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Stereotactic Radiosurgery

An Innovative Alternative to Brain Surgery

For some patients with brain tumors or blood vessel malformations, surgery may be too difficult or dangerous because of the risks involved. Now, Adventist Hinsdale Hospital is able to offer patients an alternative to brain surgery.

Stereotactic radiosurgery, supported by over 20 years of research and successful treatment of hundreds of patients in Europe and the United States, is a non-invasive procedure that has revolutionized the treatment of previously inoperable brain abnormalities. Adventist Hinsdale Hospital's Radiosurgery program is one of only few such programs in Illinois and the only one in Chicago's western suburbs. This program offers a potentially lifesaving treatment option while eliminating the risks of traditional brain surgery and the lengthy recovery period. Radiosurgery offers a potentially lifesaving treatment option to patients that may have been previously considered untreatable.

Stereotactic radiosurgery uses a precisely directed beam of radiation to treat tumors and other abnormalities of the brain without a single incision. A single, small x-ray beam irradiates the legion from angles carefully predetermined by the radiosurgery team on computer. The method employs two key components: a sophisticated computer with three-dimensional analysis and viewing capabilities; and a linear accelerator an x-ray machine commonly used in the treatment of cancer patients. Stereotactic radiosurgery avoids potential side effects associated with surgery such a brain impairment, loss of motor function, scarring or disfigurement.

Candidates for Radiosurgery

Candidates for this procedure include patients who have a brain lesion or an arteriovenous malformation (AVM). Patients may be eligible for radiosurgery even if they previously had surgery, radiation therapy, chemotherapy, or in the case of AVM's, embolization procedures. Because only local anesthesia is required, radiosurgery can be done on patients who are young, elderly or who are poor candidates for general anesthesia. And because radiosurgery is performed without a single incision, recovery is much easier for the patient. Patients may be able to return to their normal activities the following day.

The candidate selection process at Adventist Hinsdale Hospital involves the entire radiosurgery team, which includes a neurosurgeon, radiation oncologist, radiation physicist, neuroradiologist and neuro clinical nurse specialist.

All radiosurgery candidates have an initial evaluation with the team's neurosurgeon and radiation oncologist. The neurosurgeon and the entire radiosurgery team remain in direct contact with the referring physician, providing written correspondence on case progress.

Patients with the following abnormalities are potential candidates for radiosurgery:

• Anaplastic Astrocytoma
• Acoustic neuroma
• Arteriovenous malformatoin
• Choroid Plexus Papilloma
• Crainopharyngioma
• Ependymoma
• Germinoma
• Glioblastoma
• Low Grade Astrocytoma
• Lymphoma
• Medulloblastoma
• Meningioma
• Metastasis
• Oligodendroglioma
• Pineoblastoma
• Pineocytoma
• Pituitary Tumors

LINAC vs. Gamma Knife

Adventist Hinsdale Hospital's radiosurgery program uses the linear accelerator (LINAC) system. Unlike the gamma knife, which uses a helmet from which more than 200 radiation beams are emitted, the LINAC system uses an open head frame for plotting three-dimensional coordinates of a single beam of radiation. Because of its mobility, the reach of LINAC is greater than the gamma knife and enables it, at times, to treat deeper-seated targets that the gamma knife cannot.

During treatment, the arm of the LINAC is moved through a series of arcs around the patient's head. From different points along each sweep, the machine directs the x-ray beam at the lesion. This drastically reduces the radiation dose to healthy tissue, while concentrating on the targeted lesion.

Treatment Procedure

Radiosurgery takes only about 30 minutes, although set-up and planing can take several hours. The radiosurgery team conducts imaging studies prior to treatment to ensure proper placement of the steteotactic headframe.

Before treatment begins, the patient is administered local anesthesia and fitted with a stereotactic headframe. This device will hold the patients head in a stationary position for treatment. The exact position and dimension of the target is plotted using high-resolution magnetic resonance imaging (MRI), computed tomographic scanning (CT), or angiography. The images are fed into a computer program that translates the information into a three-dimensional image of the area to be treated, showing the intracranial target lesion's location in relation to critical brain structures.

After the radiosurgery team designs the patient's treatment plan, the patient is placed on a treatment table and the patient's headframe is attached to an immobilization stand. Then, the radiosurgery team goes through another series of checks to make sure the patient is precisely positioned.

The computerized location techniques make it possible to direct the radiation to within one millimeter, with minimal risk of damaging surrounding brain tissue.

During the procedure, the patient may feel some discomfort because of the headframe. After treatment, the headframe is removed and the patient returns to his or her room for overnight observation. In most cases, the patient is able to leave the hospital the next day and resume normal activities.

Results from radiosurgery occur over time. The abnormality slowly shrinks and, in many cases, eventually disappears completely.