Prone positioning for successful gamma knife radiosurgical treatment of far anterior skull base lesions: a technical note. J Neurol Surg A Cent Eur Neurosurg 2012 Aug;73(4):243-8
Date
07/25/2012Pubmed ID
22825837DOI
10.1055/s-0032-1304214Scopus ID
2-s2.0-84871866121 2 CitationsAbstract
BACKGROUND: Gamma Knife targeting is geometrically limited by the physical dimensions of the head, helmet, headframe, and the radiation target position. All four aspects need to be considered for accurate treatment planning. Within the available space, delivery of the treatment isodose is based on the target position, which must be brought into the center of the collimator. In cases of anatomically challenging target positions in far eccentric locations of the head, careful treatment planning needs to be performed that does not exceed the limits of the system.
CLINICAL PRESENTATION: We describe a case of a challenging far anterior ethmoid sinus hemangiopericytoma in an 80-year-old woman.
TECHNIQUE: The tumor was treated successfully by positioning the patient prone on a Model C Gamma unit. The physical restrictions of the Gamma Knife surgical system and the rationale for improved anterior targeting using the prone position are discussed.
CONCLUSION: A thoughtful approach to positioning in challenging anterior lesions extends the targeting capabilities of certain Gamma units.
Author List
Clarke MJ, Foy AB, Garces YI, Link MJAuthor
Andrew Foy MD Associate Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Aged, 80 and overEthmoid Sinus
Female
Hemangiopericytoma
Humans
Magnetic Resonance Imaging
Nasal Cavity
Prone Position
Radiosurgery
Skull Base Neoplasms
Tomography, X-Ray Computed
