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Stereotactic Radiosurgery Gamma knife Cyberknife
Trends in Melanoma Incidence and Mortality in the United States
Brain Metastases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Nussbaum ES et al.  Cancer . 2000;78:1781-1788.
Primary and secundary CNS Tumors: Incidence November 2002 * These figures apply to adult populations. In children, about three-quarters of cerebral tumors are gliomas. Type of Intracerebral Tumor * Percent Incidence Secondary carcinoma 40 Gliomas, all types 40 Meningiomas 13 Pituitary adenomas Neurofibromas Congenital tumors Tumors of blood vessels Others tumors 4 3
Secondary Brain Tumors: Incidence by tumor type November 2002 Primary Tumor Patients Percentage Lung Breast Melanoma Colon Other known primary Unknown primary Total 270 82 50 26 72 61 561 48 15 9 5 13 11 100
RESULTS
Changes in Overall Cancer Mortality (1975-2003), United States US SEER Cancer Registry, 2003
Metastatic Brain Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.neurobc.com/conditions/Brain_metastases.htm
Metastases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Metastases ,[object Object],[object Object],[object Object],[object Object],[object Object]
Brain metastases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
Secondary Brain Tumors: Radiotherapy November 2002
Radiosurgery ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment Paradigm
 
 
 
Whole brain radiation therapy  vs.  Stereotactic radiosurgery
Role of Stereotactic Radiosurgery in the Management of Brain Metastases ,[object Object],[object Object],[object Object]
What is Stereotactic Radiosurgery? ,[object Object]
Computerized Image of Radiosurgery
What is Gamma Knife?
Side view of the Gamma Knife Patient Couch Helmet Helmet in treatment position Shielding Radiation source
Collimator up close Helmet (collimators)  Stereotactic headframe
What is Cyberknife?
Detailed view of Cyberknife Linear accelerator Robotic Arm Radiation Exit point Patient couch
CRT  linear accelerator A – Cathode B – Conductive  coating C – Anode D – Phosphor  Coated screen E – Electron Beams F – Shadow mask **A particle accelerator works basically the same way.
Brain Lab Novalis ® - 3 – 5.5 mm micro-multileaf collimator to conform to the shape of the target  - Dynamic conformal arc therapy
www.albertaradiosurgery.ca
Trials Ongoing/Planned ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stereotactic procedures ,[object Object],[object Object],[object Object],[object Object]
Image registration ,[object Object],[object Object]
Image registration CT scan MRI Leksell fiducial markers on both
Stereotactic procedures ,[object Object],[object Object],[object Object],Both systems MedTec
UF LINAC Stereotactic Radiosurgery- Gantry
Radiation treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gammaknife ,[object Object],[object Object],[object Object]
Gamma knife head applicator
Patient in gamma knife collimator head  (from Ertl  et al.  Phys. Med. Biol. 42 (1997) 2137)
Secondary Brain Tumors: Surgery Galicich JH  et al ., Met. Brain tumors,In Wilkins: Neurosurgery, 597-61, 1985. November 2002
Secondary Brain Tumors: Radiotherapy November 2002 0 30 x 0 30 s 1 5 2 12 2.5
Secondary Brain Tumors: Radiotherapy November 2002
 
 
La radiothérapie est couramment utilisée pour traiter le cancer  2°) Treatment planning  Calculation of deposit dose on the tumor (~1mn): A treatment plan is  developed using the images  1°) Obtain scanner  slices images The head is imaged using  a MRI and/or CT scanner 3°) Radiotherapy  treatment Irradiation of the brain  tumor with a linear accelerator
 
Linear accelerator
 
Brain tumors: management ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
RTOG 0023: Results Cardinale, Red J, 2006 FSRT MIGHT BENEFIT GROSS-TOTALLY RESECTED GBM Although overall survival was not improved, there  was a trend toward improved survival with FSRT for patients with total resection
Gamma Knife Radiosurgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gamma Knife Radiosurgery ,[object Object],[object Object],http://www.sh.lsuhsc.edu/neurosurgery/gammaknife/gamma-knife/
Specialized Devices for SBRT ,[object Object],[object Object],[object Object]
WFUBMC SBRT 3-D Imaging Device ,[object Object],[object Object],[object Object],[object Object]
WFUBMC SBRT ,[object Object],[object Object],[object Object],[object Object]
Metastatic Brain Tumor ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],http://www.neurobc.com/conditions/Brain_metastases.htm
Gamma Knife Radiosurgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gamma Knife Radiosurgery ,[object Object],[object Object],http://www.sh.lsuhsc.edu/neurosurgery/gammaknife/gamma-knife/
Thanks for Your Attention & Have a Good Day!!!
 

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