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February 2, 2011

No Scalpel in Hand, Surgeons Treat UVa’s 6000th Gamma Knife Patient UVa’s Gamma Knife Center Has Reputation as a World Leader

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Recently, Francis Gingras arrived at the University of Virginia Health System ready to undergo a form of brain surgery with many benefits. There’s no scalpel, no risk of hemorrhage, minimal chance of infection and a good likelihood of success.

Gingras soon learned he was the 6000 th patient of UVa’s Lars Leskell Center for Gamma Knife Radiosurgery and one of the first to be treated with a new generation of equipment called the Perfexion.

“We’re among a handful of centers around the world using the new Gamma Knife Perfexion,” says Jason Sheehan, M.D., PhD, the center’s associate director and an assistant professor of Neurosurgery and Radiation Oncology. Impressed by the equipment’s advanced capabilities and expanded indications, he says it will help “provide optimal care to our patients.”

During Gamma Knife procedures, neurosurgeons treat problems inside the brain without cutting open the skull. They use a single dose of radiation so precisely targeted that nearby normal brain tissue is preserved.

The Gamma Knife effectively treats tumors that arise in or spread to the brain as well as blood vessel defects and functional problems like trigeminal neuralgia and Parkinson’s disease. The Perfexion represents a total redesign of the original Gamma Knife and has the potential to treat additional conditions. These could include tumors at the base of the skull and tumors and vessel malformations at the level of the cervical spine.

Gingras, who resides in Johnson City, TN, suffers from a pituitary tumor that has caused him to develop Cushing’s disease, a rare disorder that over-stimulates hormone production in the adrenal gland. When surgery and conventional radiation therapy failed to eradicate his tumor, doctors recommended Gamma Knife treatment.

At UVa, Gingras underwent a two-hour procedure focused on deactivating a small area of his tumor. Doctors are hopeful this will normalize his hormonal secretions. Gingras will return to UVa every six months to check his progress.

“I was comfortable throughout the entire process,” he says. “I really cannot say enough good things about my Gamma Knife surgery experience and the entire UVa Health System. My wife and I don’t mind the six-hour drive because we’ve been impressed by the people at UVa. My doctors really know what they’re doing.”

UVa’s Gamma Knife Center is one of the most successful and experienced radiosurgery programs in the world. Since installing the world’s fifth Gamma Knife 18 years ago, the center has attained global recognition as a pioneer and leader in its use. Besides offering the nation’s only accredited advanced radiosurgical training course for physicians, the center’s staff has produced many peer-reviewed publications, performed clinical and laboratory research, lectured worldwide and organized symposia that have drawn international participation. In the months ahead, the staff will explore additional indications for the Perfexion.

The director of the center is Ladislau Steiner, M.D., PhD, a professor of Neurosurgery and Radiology. A pupil and associate of Gamma Knife inventor Lars Leksell, he was involved in the development of the original Gamma Knife and its clinical application. Dr. Steiner has received many distinguished honors for his work, including the 2001 Surgita Award from the International Society for Neurosurgical Technology and Instrument Invention and the 2003 Gold Medal of Honor from the World Federation of Neurosurgical Societies.

Dr. Steiner calls the Gamma Knife “the gold standard of radiosurgery” and believes it will remain so, thanks to the Perfexion’s key advancements. The new system, he says, is more comfortable for patients, completes treatments faster, and offers better dose planning – a capability that reduces radiation of surrounding tissue.

UVa’s other leading Gamma Knife expert is Neal F. Kassell, M.D., professor of Neurosurgery. “Equipment like the new Perfexion is most effective when combined with experienced physicians,” he observes. “Our staff is highly experienced and skilled in Gamma Knife procedures as well as conventional surgery. This enables us to objectively determine the best treatment for our patients. When it comes to the Gamma Knife, our broad experience translates into a higher degree of technical success and fewer complications. Patients know that by coming here, they’re getting the best possible chance of a cure.”

For more information about UVa’s Lars Leskell Gamma Knife Center, log on to .

Photos and more information about Frank Gingras are available on the Caring Bridge website, .


UVa’s Lars Leskell Center for Gamma Knife Radiosurgery Gamma Knife Overview

Nov. 19, 2007 The Gamma Knife enables neurosurgeons to treat problems inside the brain without cutting open the skull. They use a single dose of radiation to control or eliminate tumors and other lesions while minimizing the impact on nearby normal brain tissue.

The Gamma Knife is so named because it achieves its effect using gamma rays that are a byproduct of Cobalt 60 radioactive decay. It consists of a series of Cobalt 60 sources arranged in a geometric configuration that focus gamma rays at a single precise point. While individual gamma rays cause minimal biological damage, when beams converge at the focus point, they deliver an intense dose of radiation to the target area. Targeting accuracy is guaranteed through the use of a mechanical guidance device known as a stereotactic frame. This ability to precisely deliver the required dose of radiation, combined with innovations in three-dimensional imaging and computer-aided treatment planning, are what make the Gamma Knife such a powerful neurosurgical tool.

The Gamma Knife can reach tissue that is inaccessible or prohibitive for open brain surgery or conventional radiation therapy. “The Gamma Knife can treat areas near critical structures like the brainstem, optic pathways and facial nerves,” notes David J. Schlesinger, PhD, a biomedical engineer and primary dosimetrist at the University of Virginia’s Lars Leskell Center for Gamma Knife Radiosurgery.

The Gamma Knife is effective in treating tumors that arise in or spread to the brain. This includes brain tumors like acoustic and trigeminal neuromas, meningiomas, low grade astrocytomas and metastatic tumors.  It is also used to treat blood vessel defects (arterio-venous malformations, or AVMs) and functional problems such as trigeminal neuralgia and Parkinson disease.

With the new Gamma Knife Perfexion, procedures are faster and more comfortable for patients because the system automatically performs treatment tasks once done manually. It enables physicians to safely and effectively radiate multiple lesions in different parts of the brain in a single session. It can also simultaneously deliver beams of different sizes, a capability that opens new possibilities for shaping the radiation dose. The Perfexion has the potential to treat tumors outside the brain to the level of the lower neck. However, this will require new innovations in patient fixation and dosimetry to become reality.

For more information about UVa’s Lars Leskell Gamma Knife Center, log on to .

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