Leksell Gamma Knife Icon Radiosurgery

What is Gamma Knife radiosurgery?

Gamma Knife radiosurgery replaces a surgeon's scalpel with a single dose of radiation. This is not a knife in the normal sense of the word. The physician makes no incision in your head. Instead, very precisely focused beams of radiation are directed to the treatment area of the brain. This procedure is simple, painless, and straight-forward.

Penn State Neurosurgery’s new Icon is the latest advance in stereotactic radiosurgery (SRS). Icon’s features allow for unprecedented accuracy and unlimited clinical and workflow flexibility. The GK Icon offers both frame-based and frameless immobilization. The frame-based option can be used for accurate localization and treatment. Patients for whom fixed frame stabilization is not appropriate can be treated using Icon’s Online Adaptive DoseControl™, which integrates several features to ensure precise and accurate dosing in each treatment.

Penn State GK Radiosurgery: What it is and what to expect

What are the benefits of Gamma Knife radiosurgery?

Since no incision is made, the risk of surgical complications is low. The patient's head does not have to be shaved and side effects are few. This Icon offers both frame-based and frameless immobilization. The frame-based option can be used for accurate localization and treatment. Patients for whom fixed frame stabilization is not appropriate can be treated using Icon’s Online Adaptive DoseControl, which integrates several features to ensure precise and accurate dosing in each treatment. A mask based immobilization solution is personalized for each patient. Treatment is much shorter than conventional surgery and causes only minor discomfort. Benefits with Icon include faster set-up and treatment delivery to multiple tumors in a single session, and the potential to treat lesions in areas not able to be reached by older models, including tumors in the sinuses, orbits, and upper cervical spine. Icon allows treatment of a wider range of targets faster and more efficiently than ever before. The radiosurgery system's unique radiation-focusing device ensures superior radiation delivery and accuracy while reducing the dose to unintended areas.

Also, the patient can leave the day of the surgery or stay overnight for observation, compared with several weeks for traditional surgery. The treatment is complete in one session and seldom takes more than an hour or two. The full effects of GK surgery may not be seen for several months following treatment.

What diseases can be treated with this procedure?

• Benign or malignant tumor
• Trigeminal neuralgia
• Certain vascular malformations (AVM)
• Cavernous malformations
• Acoustic neuromas (schwannoma)
• Parkinson's disease and essential tremor
• Lesions causing epilepsy

This procedure treats many types of tumors found in the head. This includes tumors that came from somewhere else (metastatic from lung, breast, ovary, kidney or skin cancers including renal cell cancer and melanoma) that don't respond well to regular radiation treatments. Icon can treat many more tumors than previously possible, saving the patient from receiving whole brain radiation, a last resort. People that have already had whole brain radiation sometimes get regrowth or new brain tumors six months or a year later, and can NOT safely have more whole brain radiation. Often, these people can still have a focused treatment that puts a high radiation dose into the tumor, but only a very small amount into the surrounding brain, giving them a new chance for longer survival.

This procedure is very effective in stopping further growth and even shrinking slow-growing tumors deep in the head called meningioma, pituitary adenoma, and vestibular schwannoma (also known as acoustic neuroma). People that had open operations for these slow-growing tumors sometimes find several years later the tumor is coming back and getting bigger. Tumors that are growing back are often straight forward to treat with this procedure, without having to go through another open skull operation.

Icon treats more than cancer. A special type of face pain characterized by electric stabbing pain - called trigeminal neuralgia - is sometimes resistant to medications, or the medications cause serious side effects. Gamma Knife treatments can give relief to many people, with up to half completely pain free, with only a small risk of numbness.

Usually hand tremor from Parkinson's disease or a condition called essential tremor can be treated with medications or deep brain stimulation with implanted electrodes. In certain patients, GK can be used to make a permanent lesion in part the brain to help control the tremor in one hand.

Certain blood vessel abnormalities inside the skull and brain can be treated with this procedure. Sometimes it requires multiple treatments, including open neurosurgery and intravascular injections of coils and glue. Arteriovenous malformation (also called AVM) and dural arteriovenous fistula (or dural AV fistula) are two conditions that have been successfully treated with radiosurgery, sometimes with no other treatment, and sometimes as part of multiple approaches.

The above conditions, from tumors, trigeminal neuralgia, tremor, to vascular malformations, are all standard accepted and proven treatments with the procedure and are covered procedures paid for by government and private insurance like any other open neurosurgical operation.