Radiosurgery and the PERFEXION device

Gamma Knife surgery is an advanced method of radiosurgery used for many years to treat brain diseases.

The Gamma Knife PERFEXION device, the latest device of its kind developed on the market, was installed at the Oncology and Radiation Center of Florence Nightingale Hospital in Gayrettepe. The team of specialists successfully performs treatments using the Gamma Knife procedure.

In addition to being a new and advanced model, this device also comes with additional features. With the help of the PERFEXION device you can get a higher effectiveness of the treatment and fewer side effects.

HOW THE GAMMA DEVICE WORKS

In radiosurgery with the Gamma Knife PERFEXION device, 201 high-energy rays are concentrated from a cobalt source, which are sent to a target marked by a defined, high-sensitivity border.

The shape and dose of the rays can be optimized to affect only the target, without damaging healthy tissues. The device can use millions of beam configuration possibilities.

Through this treatment, the DNA of the tumor or the cells of the lesion are degraded and the cells lose their ability to survive. This results in the tumor shrinking over time.

In vascular disease, this application thickens the vein wall and eventually saturates the vascular malformation. In malignant tumors and in cases of metastasis, it takes only a few months to get good results.

In the case of functional diseases, the goal is to create a small lesion in the target area of ​​the brain, so a higher dose of radiation is sent to the target cells.

The lesion created by this application disrupts abnormal transmission, treats functional illness and symptoms such as movement disorders, pain or epilepsy.

GAMMA KNIFE STEPS OF TREATMENT

  • Patient selection and preoperative stage

The decision to use radiosurgery is made after all the information about the patient is evaluated, a board is formed consisting of a neurosurgeon, oncologist radiotherapist and other specialists, who reach a consensus on this method.

As this method does not require any incision, being a minimally invasive method, patients will be informed that the procedure will take place during the day, with the possibility of returning home until the evening.

  • Placement of the frame

This is a necessary step in determining the target to be hit with high precision. The frame is rigidly stabilized on the skull by screws at four different points, which allows a personalized treatment of stereotactic radiosurgery, unlike other methods of radiation therapy. The target is reached with high precision, on average 0.15 mm.

The frame is placed on the stabilization points under light sedation and local anesthesia is applied to the stabilization points on the patient’s head. The only disadvantage of this procedure is that it cannot be applied to children under 8 years of age.

 

  • Target setting and dose planning

After the x-rays are taken, the patient is taken to the salon and here has the opportunity to rest, eat, etc., during the planning period of 1-2 hours. Radiological images involved in the stereotactic volume are used in the treatment planning program. The target area and its edges are identified, the dosing plan is established and the dose to be sent is determined.

  • Radiosurgical treatment

After the planning stage is completed, the patient is brought to the treatment department. The treatment period varies from a few minutes to a few hours, depending on the number and size of the lesions.

The treatment room is a large and bright area. The irradiation department is also extremely large, so there is no problem for claustrophobic patients.

The patient is monitored through a monitor and communicates vocally with him throughout the treatment period. In case of a problem, you can pause during the treatment and then continue the treatment at the same point.

  • Postoperative

After treatment, the frame is removed from the patient’s skull and given a report that includes details of the therapy and planning steps. The patient is taken to rest for a few hours and is later discharged.

  • Further treatment

The patient is further examined or treated at certain intervals, depending on the lesions treated, and periodic radiographs are taken to monitor his condition.

KNIFE RANGE IN THE WORLD

GAMMA KNIFE treatment is currently used worldwide in 275 centers. In total, 676,000 patients were treated with GAMMA KNIFE therapy and the annual number gradually increased.

Experiences and medical information from the growing number of patients treated and with treated diseases are shared by the GAMMA KNIFE Treatment Centers through a network. This experience is shared with the world through 3,000 scientific publications.

The GAMMA KNIFE PERFEXION device in Florence Nightingale Hospital is the first in Turkey and neighboring countries. Thus, patients are not only Turkish citizens, at least 30% of them are international patients.

 

 

 

 

DISEASES TREATED WITH GAMMA KNIFE

Vestibular Scwanoma

Due to its location near the brainstem, cranial nerves, auditory system, cerebellum and vital vascular structures, surgery of this tumor is permanently a risky method to a certain extent. A complication observed especially in 40% of cases is the degradation of the facial nerves.

With GAMMA KNIFE PERFEXION radiosurgery methods, the level of degradation of the facial nerves is low, while protecting the auditory system. This method is also used for postoperative residual tumors and in recurrent cases.

Arteriovenous malformations

These are the main group of intracranial vascular lesions treated with GAMMA KNIFE PERFEXION. All treatment methods for these conditions are available at the Florence Nightingale Center, such as surgery, endovascular surgery and GAMMA KNIFE treatment. However, the combination of these methods provides the best results.

Pituitary adenoma (pituitary)

Along with the treatment of primary pituitary tumors, treatment of residual and recurrent tumors can be planned, with protection of the optic nerves and normal tissues.

GAMMA KNIFE PERFEXION is the first choice of treatment, especially in the case of the involvement of the cavernous sinus and the carotid artery infiltrated with adenomas, which otherwise require extremely risky surgery.

Meningioma

Meningiomas are mainly benign tumors that appear in the cerebral cortex, which are sometimes located in areas where surgical removal is risky. It is possible to treat these tumors with GAMMA KNIFE PERFEXION.

In the case of large meningiomas, following a maximum surgical resection, the application of the Gamma Knife procedure on tumors located in risk areas has become a successful method in recent years and accepted as a method with low complications. In addition, it is actively used to treat cases of recurrent meningiomas.

Trigeminal neuralgia

Treatment of trigeminal neuralgia that causes severe facial pain can be done with Gamma Knife PERFEXION.

Other therapy methods designed for this condition (microvascular decompression, percutaneous retrogaserian compression and radiofrequency, local injections, etc.) are also available at Group Florence Nightingale.

Vascular diseases

  • AVM (Arteriovenous Malformation)
  • Aneurysm
  • Angiom cavernos
  • Other vascular diseases

Benign tumors

  • Schwanom vestibular
  • Pienal tumors
  • Trigeminal schwanom
  • Hemangioblastoma
  • Other Schwanoame
  • Hemangiopericytoma
  • Benign glial tumors (grade 1 + 11)
  • Craniopharynx
  • Miningiom Cordom
  • Pituitary adenoma (secretant)
  • Glomic tumors
  • Pituitary adenoma (non-secreting)
  • Other benign tumors

Malignant tumors and metastatic brain tumors

  • Malignant glial tumors (grade 1 + 11)
  • Metastatic tumors
  • Chondrosarcoma
  • Carcinoma NPH
  • Other malignancies

Functional diseases

  • Trigeminal neuralgia
  • Parkinson’s disease
  • Intractable pain
  • Epilepsy
  • Obsessive-compulsive disorder
  • Other functional diseases

Eye diseases

  • Uveal melanoma
  • Glaucoma
  • Hemangioblastoma
  • Hemangiopericytoma
  • Craniopharynx
  • Cordom
  • Glomic tumors
  • Other eye tumors

Gamma Knife Vs. Open surgery

The treatment is completed in one session, in one day. It can be performed in cases where surgery is not possible. A high-precision method for reaching the target site. Minimal risk compared to normal surgery. Easy, painless treatment. The patient can resume his activity immediately. It can be repeated as many times as needed.

Open surgery cannot be replaced by Gamma Knife surgery, but these two methods complement each other. Some lesions are more suitable for Gamma Knife surgery, while others are more suitable for open surgery. In some cases, both types must be applied.

For example, in the case of large tumors, a planned two-step procedure may be applied and the volume of the lesion may be reduced, while tumors that cannot be reached or removed due to their location may be treated with Gamma Knife surgery. In cases where Gamma Knife surgery can be applied, it is preferred over conventional surgery, both in terms of patient comfort and treatment costs. Certainly patients will prefer a method of treatment without blood, without pain and without anesthesia.