Radiosurgery Revised

Radiosurgery: Overview R. Rick Bhasin, MD Department of Neurosurgery University of Florida

Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Definitions ,[object Object],[object Object]

History ,[object Object],[object Object],[object Object]

How does radiation work? ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Proton Therapy ,[object Object],[object Object]

Bragg Peak Effect While rapidly traveling through tissue, high-energy proton beams lose energy. As this energy is lost, the likelihood of the particle interacting with the tissue increases. This leads to deposition of most of the energy within a discrete band of spatial depth measuring roughly 12-20 mm.

Proton Beam Centers in the USA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Proton Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Development of the Gamma Knife ,[object Object],[object Object],[object Object],[object Object]

Development of the Gamma Knife ,[object Object],[object Object],[object Object],[object Object],[object Object]

Linear Accelerator Radiosurgery

History of LINAC Radiosurgery ,[object Object],[object Object],[object Object],[object Object]

History of LINAC Radiosurgery ,[object Object],[object Object],[object Object],[object Object],[object Object]

How LINAC Radiosurgery Works ,[object Object],Reduced error to within 2/10 mm

How LINAC Radiosurgery Works ,[object Object]

[object Object],Frame-based intracranial positioning

Frameless intracranial positioning Used for fractionated radiotherapy

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Trilogy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Intensity Modulated Radiotherapy (IMRT) ,[object Object],[object Object]

UF Radiosurgery Treatment Paradigm ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

How to place a headring ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dose Planning ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What do we treat with radiosurgery? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Radiation Doses Prescribed ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Brain Metastasis ,[object Object],[object Object],[object Object],[object Object],[object Object],Ulm et al, Neurosurgery 55: 1076-1085, 2004

AVM ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Bradshaw et al, Neurosurgery 52:296-308,2003

Vestibular Schwannoma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Foote et al, J Neurosurg 95:440-449, 2001

Meningioma ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Friedman et al, J Neurosrg 103:206-209, 2005

Glioblastoma Multiforme ,[object Object],[object Object],[object Object],[object Object]

Glioblastoma Multiforme ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Ulm et al, Neurosurgery 57:512-517, 2005

Spinal Radiosurgery ,[object Object],[object Object],[object Object],[object Object]

Cyberknife Outcomes ,[object Object],[object Object],[object Object],[object Object],[object Object]

Spinal Radiosurgery with Trilogy ,[object Object],[object Object]

Trigeminal Neuralgia ,[object Object],[object Object],[object Object],[object Object],Mehta et al, Neurosurgery: 57:1193-2000, 2005 .

Radiosurgery Revised

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Radiosurgery Revised