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Radiosurgery

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Stereotactic and Functional Neurosurgery

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Abstract

Radiosurgery is a blending of radiosurgery and radiation techniques that was pioneered by Dr. Lars Leksell at the Karolinska Institute in Stockholm, Sweden. This technique involves the ablation of intracranial targets and induction of desired biological effects in target tissues through the use of a high dose of highly conformal ionizing beams through the body. This technique has evolved over time to include the delivery of anywhere between one and five treatments or fractions. Since radiosurgery often involves targeting small radiographically deep lesions within the brain and spine, precision is absolutely essential and is readily obtained by immobilization. The vast majority of clinical experience with radiosurgery has been using photon-based sources, such as the Gamma Knife®, Cyberknife®, or other linear accelerator (LINAC)-based platforms. There are also facilities delivering radiosurgery with charged particles (e.g., protons). There are many similarities in both the delivery and physical principles between conventionally fractionated radiation therapy and radiosurgery. However, there are distinct differences between these two modalities which are employed by clinicians to maximize benefits to patients. This chapter will focus on the unique nature of radiosurgery with regard to medical physics and radiation biology.

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Abbreviations

60Co:

Cobalt-60

AVM:

Arteriovenous malformation

BRW:

Brown-Roberts-Wells

CT:

Computerized tomography

CTV:

Clinical target volume

DNA:

Deoxyribonucleic acid

DPL:

Dynamically penalized maximum likelihood

FSE:

Fast spin echo

GTV:

Gross target volume

Gy:

Gray

IMRS:

Intensity-modulated radiosurgery

LINAC:

Linear accelerator

MLCs:

Multileaf collimators

MR:

Magnetic resonance

MRI:

Magnetic resonance imaging

PTC:

Planned target volume

SRS:

Stereotactic radiosurgery

US:

United States

VP:

Ventriculoperitoneal

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Authors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA

    Daniel M. Trifiletti

  2. Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Eric J. Lehrer

  3. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, USA

    Jason P. Sheehan

Authors
  1. Daniel M. Trifiletti
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  2. Eric J. Lehrer
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  3. Jason P. Sheehan
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Corresponding author

Correspondence to Jason P. Sheehan .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Nader Pouratian

  2. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Sameer A. Sheth

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Trifiletti, D.M., Lehrer, E.J., Sheehan, J.P. (2020). Radiosurgery. In: Pouratian, N., Sheth, S. (eds) Stereotactic and Functional Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-34906-6_17

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  • DOI: https://doi.org/10.1007/978-3-030-34906-6_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-34905-9

  • Online ISBN: 978-3-030-34906-6

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