lung carcinoma (NSCLC), but radical radiosurgery may be Varian Medical Systems and BrainLAB to Showcase Novalis Tx(TM ... - Jan 26, 2009 PR Newswire (press release),The Novalis Tx(TM) platform from Varian Medical Systems (NYSE: VAR) and BrainLAB enables doctors to perform image-guided radiosurgery on tumors of the lung, Advanced body radiosurgery can bring new hope for patients with ... - Jan 27, 2009 Business Intelligence Middle East (press release),Varian Medical Systems and BrainLAB announced today the new outpatient high-precision radiosurgery platform Novalis Tx with Adaptive Gating, during a press Accuray Incorporated to Report Second Quarter Fiscal Year 2009 ... - Jan 14, 2009 PR Newswire (press release),The CyberKnife Robotic Radiosurgery System is the world's only robotic radiosurgery system designed to treat tumors anywhere in the body non-invasively. Upland gamma knife center is first for region - Feb 3, 2009 San Bernardino Sun,He also has a private practice in pediatric neurosurgery in Orange and performs radiosurgery with the gamma knife on adults and children. Varian Medical Systems Announces Net Orders Growth Estimates for ... - Jan 12, 2009 PR Newswire (press release),...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, Broward Health is South Florida’s First Hospital System to Offer ... - Jan 23, 2009 PRLog.Org (press release),...“This non-invasive treatment allows tumors to be tracked in real-time, thereby potentially offering the best whole-body radiosurgery solution for our South Wife’s death spurs eBay auction - Jan 12, 2009 Lismore Northern Star,CyberKnife radiosurgery uses image-guided robotics to target and destroy tumours and lesions with beams of high-energy radiation. US-based company, Accuray, Varian Medical Systems Reports Results for First Quarter of Fiscal ... - Jan 29, 2009 SYS-CON Media,...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, Research and Markets: In-Depth Research Now Available for ... - Feb 4, 2009 Trading Markets (press release),Australia 11 Neurostimulation Devices In Australia 12 Neurosurgical Products (Neuroendoscopes) In Australia 13 Radiosurgery In Australia 14 Medtronic, Varian Medical Systems: Top Belgian Cancer Center Becomes First in ... - Feb 4, 2009 Trading Markets (press release),...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, Elekta: Revolutionary Treatment Option Offers New Hope To Russian ... - Feb 2, 2009 Medical News Today (press release),This definitely helps to streamline clinicians' workflow, ultimately saving precious time," says Dr. Olga Efimova, NRIBCP's Head of Radiosurgery. Cancer centers rejected CULPEPER'S PLANS - Jan 30, 2009 The Free Lance-Star,The rejected projects would have added two linear accelerators and other treatment options, such as stereotactic radiosurgery, an advanced technology not Davis: Learning to play the cards we're dealt - Feb 1, 2009 Kentucky.com,She had survived weeks of radiation and chemotherapy, and had undergone an experimental non-invasive procedure called CyberKnife Robotic Radiosurgery System “Bad bank� delay sparks slide; GDP upside tainted; worst Jan. ever ... - Jan 30, 2009 SmallCapInvestorOn the upside, radiosurgery firm Accuray Inc. (Nasdaq:ARAY) rose 22% after reporting quarterly results. Looking at the chart picture, small caps left a Ride the Health Care Wave with Accuray (Nasdaq: ARAY) - Feb 3, 2009 Contrarian Profits,...growth plus strong installation and shipment numbers for the quarter, reflecting an expanding demand for our CyberKnife Robotic Radiosurgery System. REMINDER: Live Webcast of a Minimally Invasive Lumbar Discectomy ... - Jan 28, 2009 SYS-CON Media,He has lectured nationally and internationally on minimally invasive spine surgery and stereotactic radiosurgery. He is currently involved in multicenter SmallCapReview - Small Cap Stocks Headed North - AMOR, CYBS - Jan 30, 2009 TransWorldNews (press release),What They Do: Accuray Incorporated is a global leader in the field of radiosurgery dedicated to providing an improved quality of life and a non-surgical Bristol Family YMCA To Operate Wellness Center - Jan 23, 2009 TriCities.com,It was the first hospital in the region to offer the CyberKnife Stereotactic Radiosurgery System, a digital cardiac catheterization lab and a Primary Stroke A Fast, New Cancer Fighting Tool Is Now Available in the Houston ... - Jan 26, 2009 PR Newswire (press release),...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, Elekta: Cancer Patients in Sweden and Estonia Receive Faster, More ... - Jan 27, 2009 WELT ONLINE,Hospital in Estonia invest in advanced radiotherapy systems from Elekta, a world leader in radiation therapy and radiosurgery treatment solutions. What are the symptoms of trigeminal neuralgia? - Jan 21, 2009 guardian.co.uk,Stereotactic radiosurgery for trigeminal neuralgia using the gamma knife. Available at http://www.nice.org.uk/guidance/index.jsp?action=byID&o=11103 Neurosurgeon appointed Assistant Clinical Professor, New York ... - Jan 16, 2009 Norwalk Plus MagazineDr. Sanderson is certified in BrainLab Stereotactic Radiosurgery as well as Charite Lumbar Arthroplasty. He has also been awarded certification in the use Cutting edge cancer treatment arrives on Tucson's east side - Jan 13, 2009 KOLD-TV,It's called stereotactic radiosurgery, and originally machines like the Novalis Tx were used only for brain tumors. But, with better targeting systems, Trinitas Comprehensive Cancer Center Now Offering Cancer Patients ... - Jan 13, 2009 PR Newswire (press release),...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, Elekta Has Received Approval for Elekta Compact™ in China - Jan 12, 2009 WELT ONLINE,The company develops sophisticated state of the art tools and treatment planning systems for radiation therapy and radiosurgery, as well as workflow Finer focus - Jan 26, 2009 The Engineer,The Cyberknife, which will begin treating patients next month at the private Harley Street Clinic in London, is a robot radiosurgery machine designed to United States: Oncology - 2009 Outlook - Jan 21, 2009 Mondaq News Alerts (registration),Additionally, stereotactic radiosurgery (SRS) is becoming more clinically accepted as the preferred treatment modality for smaller soft tissue tumors, Devizes undertaker's revolutionary cancer treatment - Jan 20, 2009 This is Wiltshire.co.uk,The CyberKnife system is a robot that performs radiosurgery using radiation to destroy tumours in a painless, non-surgical way. By combining a robotic arm Device lines up for small-field dosimetry - Jan 20, 2009 Medical Physics Web (subscription),At the extreme, stereotactic radiotherapy and radiosurgery typically use field sizes of less than 4 cm, and at times as small as 5 mm. News > Unternehmensnachrichten > Alliance Imaging Announces Name ... - Jan 20, 2009 Ad-Hoc-News (Pressemitteilung),The Company also operated 18 radiation therapy centers and stereotactic radiosurgery facilities (two radiation therapy centers are in unconsolidated joint Resolute Ruth refuses to give up fight - Jan 16, 2009 Bridgwater Mercury,She wants others to benefit from the frameless robotic radiosurgery machine's ability to treat cancer, tumours, legions and other illnesses. Monte Carlo optimizes AMD radiotherapy - Jan 12, 2009 Medical Physics Web (subscription),Oraya devised PORT specifically for stereotactic kilovoltage radiosurgery of the eye. The system delivers dose via a fine-collimated photon beam of up to North Shore Radiation Therapy in New York Performing 4-Dimensional ... - Jan 12, 2009 PR-Inside.com (Pressemitteilung),SRS (Stereotactic Radiosurgery), RapidArc, Prostate Brachytherapy, MammoSite and Contura Breast Brachytherapy along with Gynecological Brachytherapy. Elekta: Revolutionary Treatment Option Offers New Hope to Russian ... - Jan 30, 2009 StreetInsider.com (subscription),This definitely helps to streamline clinicians' workflow, ultimately saving precious time," says Dr. Olga Efimova, NRIBCP's Head of Radiosurgery. Good Samaritan Hospital Among Top Five Percent in Nation According ... - Jan 27, 2009 PR-Inside.com (Pressemitteilung),Good Samaritan Hospital offers Cardiology and Cardiothoracic Surgery, Neurosciences program featuring the Gamma Knife radiosurgery, Oncology Program, Varian Medical Systems: Estonian Cancer Patients Have Access to ... - Jan 15, 2009 Trading Markets (press release),...is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, Background information on Radiosurgery [When available] Radiosurgery is a medical procedure which allows non-invasive brain surgery, i.e., without actually opening the skull, by means of directed beams of ionizing radiation. It is a relatively recent technique (1951), which is used to destroy, by means of a precise dosage of radiation, intracranial tumors and other lesions that could be otherwise inaccessible or inadequate for open surgery. There are many nervous diseases for which conventional surgical treatment is difficult or has many deleterious consequences for the patient, due to arteries, nerves, and other vital structures being damaged. Definition and applications Radiosurgeons make use of highly sophisticated, highly precise and complex instruments, such as stereotactic devices, linear accelerators, computers and laser beams. In the last 20 years, radiosurgery has been used as a first approach, by exclusion or failure of other techniques or as supplements to them, such as other kinds of brain surgery, chemotherapy and radiotherapy. The highly precise irradiation of targets within the brain is planned by the surgeon with basis on images, such as computed tomography (CT), magnetic resonance imaging (MRI), and angiography of the brain. The radiation is applied coming from an external source, under precise mechanical orientation by a specialized apparatus. Multiple beams are directed (collimated) and centered at the intracranial lesion to be treated. In this way, healthy tissues around the target are preserved. Patients can be treated within one day of hospital stay, or even as outpatients. By comparison, the average hospital stay for a craniotomy (conventional neurosurgery, requiring the opening of the skull) is about 15 days. Radiosurgery costs about the same as a conventional surgery, but it avoids mortality, pain and post-surgical complications, such as hemorrhage and infection. The period of recovery is minimal, and in the day following the treatment the patient may return to his or her normal life style, without any discomfort. Thus, the community gains many socio-economical benefits. The major disadvantage of radiosurgery in relation to open surgery (craniotomy) it is the duration of time required to achieve the desired effects, while its non-invasive character is perhaps its major advantage. Radiosurgery has arisen as the result of many scientific developments which have occurred in the fields of neuroimaging and stereotactic surgery, continue to expand its application areas in neurosurgery, oncology (cancer), surgery of head and neck, and other specialties. History Radiosurgery started with Dr. Lars Leksell from the Karolinska Institute of Stockholm, Sweden, in 1959, in a joint development with Bjorn Larsson, a radiobiologist from Uppsala University. Leksell initially used heavy particles, protons from a to irradiate brain tumor lesions. In 1968, they developed the "gamma knife", a new device exclusively for radiosurgery, which consisted of radioactive sources of Cobalt-60 placed in a kind of helmet with central channels for irradiation, using gamma rays. In the last version of this device, 201 sources of radioactive cobalt direct gamma radiation to the center of a helmet, where the patient's head is inserted. In order to achieve high precision in the positioning of the patient's head, it is placed first on a rigid frame of reference called a stereotactic device. It uses a geometrical coordinate system for each structure of the brain, so the surgeon knows, by using a published atlas, precisely the point where the gamma rays must converge. The stereotactic frame then fits into the helmet. The "Gamma-knife" is used nowadays in four continents for carrying out what is called functional stereotactic neurosurgery, and for the superselective irradiation of tumors and brain arteriovenous malformations. Another type of radiosurgery which has enjoyed great dissemination in neurosurgery was introduced by Betti and Colombo, in the mid 80's, utilizing commercial medical linear accelerators available for radiation therapy in oncology (the so-called LinAc). High energy, narrowly focused beams of x-rays are employed. This system differs from the Gamma Knife in the way the radiation beams are delivered to the patient's head. In a similar way, a stereotactic device is used to provide a geometric coordinates reference, but the radiation beams are emitted by a single source, which rotates slowly around the patient's head. Finally, at some medical centers such as in Boston and in California, particle accelerators built for doing research in high energy physics have been used since the 1960's for the treatment of brain tumors and brain arteriovenous malformations in humans. A still experimental type of radiosurgery, that utilizes a nuclear reactor for the nuclear fission of uranium, is the Neutron Capture Therapy (NCT) which was started in the United States at the nuclear reactor of the Massachusetts Institute of Technology (MIT) in the 60's, with promising results. Nowadays it is carried out as a promising advanced clinical research in several countries, due to the progress and to the results obtained in Japan by Dr. Hiroshi Hatanaka. He used NCT in more than 100 cases in the treatment of malignant tumors and of gigantic arterio-venous malformations. How it works The fundamental principle of radiosurgery is that of selective ionization of the tissue to be operated upon, by means of high-energy beams of radiation. Ionization is the production of inorganic ions which are usually deleterious to the cells, by forming free radicals that are harmful to the cellular and nuclear membranes, and even to the RNA and DNA chains of the cells, producing an irreparable damage to these structures and then the cell's death. Thus, biological inactivation is carried out in a volume of tissue to be treated, with a precise destructive effect. The radiation dose absorbed by the treated mass of tissue is what defines the degree of biological inactivation. It usually is measured in Gray units, where one Gray (Gy) is the absorption of one joule per kg of mass. In order to perform optimal therapy, the neurosurgeon, assisted by physicists specialized in nuclear medicine and often in conjunction with a radiation oncologist, chooses the best type of radiation to be used, and how it will be delivered. Usually, the total dose of radiation required to kill a tumor, for example, is not delivered in a single, massive section, because this would cause undesirable effects on the patient. Instead, it is divided into several sessions of smaller duration and energy dose, in a procedure called dose fractioning. The aim of dose fractioning is to minimize the undesirable damage to healthy tissues, as healthy tissue cells are better than cancerous cells at repairing radiation induced damage between irradiations. In order to plan the radiation incidence and dosage, the physicists calculate a map portraying the lines of equal absorbed dose of radiation upon the patient's head (this is called a isodose map). Information about the tumor's location is obtained from a series of computerized tomograms, which are then feed to special planning computer software. There are five types of irradiation currently used in radiosurgery: electromagnetical waves (gamma rays and x-rays), subatomic particles (protons and neutrons), and carbon ions. The first type of radiation is gamma rays, which are beams of high energy photons that interact with the corona of electrons of the atoms that compose the irradiated tissue, ionizing them. Gamma radiation is used in the "Gamma Knife" device, where they are produced by fixed sources of radioactive cobalt. The second type of radiation, X-rays, are also high energy photons that are identical to gamma rays except for the way they are produced. Radiosurgery can be performed using a linear accelerator, the source being now a commercial medical device of universal use in radiotherapy. The Linac consists of a emitting tube of X radiation, with an energy of 4, 6, or 18 million electron-volts (MeV). The emission head (called "gantry") is mechanically rotated around the patient, in a full or partial circle. The table where the patient is lying, the 'couch,' can also be moved in small linear or angular steps. The combination of the movements of the gantry and of the couch makes possible the computerized planning of the volume of brain tissue which is going to be irradiated. Devices with an energy of 6 MeV are the most suitable for the treatment of the brain, due to the smaller volume to be irradiated. In addition, the diameter of the energy beam leaving the emission head can be adjusted to the size of the lesion by means of interchangeable collimators (an orifice with different diameters, varying from 5 to 40 mm, in steps of 5 mm). There are also multileaf collimators, which consist of a number of metal leaflets that can be moved dynamically during treatment in order to shape the radiation beam to conform to the mass to be ablated. The third type of radiation, protons, is used in Proton Beam Therapy (PBT). Protons are produced by cyclotrons, extracting them from proton donor materials and accelerating them in successive travels through a circular, evacuated conduit, using powerful magnets, until they reach a high energy and are released toward the irradiation target, in the patient's body. Because of the Bragg peak effect, proton therapy has some theoretical advantages over other the other forms of radiation, since most of the proton's energy is deposited within a limited distance, and so tissue beyond this range is spared from the effects of radiation. This property of protons allows for conformal dose distributions to be created around even very irregularly shaped targets. In recent years, however, so-called "intensity modulated" techniques have allowed for similar conformities to be attained using linear accelerator radiosurgery. Neutrons, the fourth type of radiation, are used in Boron neutron capture therapy (BNCT). BCNT depends on the interaction of slow neutrons with boron-10 to produce alpha particles, another type of radiation. Patients are first given an intravenous injection of a boron-10 tagged chemical that preferentially binds tumor cells. The neutrons are created either in a nuclear reactor or by colliding high-energy protons into a Lithium target. The neutrons pass through a moderator, which shapes the neutron energy spectrum suitable for BNCT treatment. Before entering the patient the neutron beam is shaped by a beam collimator. While passing through the tissue of the patient, the neutrons are slowed by collisions and become low energy thermal neutrons. The thermal neutrons undergo reaction with the boron-10 nuclei, forming an unstable boron-11 nucleus which then undergoes spontaneous decay to lithium-7 and an alpha particle. Both the alpha particle and the lithium ion produce closely spaced ionizations in the immediate vicinity of the reaction, with a range of approximately 10 micrometres, or one cell diameter. This technique is advantageous since the radiation damage occurs over a short range and thus normal tissues can be spared. Also, there are two mechanisms for tumor selectivity, since both the boron compound is made to bind to tumor cells and the neutron beam is aimed at the location of the tumor. BNCT has been developed in only in an experimental basis, and it has not entered surgical routine. The selection of the proper kind of radiation and device depends on many factors including lesion type, size and location in relation to critical structures. Data suggests that similar clinical outcomes are possible with all of these methods. More important than the device used are issues regarding indications for treatment, total dose delivered, fractionation schedule and conformity of the treatment plan. Latest generation Linacs are capable of achieving extremely narrow beam geometries, such as 0,15 to 0,3 mm. Therefore, they can be used for several kinds of surgeries which hitherto are carried out by open or endoscopic surgery, such as for trigeminal neuralgia, etc. Radiosurgery of brain tumors Radiosurgery has been especially helpful for the localized, highly precise treatment of brain tumors. Due to the steep fall of the irradiation fields (isodoses) from the center of the target to be destroyed, the biological inactivation happens only on it; while the brain, and other vascular and neural structures around it, are protected. This is achieved through the high mechanical precision of the radiation source, and the assured reproducibility of the target. The precision in the positioning of the patient, in the calculation of dosages, and in the safety of the patient, are all extremely high. Radiosurgery is indicated primarily for the therapy of tumors, vascular lesions and functional disorders. Significant clinical judgment must be used with this technique and considerations must include lesion type, pathology if available, size, location and age and general health of the patient. General contraindications to radiosurgery include excessively large size of the target lesion or lesions too numerous for practical treatment. The non-interference with the quality of life of the patient in the post-operatory period competes with the inconvenience of the latency of months until the result of the radiosurgery is accomplished. Patients with a bad general state of health and those with tumors which are unreachable by conventional means, are specially helped. Rbecome may not be evident for months after the treatment. Since radiosurgery does not remove the tumor, but results in a biological inactivation of the tumor, lack of growth of the lesion is normally considered to be treatment success. Radiosurgery has been used to treat many kinds of brain tumors, such as acoustic neuromas, astrocytomas, gliomas, germinomas, meningiomas, among others. Even highly fatal cancerous metastases in the brainstem can be reduced, leaving the patient neurologically intact. It has been demonstrated by the thousands of successfully treated cases, that radiosurgery can be a very safe and efficient method for the management of many difficult brain lesions, while it avoids the loss in quality of life associated to other more invasive methods. For many indications, such as acoustic neuroma, brain arteriovenous malformations and skull base tumors, radiosurgery has emerged as the treatment of choice. Patients are being treated for lesions which only radiosurgery can solve, or because they prefer it as a first treatment, after receiving complete information of its risks and benefits as compared to the conventional surgery, when the choice is available. In the future, advanced computer methods, such as intensity-modulated radiosurgery will be used to improve the accuracy and scope of radiosurgery. From Wikipedia Background information on Search the web for more resources on Radiosurgery |
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