Gamma Knife (Gamma Knife) is one of the world’s newest technological devices in the Department of Nuclear Medicine Sciences, where it is given to brain tumor patients with very high doses of radiation (laser irradiator).
Gamma Knife radiation does not affect healthy brain cells because Gamma Knife radiation is a very small radiation and does not damage healthy cells and when it reaches the cells affected by tumors in the brain, at the point of tumor cells, all directions of Gamma Knife radiation gather at the tumor point, so the Rays are very intense and it is possible to affect even a weak percentage on healthy cells only at the point of the targeted Rays.
In the Gamma Knife treatment a beam of very thin rays is directed to patients in the affected area of the brain skull . Thanks to the Gamma Knife feature, it is normal to focus on the direction of radiation only in the area affected by the tumor and neglect the rest of the brain areas, which is why the exposure of other areas to radiation is very low.
The Gamma Knife topical knife has a sensitivity of less than 0.5 mm. About 40,000 patients are treated annually with Gamma Knife, a simple and painless treatment.
Gamma Knife provides treatment opportunities to patients within limited hours without any blood or surgery and without the need for any intensive care. Patients undergoing Gamma Knife therapy can continue their normal daily life the next day after the operation.
Gamma Knife is used in the processing of the following:
Its use as an alternative to surgery has been scientifically proven in facial pain syndromes such as trigeminal neuralgia , and Parkinson’s patients and is now widely used.
Gamma Knife can also be used in the treatment of many brain diseases, studies have been conducted on the effectiveness of the Gamma Knife in some mental disorders such as epilepsy patients and others and the results have been very positive.
In patients with brain tumors, especially when the tumor is metastatic and surgery is difficult, Gamma Knife treatment is considered one of the best global treatment methods. Patients can continue other treatments such as chemotherapy or other therapies concurrently with Gamma Knife treatment for brain tumors, without delaying comprehensive cancer treatment.
This helps stabilize the patients’ condition. Memory disorders and dementia are very common in all brain tumors, significantly deteriorating the patient’s quality of life. Gamma Knife treatment reduces this risk and is also successfully used in treating multiple brain tumors. It is known that Gamma Knife protects brain tissue better than other radiation therapy methods.
Primary brain tumors include various types such as glioblastomas, astrocytomas, oligodendrogliomas, and astrocytomas. Treatment includes surgery, radiation therapy, and chemotherapy when necessary. When the tumor spreads, Gamma Knife treatment is essential to prolong patients’ survival with specialized treatment methods.
Pituitary tumors, resulting from the pituitary gland responsible for hormone secretion in the brain, can manifest with hormonal imbalances or vision loss. Medications, surgical methods, and Gamma Knife can be used to treat these tumors. Gamma Knife surgeries provide an effective and safe treatment, especially for recurrent pituitary tumors where the risk of surgical operations is high.
Meningiomas are usually benign tumors that arise from the meninges (membranes surrounding the brain and spinal cord). Although surgery is the first option in treatment, the risk of surgery might be higher, and complete removal may not be possible. In such cases, Gamma Knife treatment is applied.
Acoustic neuromas are benign tumors arising from the auditory nerve. Hearing loss, tinnitus, and imbalance are the most common symptoms in varying degrees. Gamma Knife treatment has become a standard treatment with high control rates for small and medium-sized tumors. For tumors larger than 3.5-4 cm, surgical treatment is applied in addition to Gamma Knife. Compared to open surgery, the risk of hearing loss is significantly lower with Gamma Knife. Additionally, risks such as infection and bleeding caused by surgery are not present in Gamma Knife treatment.
Intravenous arterial deformity and abnormal blood vessels appear in the brain. These tumors can cause bleeding in the brain. Brain bleeding that can develop and cause very serious health problems. In addition, the seizures caused by it reduce the quality of life of the patient.
In the treatment of venous arterial deformity, it is surgically removed, and destroyed by radiation surgery. Sometimes these methods are used in addition to each other. However, surgical treatment, especially in areas of the brain or deep roots of the brain, is risky, and sometimes surgery is not possible. In this case, Gamma Nayef provides a very effective and safe treatment option.
Triplet neuritis (pain syndromes in the face) is usually explained by sudden and violent blows in the distribution range of the trigeminal nerve in half an hour, lasting from a few seconds to a few minutes. Since pain may start on its own, the percentage and stimulation point in the mouth may also occur.
Due to the severe pain of patients with trigeminal nerve pain, their quality of life deteriorates further and they are exposed to side effects due to the doses of medications they use. Gamma Nayef treatment is a very effective option for these patients and is more effective than local needle therapy.
Triplet neuralgia is seen in about 3-6% of patients. If there is a reason to stimulate trigeminal nerve in the appearance of pain, trigeminal neurological pain is called and attempts to remove it in the middle of treatment.
(Meningioma) |
(Hypopysis Tumors) |
(Vestibular Schwannoma ) |
(Trigeminal Schwannoma ) |
(Hemangioblastoma) |
(Pineal Tumors) |
(Craniopharyngioma) |
(Glomus Jugulare Tumor) |
(Chordoma) |
(Arteriovenous Malformation) |
(Covernoma) |
(Trigeminal Neuralgia) |
(Parkinson ) |
(Essential Tremor) |
(Metastasis) |
(Uveal Melanoma) |
(Some of Glial Tumors) |
(Hemangiopericytoma) |
(Nasopharynx Carcinoma) |
Initial Consultation
When consulting patients regarding Gamma Knife treatment, we first review the patient’s medical history, conduct an examination, and check radiological images such as MRIs. Once the patient’s condition is fully assessed, the most suitable treatment options are determined, and the advantages and disadvantages of these options are explained. Based on the patient’s expectations and opinions, we decide on the most appropriate treatment for the patient’s condition.
Preparation for Gamma Knife Treatment
When the decision for Gamma Knife treatment is made, the patient is prepared, and at this stage, the Gamma Knife unit conducts necessary tests through an interview with the patient. Important information to be considered includes:
Day of the Procedure
After completing the necessary evaluations and preparations, the patient must fast from midnight and arrive at the Gamma Knife unit at 7:45 AM to prepare for the procedure. During this time, an intravenous line is opened for the patient. If needed, some conditions are moderately sedated, and heart rate, blood oxygen levels, and blood pressure are monitored. Local anesthesia is then applied to the patient’s head, and a metal frame called the Gamma Knife frame is placed on the head.
The goal here is to determine the three-dimensional position of the tumor using radiological images captured with this frame and to plan the treatment according to the determined coordinates. The patient is then taken to the radiology unit with the presence of a doctor, nurse, and radiation physicist, where an MRI or CT scan is performed.
Treatment Planning
These images are uploaded to the computer where the Gamma Knife plan is prepared. After imaging, the patient is taken to the Gamma Knife unit and transferred to the bed. The patient can now eat and drink lightly. During this time, the treatment program, called the Gamma plan, is designed, specifically irradiating the tumors to be treated with the appropriate dose. During this process, special methods are used to protect the optic nerves, brain stem, and hearing-related organs.
Thanks to the high technology provided by the Gamma Knife, a safe treatment plan can be created. The planning process takes about 15 minutes to one hour, during which the patient waits in bed without feeling any pain due to the frame on their head. After planning, the patient is moved to the Gamma Knife treatment device and secured to the head apparatus with the help of the frame.
Radiation Procedure
The radiation process then begins, which can last between 15 minutes to 3 hours, depending on the size and shape of the tumor. The patient is allowed to rest during the radiation period. After the radiation is completed, the patient is returned to the bed, and the frame is removed from their head.
Post-Procedure and Follow-Up
After resting for an hour or two, the patient is sent home. Following the treatment, the patient is invited back to the hospital at regular intervals for routine monitoring and radiological imaging to closely observe the progress of the disease.
The Gamma Knife Eikon device offers a comprehensive possibility of treatment sensitivity according to the patient’s need, as it gives the opportunity to choose how to treat: one session with a frame, one session with a mask, or segmented therapy over several sessions. This device offers the opportunity of treatment within the framework of a compendium of experience of about 40 years.
Unlimited therapeutic flexibility and workflow in brain radiosurgery
Continuous quality control through direct follow-up and possible change of doses used
The highest level of sensitivity and accuracy
Perfect integration, efficiency and security in configuration
Flexibility
The device offers the opportunity for treatment in a single session or fractionated over multiple sessions, either with or without a frame. It is possible to perform traditional radiosurgery and very precise radiosurgery. The Leksell Gamma Knife Icon allows for the same result and level of movement precision whether using the frame or not. This feature sets the Gamma Knife Icon apart from other frameless machines.
Direct Dose Control / New Standard
Direct dose control is a comprehensive and broad concept that enables precise treatment delivery. Through this system integrated with the basic control system, it is possible to ensure the quality of each stage throughout the entire process. The system also provides the ability to monitor treatment in real-time and accurately.
Real-Time Motion Management
The Icon device, which offers frameless motion management, provides the same sensitive level as framed devices. The high-definition motion management system tracks the patient in real-time with a sensitivity of 0.15 mm, which is six times better than traditional methods. If the patient moves out of the designated range, the control system immediately stops the radiation.
Direct Radiation Delivery Control
This feature is unique to the Icon machine. The treatment plan is automatically adjusted according to changes in the patient’s position derived from the images produced by the integrated (StereoT Cone Beam CT) touch beam cone system and MRI. The direct dose control evaluation helps determine the distribution of the delivered dose and compare it with the planned dose.
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