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Introduction to Radiosurgery

Article information

J Korean Med Assoc. 2008;51(1):5-15
Publication date (electronic) : 2008 January 31
doi : https://doi.org/10.5124/jkma.2008.51.1.5
Hyun-Tai Chung, MD, Dong Gyu Kim, MD
Department of Neurosurgery, Seoul National University College of Medicine, Korea. htchung@korea.com, gknife@plaza.snu.ac.kr

Abstract

Radiosurgery, or stereotactic radiosurgery, is a minimally invasive modality to treat a lesion with stereotactically focused ionizing radiation without surgical incision. Because there are no incision procedures, general anesthesia or transfusion is not required, and complications related to incisional procedures do not occur in radiosurgery. As a result, radiosurgery shows much low rates of complications than conventional open surgery with comparable cure rates. In the beginning, radiosurgery was applied only to a few intracranial diseases because a stereotactic frame was applied to the skull. Along with the development of technologies and accumulation of knowledge on radiosurgery such as medical imaging, computer, radiation physics, and radiobiology, indications of radiosurgery have been expanded in various ways. Nowadays, radiosurgery is accepted as an adjuvant treatment or a primary treatment option for many neurosurgical diseases and cancers. Cranial nerve schwannomas, brain meningiomas, pituitary adenoma, and other benign brain tumors are good indications for radiosurgery. Intracranial arteriovenous malformation, brain metastases from extracranial cancers, and trigeminal neuralgia are also well controlled by radiosurgery. Spinal metastases and various cancers are emerging indications for extracranial radiosurgery, which has been recently introduced. In this article, the authors summarized the basic concept, history, development, and future of radiosurgery as an introduction to radiosurgery.

Keywords: Radiosurgery; Basic concept; Indications

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Copyright © 2008 Korean Medical Association

Figure 1

Figure 1

The first trial of stereotactic radiosurgery used a 200 kVp X-ray tube mounted on a stereotactic frame (Courtesy of Elekta AB. Stockholm, Sweden).

Figure 2

Figure 2

Lars Leksell (left) is preparing a radiosurgery with a proton beam generated by the Uppsala synchrocyclotron in 1960 (Courtesy of Elekta AB. Stockholm, Sweden).

Figure 3

Figure 3

Lars Lekell and the first Gamma Knife (Courtesy of Elekta AB, Stockholm, Sweden).

Figure 4

Figure 4

A) Gamma Knife Perfexion (Courtesy of Elekta Korea).

B) Novalis Shaped Beam Surgery (Courtesy of BrainLAB Korea).

C) CyberKnife G4 (Courtesy of CyberKnife Korea).

D) Tomotherapy (Courtesy of Oncology Total Solution).