Gamma Knife treatment

A non-invasive radiation treatment.The Gamma Knife sends precise radiation beams to targets in the brain that respond to radiation treatment.

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What is gamma knife treatment?

The Leksell Gamma Knife isn't a knife at all. It was developed by a Swedish neurosurgeon who wanted to emphasize surgical precision in its delivery of gamma rays.

As a state-of-the-art piece of equipment it allows a consultant to direct radiation beams to specific areas within a patient's head without making an incision. It allows day case treatments with fewer complications.

Its precision and non-invasive nature means it can treat tumours in areas previously considered inoperable due to the high risk of surgical complications.

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What are the advantages?

Benefits of gamma knife treatment

Non-invasive

Despite its name, no incisions are made. There are none of the complications associated with surgery.

Effective

More than 85% of tumours treated do not return.

Proven

Over 2,800 scientific articles have been published on Gamma Knife radiosurgery, and more than 1 million patients have been treated worldwide, of which more than 250,000 have been treated for brain metastases.

Accurate

Leksell Gamma Knife is known for delivering radiation with submillimetre accuracy, precisely to the unique contours of the tumour while minimising radiation to surrounding healthy tissue.

Flexible

Gamma Knife radiosurgery can be used to treat metastases located in areas that cannot safely be reached by traditional surgery, such as the brainstem.

One treatment session

Unlike conventional radiation therapy, which requires treatment over multiple days or weeks, Leksell Gamma Knife delivers a high dose of radiation to one or more brain tumours during a single treatment session, in one day. If the tumour being treated is too large for single fraction radiation, it is also possible to stage the treatment in three fractions at 2 weekly intervals.

Fast and Gentle

Most patients can leave the hospital the same day or the day after treatment and resume normal activities in a day or two. Therefore, recovery time and time spent in hospital is kept to a minimum.

Minimal side effects

As radiation is delivered specifically to the tumour, there is a reduced risk of a negative impact on brain function. Some people may experience headaches just after treatment.

Treatment process

Stereotactic frame fitting

In order to pinpoint the area that will be treated by the Gamma Knife, a guiding device called a stereotactic frame is fitted. This is a lightweight aluminium frame which is attached to your head with four surgical pins (two on the forehead and two on the back of the head). They pierce the skin and rest on the skull, but do not pierce the skull. Four small injections of local anaesthetic will be administered to numb the skin where the pins are to be placed. No hair will be shaved from your head. The fitting of the frame takes approximately 10 minutes.

You will experience a feeling of increasing pressure being applied to the head. However, this feeling will subside within 15 minutes. Once the frame is fitted it remains in place for the duration of your treatment and is removed immediately once treatment has been completed.

Diagnostic imaging

All patients require an MRI scan (or a CT scan if for any reason you cannot have an MRI scan) which is used to plan the treatment.

You will be required to remove your jewellery and any metal objects for the MRI scan
In order to produce high quality pictures of your brain, your head frame will be secured so it cannot move. An injection of contrast will be given before the scan. The imaging will take around 20 minutes
Throughout the examination, the staff will be able to see you and you will be able to communicate through an intercom

Angiography

Angiography is only necessary for patients who are having treatment for a vascular abnormality such as an arterio-venous malformation (AVM). In which case:

You will be asked not to eat for a minimum of six hours and not to drink for a minimum of two hours prior to this procedure
You will to asked to wear a hospital gown for the duration of the treatment
The procedure will involve a local anaesthetic being injected into the groin to numb the surrounding area
A small skin incision will be made to allow a tube (catheter) through the femoral artery in the groin
Dye is added through the catheter - you may notice a feeling of warmth in your head or face during the injection, but this will pass quickly
A series of X-ray images taken of the artery or arteries will be taken
Once this procedure is finished, pressure will be applied at the site of the skin incision, for a minimum of 10 minutes, until it has closed
Afterwards you will need to lie flat for between 4 to 6 hours which will coincide with your treatment time. You can usually expect to resume normal activities the following day

Treatment planning

After the diagnostic imaging is performed you will rest while the medical team plans your treatment.

The images taken will be transferred to the Gamma Knife planning station for examination, and the treatment area will be mapped out. The team will calculate the exact dose, treatment time and head position(s) required.

Treatment

You will now be taken to the treatment room and positioned on the Gamma Knife couch. The stereotactic frame or mask will be fixed onto the treatment couch. As the team leave the room you will hear a beeping noise to let you know that your treatment is about to begin.

The treatment is not painful and you will not feel or see anything. You can listen to music during treatment if you wish.

You will be constantly monitored by the team on closed circuit television and via an intercom. You can talk to the team during your treatment and you can request that the session be stopped at any time.

Post-treatment

Immediately following treatment the stereotactic frame is removed and small dressings will be placed over the forehead pin sites. If you are allergic to Elastoplast please let us know. Many patients feel very tired following the treatment. However, this is most likely due to the demands of the day itself, such will be early start, unfamiliar surroundings and procedures, and general anxiety.

If you were on any restrictions, prior to Gamma Knife treatment, they will continue.

Meningioma treatment

Giorgina, age 37 previous patient at The London Gamma Knife Centre

Hear how Gamma knife treated, Giorgina, who suffered from headaches and neck spasms throughout her childhood and teenage years.

“My symptoms were brushed off as a hormone imbalance, but it was in fact a brain tumour, which had been growing for years”

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