Gamma Knife

Gamma Knife radiosurgery, known as “scalpel-free brain surgery,” is a highly precise radiation treatment used to address issues in sensitive areas of the brain. This advanced technique targets diseased tissues with millimeter-level accuracy using high doses of radiation, destroying them while preserving the surrounding healthy brain tissue. This makes it a vital treatment option in cases where traditional surgical interventions are risky or not feasible. This innovative approach stands out as a reliable method that provides patients with a more comfortable and shorter recovery period.

What is Gamma Knife?

Gamma Knife is a radiosurgery device developed for brain treatment. This technology focuses 192 low-energy radiation beams onto the diseased area in the brain, much like a magnifying glass focuses sunlight. A high dose of radiation is formed at the point where the beams intersect, while the surrounding healthy brain tissue is protected. This non-invasive procedure, which does not require an incision, differs from traditional surgery. It also stands apart from conventional radiotherapy because it does not spread radiation over a wide area. Treatment with this precise radiosurgery device is performed with sub-millimeter accuracy.

What are the features of Gamma Knife?

Gamma Knife radiosurgery offers a unique set of features that distinguish it as a highly advanced and patient-friendly treatment method. These characteristics contribute to its effectiveness, minimize patient discomfort, and provide a precise, less invasive option for various brain conditions.

• Sub-millimetric precision: This technology targets diseased areas within the brain with an accuracy of less than a millimeter. This precision ensures that radiation is delivered directly to the target, preserving surrounding healthy brain tissue.
• No incision or bleeding (non-invasive): Unlike conventional brain surgery, Gamma Knife treatment does not require surgical cuts. This non-invasive approach significantly reduces the risks associated with open surgical procedures, such as infection or hemorrhage.
• Usually completed in a single session: One of the major advantages of this treatment is that most procedures are completed in a single session. This efficiency means less time in the hospital and a quicker return to daily routines for the patient.
• Possibility of outpatient treatment: Due to its non-invasive nature and single-session completion, many patients can undergo the treatment and return home on the same day. This outpatient approach enhances convenience by often eliminating the need for an overnight hospital stay.

In which diseases can it be used?

Gamma Knife radiosurgery treats a wide spectrum of neurological conditions, which can be categorized into several groups. It is frequently used for various brain tumors, including benign types like meningiomas and pituitary adenomas, and malignant brain tumors such as metastases. The procedure is also a primary option for vascular abnormalities, especially arteriovenous malformations (AVMs), as its precision is ideal for safely treating these complex arteriovenous malformations (AVMs).

Furthermore, Gamma Knife effectively addresses functional disorders. It provides significant relief for patients with trigeminal neuralgia, a condition causing severe facial pain, making it a leading treatment for trigeminal neuralgia. Certain movement disorders, like essential tremor, can also be managed with this technique. The treatment is generally most effective for lesions smaller than 3.5 cm in diameter, allowing for optimal radiation delivery while sparing healthy tissue.

Which method is used for Gamma Knife?

Gamma Knife utilizes a method called stereotactic radiosurgery. In this technique, a three-dimensional map of the patient’s brain is created using imaging methods such as Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). This map allows the location, shape, and size of the lesion to be treated to be determined with millimeter precision. Based on the prepared plan, the Gamma Knife radiosurgery device focuses the radiation beams directly on the target, thereby protecting the surrounding healthy tissues.

How is it applied?

Gamma Knife radiosurgery is a carefully planned and step-by-step process that allows for precise targeting within the brain. This non-invasive procedure ensures high accuracy while offering minimal discomfort for patients. The application process generally consists of the following stages:

1.  Planning: An expert team reviews the patient’s MRI or CT scans to create a personalized treatment plan that determines the optimal radiation dose and target for the area to be treated.

2.  Frame or Mask Fitting: To keep the head stationary during treatment, a lightweight frame is attached with local anesthesia. Alternatively, a custom-made mask may be used in some cases.

3.  Imaging: After the frame or mask is fitted, current images are taken with MRI or CT to confirm the exact location of the target. This data is used to finalize the treatment plan.

4.  Treatment Application: The patient is positioned inside the Gamma Knife unit. In line with the plan, hundreds of precise beams are directed to the diseased tissue, converging only at the targeted point to create a high dose of radiation. The patient feels no pain during this process.

5.  End of Procedure: Once the treatment is complete, the frame or mask is removed. After a short observation period, the patient is usually discharged on the same day.

How long does the application/procedure take?

The duration of the Gamma Knife procedure typically ranges from 30 minutes to several hours. This timeframe is primarily determined by the size, location, and complexity of the lesion being treated. Throughout the entire application, patients remain awake and are fully able to communicate with the medical team. This continuous interaction allows for a comfortable and closely monitored treatment experience.

Is the Gamma Knife procedure painful?

No, the Gamma Knife procedure is not a painful process. The radiation beams used during the treatment are not felt by the patient. The only potential discomfort from the procedure occurs during the fixation of the stereotactic frame to the head before treatment. At this stage, local anesthesia is applied to the contact points of the frame, and patients may only feel a brief sensation of pressure. The treatment itself is completely painless.

Which patients is it applied to?

Gamma Knife is an ideal treatment method, especially for patients with small to medium-sized, well-defined lesions such as brain tumors. This treatment offers an excellent alternative for patients who are considered high-risk for traditional open surgery due to their age, general health condition, or the location of the tumor. Its minimally invasive nature minimizes the risks of surgery-related complications, allowing patients to have a more comfortable and faster recovery process.

Who is not suitable for Gamma Knife application?

Although Gamma Knife treatment is an effective method, it may not be suitable for every patient. Gamma Knife radiosurgery may not be sufficient on its own, especially for very large tumors (generally larger than 3.5 cm). Lesions with poorly defined borders or diseases that have spread to multiple areas are also not suitable for this treatment. Additionally, patients who cannot undergo the MRI scan required for treatment planning (for example, those with incompatible pacemakers or metal implants) cannot benefit from this method.

What are the advantages?

Gamma Knife radiosurgery offers significant advantages for patients compared to traditional brain surgery. This modern treatment promises a safer and more comfortable process.

• No incision, stitches, or risk of bleeding: As a non-invasive procedure that does not require a surgical cut, it eliminates the risk of complications like infection.
• Does not require general anesthesia: The procedure is performed with local anesthesia, avoiding the potential risks and side effects of general anesthesia.
• Hospitalization is usually not necessary: Patients can typically be discharged on the same day after the procedure is completed.
• The recovery process is very fast: Following the treatment, patients can usually return to their normal lives and daily activities the next day.
• Minimal risk of damage to surrounding tissues: Thanks to the high-precision technology, radiation is focused only on the targeted tissue, thus maximally protecting healthy brain tissues.

Are there any side effects of using Gamma Knife?

Side effects from Gamma Knife treatment are rare and typically temporary. Because this advanced radiosurgery method targets lesions with high precision, damage to surrounding healthy tissue is minimal, and most patients do not experience significant issues.

In some cases, mild and temporary effects may occur, such as swelling (edema) around the treated area, headaches, or fatigue. These symptoms are generally short-lived and can be easily controlled with medication. Any discomfort usually subsides within a few days, allowing patients to quickly return to their normal routines.

What should be considered after the application?

After a Gamma Knife procedure, it is important to understand that the treatment’s effects are not immediate. The radiation works gradually, causing the targeted cells to shrink or become inactive over time. The timeline for these results varies depending on the specific condition; for some brain tumors, noticeable changes may occur within a few months, while for others, the full impact can take several years. As part of the standard follow-up care, your doctor will schedule periodic MRI scans, typically at 3, 6, or 12-month intervals, to monitor the progress and assess the long-term effectiveness of the treatment.