What is Gamma Knife?
Gamma Knife was created by a Swedish neurosurgeon. It uses gamma beams to treat brain diseases with great precision. The latest model, Gamma Knife Icon, is used at Acıbadem Gamma Knife unit for treatments.
How does it work?
Gamma Knife sends beams from hundreds of cobalt sources to a precise target. Each source sends low-energy rays. But, when combined, they create a high-energy beam at the target.
This therapy damages the genetic codes of tumors in the brain. It does this through two different pathways, depending on the brain disease.
Gamma Knife aims to destroy fast-growing tumors and stop slow-growing ones. It treats various brain diseases and conditions affecting bones, vessels, nerves, skin, and more around the brain.
It’s often used for brain cancer metastases, AVMs, and benign tumors like vestibular schwannomas and meningiomas.
Over 300 facilities worldwide have Gamma Knife. It has treated over a million patients. Acıbadem Gamma Knife Unit has treated 7000 patients.
What are Target Organs for Gamma Knife?
Gamma Knife is designed for brain diseases. It treats brain diseases and conditions affecting bones, vessels, nerves, eyes, skin, and more around the brain.
Other body parts have different treatments. Gamma Knife is a standard for brain diseases. It’s used in over 300 facilities and has treated over a million patients.
Gamma Knife is a standard treatment for brain diseases. 7000 patients have been treated at Acıbadem Gamma Knife Unit.
Gamma Knife technology has been used more and more. It was introduced in 1968. Over a million patients worldwide have been treated for brain diseases.
- Cerebrovascular Diseases
- Arteriovenous malformation (AVM – Abnormal arteriovenous plexus in brain)
- Cavernomas
- Benign Brain Tumors
- Vestibular schwannoma (Acoustic neuroma)
- Hemangioblastoma
- Meningioma
- Chordoma
- Pituitary tumor
- Trigeminal schwannoma
- Tumors of pineal gland
- Craniopharyngioma
- Glomus jugulare tumor
- Malignant Brain Tumors
- Metastases
- Uveal melanoma
- Some glial tumors
- Hemangiopericytoma
- Nasopharyngeal carcinoma
- Patients with Movement Disorders
- Tremor secondary to Parkinson’s disease
- Essential tremor
- Patients with Functional Disorder
- Trigeminal neuralgia
- Patients with tumors at hardly accessible and deep locations of brain
- Patient who cannot tolerate surgical procedures due to certain reasons like age, medical condition, general health status
- Patients who refuse open surgery.
Gamma Knife Icon is also used for treating certain diseases.
Brain tumor
A brain tumor is uncontrolled growth in the brain or surrounding tissues. It grows and takes up space in the skull, causing problems.
Treatment of Brain Tumor
Finding out the type of brain tumor is key. Different tumors need different treatments. Options include surgery, radiotherapy, chemotherapy, or Gamma Knife.
Acromegaly
Acromegaly comes from tumors in the pituitary gland. These tumors make too much growth hormone. It’s hard to treat.
Gamma Knife is a good option. It stops the tumor from growing and helps restore hormone levels.
Cerebrovascular Diseases
Cerebrovascular diseases affect the brain’s blood supply. They can cause sudden strokes or chronic conditions.
First, you need to know what’s causing the problem. Treatment depends on the disease. It could be medicine, surgery, endovascular methods, or Gamma Knife.
Arteriovenous Malformation
Arteriovenous malformations (AVMs) start in blood vessel development. They cause tangles of blood vessels in the brain.
AVMs can lead to bleeding, seizures, and brain problems. They’re serious and need treatment. Gamma Knife is a good option.
Astrocytomas
Astrocytomas start in brain tissue. There are two types. Pilocytic astrocytomas grow but don’t spread.
Pilocytic astrocytomas can be treated with surgery, Gamma Knife, or other methods. Diffuse astrocytomas grow and spread. They need a combination of treatments.
Intracranial Hemorrhage
Cerebral hemorrhages are sudden brain crises. They can be caused by high blood pressure or other issues.
First, find out what’s causing the problem. Treatment varies. It could be medicine, surgery, endovascular methods, or Gamma Knife.
Brain cancer
Brain tumors are divided into two types. Cerebral metastasis spreads from other cancers. Brain tumors start in brain tissue.
Treatment of Brain Cancer
Treating brain cancers is hard. They grow and spread. A mix of treatments is needed.
Brain Stem Tumor
Brain stem tumors vary by age and location. Surgery, Gamma Knife, or other treatments are used.
Brain tumor
Brain tumors grow uncontrollably. They take up space in the skull. This can cause problems.
Symptoms of Brain Tumors
Brain tumors can cause headaches, nausea, and changes in mental status. They can also lead to seizures.
They can also affect brain functions. This can cause weakness, speech problems, or vision loss.
Types of Brain Tumors
Brain tumors are rare compared to tumors in other parts of the body. Most are benign. But, malignant tumors have the worst prognosis.
The most common brain tumors include metastases, meningeal tumors, and glial tumors. Also, benign tumors of the pituitary gland and vestibular schwannomas are common.
Treatment of Brain Tumor
First, it’s important to know the type of tumor. Different types need different treatments.
Treatment options include surgery, radiotherapy, chemotherapy, or Gamma Knife.
Gamma Knife for Treatment of Brain Tumors
Gamma Knife is a technology for treating brain diseases. It’s used for various brain tumors.
It’s mainly used for metastatic and benign brain tumors worldwide.
Radiotherapy in Brain Tumors
Radiotherapy is used for tumors in healthy brain tissue. It aims to kill tumor cells without harming the brain.
GammaKnife or Stereotactic radiosurgery are focused forms of radiotherapy.
Arteriovenous Malformations in Brain
Arteriovenous malformations (AVMs) start in blood vessel development. They cause tangles of blood vessels in the brain.
AVMs can lead to bleeding, seizures, and brain dysfunction. They are dangerous and need treatment. Gamma Knife is an effective treatment.
Brain Cancer
Brain tumors are divided into two types. Cerebral metastasis is the spread of cancer to the brain. Brain tumors can also start in brain tissue.
Glioblastoma (GBM) is a common brain tumor in adults. It has a poor prognosis.
Chondrosarcoma
Chondrosarcoma and chordoma start in cartilage tissue. They grow slowly and invade bone.
Treating these tumors is complex. They are in the cranium and near important nerves and blood vessels. Gamma Knife, radiotherapy, and particle irradiation are options.
Chordoma
Chordoma and chondrosarcoma start in cartilage tissue. They grow slowly and invade bone.
Treating these tumors is complex. They are in the cranium and near important nerves and blood vessels. Gamma Knife, radiotherapy, and particle irradiation are options.
Cushing Disease
Cushing disease is caused by tumors in the pituitary gland. These tumors secrete cortisone. The disease is hard to treat.
Gamma Knife can help by stopping tumor growth and shrinking it. It can also restore hormone levels to normal.
Arteriovenous Malformation
Arteriovenous malformations (AVM) start in the brain’s blood vessel development stage. They are marked by tangled blood vessels in the brain. This is due to too much blood vessel growth.
AVMs can cause bleeding, seizures, and brain function problems. They are dangerous and need treatment. Gamma Knife is a good treatment option for AVMs.
Balance Nerve Tumor
Vestibular schwannoma is a benign tumor on the balance nerve. It’s also known as acoustic neurinoma or Acoustic schwannoma. Gamma Knife can control its growth in patients who don’t need surgery.
Low Grade Glial Tumor
Low-grade glial tumors start in the brain’s tissue. Pilocytic astrocytoma is a common type that grows but doesn’t spread. Treatment depends on the tumor’s location and the patient’s age.
Gamma Knife, surgery, radiotherapy, or chemotherapy are options. But, diffuse gliomas grow by taking over brain tissue. They need a mix of treatments.
Movement disorders
Parkinson’s disease, multiple sclerosis (MS), and essential tremors affect quality of life. Gamma Knife thalamotomy can help along with medication.
Pituitary adenomas (Pituitary Tumor)
Pituitary adenomas are benign tumors from the pituitary gland. They can cause hormone problems or press on important brain areas. Gamma Knife is a treatment for these tumors.
Doctors check if patients are right for Gamma Knife treatment. It can be used alone or with other treatments.
Growth of these tumors can be stopped in 95 to 98 percent of cases with Gamma Knife.
Hearing Nerve Tumor
Gamma Knife is used for vestibular schwannoma, a benign tumor on the balance nerve. It’s a good option for those not needing surgery.
Benign Brain Tumor
Benign tumors grow slowly over time. Gamma Knife therapy aims to stop their growth.
Chondrosarcoma
Chordoma and Chondrosarcoma come from cartilage and grow slowly. They invade bone. Treatment is complex due to their location and surrounding nerves and blood vessels.
Gamma Knife, radiotherapy, and particle irradiation are options. They are used for intracranial chordoma and chondrosarcoma.
Chordoma
Chordoma and Chondrosarcoma come from cartilage and grow slowly. They invade bone. Treatment is complex due to their location and surrounding nerves and blood vessels.
Gamma Knife, radiotherapy, and particle irradiation are options. They are used for intracranial chordoma and chondrosarcoma.
Malignant Tumors
Malignant tumors grow quickly. Gamma Knife treatment’s effects are seen quickly, within months. It usually destroys these tumors completely.
AVMs also reduce and disappear with Gamma Knife therapy, but this takes years.
Meningiomas
Meningiomas are slow-growing tumors that start in the membranes around the brain and spinal cord. They are mostly harmless. Symptoms come from the tumor’s size and location.
Treatment of Meningioma
The first step is surgery. But, some meningiomas can’t be fully removed. For high-risk cases, Gamma Knife radiosurgery is a good option.
It’s also used for leftover tumors after surgery or when they come back. Gamma Knife aims to stop the tumor from growing.
Mostly, it works well in stopping tumor growth. It can shrink the tumor by 95% in meningiomas.
Oligodendroglioma
Oligodendroglioma is a common brain tumor. It grows slowly and doesn’t spread to other areas. There are two main types, with pilocytic astrocytoma being one.
Pilocytic astrocytoma can be treated with surgery, Gamma Knife, or other methods. The choice depends on the patient’s age and where the tumor is.
But, diffuse gliomas like astrocytoma or oligodendroglioma spread through brain tissue. They need a combination of treatments.
Pilocytic Astrocytoma
Pilocytic astrocytoma is a slow-growing brain tumor. It doesn’t spread to other areas. It’s one of the most common types.
It can be treated with surgery, Gamma Knife, or other methods. The choice depends on the patient’s age and where the tumor is.
But, diffuse gliomas like astrocytoma or oligodendroglioma spread through brain tissue. They need a combination of treatments.
Trigeminal Schwannoma
Trigeminal Schwannoma is a benign tumor that starts in the trigeminal nerve. This nerve controls the face’s sensory functions.
Trigeminal neuralgia
Trigeminal neuralgia causes sharp pain like an electric shock on one side of the face. It often affects the nose, mouth corners, and jaw. Doctors diagnose it based on what the patient says and a physical exam.
Treatment of Trigeminal Neuralgia
Medicine is the first treatment. If it doesn’t work, surgery might be needed. Gamma Knife is also an option for surgery.
It offers a similar pain relief rate as other methods. It’s a good choice for older patients.
Vestibular Schwannoma (Tumor of the Hearing and Balance Nerve)
Vestibular schwannomas are benign tumors that start in the vestibulocochlear nerve. They are the fifth most common brain tumor. They are more common in middle-aged and older people.
Patients often come in with hearing loss and tinnitus. This can lead to balance problems, facial paralysis, and sensory loss in the face. It can even threaten the patient’s life by pressing on the brain stem.
Treatment of Vestibular Schwannoma
Gamma Knife is now used to treat vestibular schwannoma. It’s a benign tumor that grows on the balance nerve. It can control tumor growth in patients who don’t need surgery.
Stereotactic Frame
The Leksell stereotactic frame is fixed to the patient’s head. It ensures precise and safe treatment. Local anesthesia is used to avoid pain. An anesthesiologist is present for children and sedation is used if needed.
Mask
Treatment with a mask is an option in Gamma Knife Icon Device. It allows for treatment in fractions over days. This protects nearby sensitive areas like optic nerves and brainstem.
Also, a mask is used when a frame is not possible or risky.
Neuroradiology Imaging
After the frame is placed, an imaging method is chosen based on the patient’s condition. MRI is used for all patients. For AVM, angiography is done with the frame in place. Computerized tomography is used for skull base tumors and for those who can’t have an MRI.
Dose Planning
Computer programs plan the radiation dose with great precision. For tumors near sensitive areas, “plugging” prevents healthy tissue exposure.
Irradiation
After planning, radiation beams are delivered in the treatment unit. It takes 15 minutes to 1 or 2 hours. The treatment time depends on the tumor’s volume and the radiation dose.
Gamma Knife Tomography
This tomography modality tracks the smallest head movements before and during treatment. It allows for precise and safe irradiation. It also makes mask treatment possible.
Patient Monitoring During Treatment
Gamma Knife Icon uses tomography and an infrared sensor to monitor treatment. The tomography device precisely locates the skull, even with a mask or frame. It can repeat scans during treatment. The infrared sensor tracks the patient’s movements, like breathing.
End of treatment
Most patients have Gamma Knife treatment in one session. It starts in the morning and ends a couple of hours later. Patients can go home and travel soon after. They can resume their daily activities after treatment.