全方位珈瑪雷射刀全方位珈瑪雷射刀

“ “ The delivery of a The delivery of a single, high dose of single, high dose of irradiation to a small irradiation to a small and critically located and critically located intracranial volume intracranial volume through the intact through the intact skull ”.skull ”.

L. LEKSELL

DEFINITION OF RADIOSURGERY.

1949 :Lars Leksell1949 :Lars Leksell

Radiosurgery.Radiosurgery.Radiosurgery.Radiosurgery.

Neurosurgical procedure where narrow ionizing beams, given in a single high dose fraction, are used either to destroy a predetermined target volume or to induce a desired biological effect in the target volume without opening the skull and with a minimum risk of damage to the surrounding non target neural tissue

(Steiner,1992).

Adler 2004

Development of image-guided frameless technology that eliminates the necessity to perform radiosurgery in a single session.

« Radiosurgery is a procedure that involves the active participation of a surgeon and in which spatially accurate and highly conformal dose of radiation are targeted at well-defined structures with an ablative intent. »

Pollock & Lunsford 2004

« Single session, precise delivery of a therapeutically effective radiation dose To an imaging defined target. »

« Adherence to accepted, descriptive terms in defining stereotactic radiosurgery and radiation therapyPermits a clear distinction among the results of the different radiation delivery techniques forThe patients, physicians, and other interested parties… »

• Leksell’s historical definition 1951• Steiner definition 1987• Adler definition 2004• Pollock definition 2004• Barnett definition 2007

Summary

Huge conflict of interestSattelite issues + 2 main

Is it still radiosurgery if 1 Frameless2 Fractionated

Leksell Gamma Knife PerfeXion

A technology driven definition ?