ABSTRACT
Since the 1950s, the stereotactic principle has been adopted by neurosurgeons in the technique of stereotactic radiosurgery (SRS), in which narrow beams of cobalt-60 gamma rays (Gamma Knife) are focused to a small target within the brain. Since the mid-1980s, adaptations of medical linear accelerators (linacs) to produce similarly precise megavoltage x-ray beams have made this technique accessible to many hospitals. With the development of relocatable head frames used with CT-based ‚ducial marker systems,
Contents 7.1 Introduction 99 7.2 Frame-Based SRS: Using Localizer Boxes 101
7.2.1 Neurosurgical Invasive Frames 101 7.2.1.1 Brown-Roberts-Wells/Cosman-Roberts-Wells 102 7.2.1.2 Leksell 102
7.2.2 Noninvasive Moveable Frames 104 7.2.2.1 Gill-omas-Cosman Frame 104 7.2.2.2 BrainLAB Mask System 104 7.2.2.3 Laitinen Stereoadapter 5000 Frame 105
7.2.3 Summary 105 7.3 Noninvasive Frameless Systems 106
7.3.1 eXtend 106 7.3.2 PinPoint® (Aktina) 106 7.3.3 Optically Guided Frameless System 108 7.3.4 BrainLAB Frameless Mask 108 7.3.5 Image-Guided Frameless SRS 109 7.3.6 Summary 109
7.4 Stereotactic Treatment Planning and Delivery 109 7.4.1 Simulation 110 7.4.2 Treatment Planning 110 7.4.3 Treatment Setup and Quality Assurance 111 7.4.4 Overall Accuracy and Margins 112
7.5 Conclusion 113 References 114
precisely planned, accurately deliverable single-fraction SRS and fractionated stereotactic radiation therapy (SRT) of the brain are readily available to many oncology centers.
