Gamma Knife surgery is a non-invasive treatment that uses radiation to remove brain tumors without cutting into the skull, which can significantly reduce the burden on the patient. The precise irradiation removes the tumor with minimal damage to normal cells, and it has fewer side effects and a faster recovery than surgery.
Brain tumors are any tumor that develops within the skull and are rare, accounting for only 0.9% of all cancer cases. However, the main surgical treatment for brain tumors involves opening the skull and cutting out parts of the brain, which is very painful for patients. Therefore, gamma knife surgery, a radiosurgery that uses radiation to destroy tumor cells, has recently gained attention.
Radiosurgery is a treatment method that removes tumors by focusing radiation only on the targeted tumor cells. To understand this, think of stage lights. The light from a single light is weak, but when multiple lights are combined, the center of the stage is illuminated with a very bright light. Similarly, radiation from a single light source is weak and has little effect on normal cells. However, when radiation from multiple directions converges on a focal point, the intensity becomes strong enough to destroy the targeted tumor cells. Radiation therapy, the use of radiation to kill tumors, has been around for a long time, but it differs from radiosurgery in that it does not distinguish between normal and tumor cells, but rather irradiates a wide area.
Gamma knife surgery is a radiosurgery that uses gamma radiation from the isotope cobalt-60 to treat brain tumors. The Gamma Knife uses cobalt-60 arranged in a hemisphere around the head that emits gamma rays from more than 200 different directions to form a focus at the center of which the tumor is placed to kill tumor cells. In this process, the tumor is removed without opening the skull and with minimal damage to normal cells.
Gamma knife surgery involves precisely locating the tumor and then determining the area to be irradiated and the intensity of the radiation. First, a device called a stereotactic frame is attached to the patient’s head, and then the tumor’s location is analyzed in three dimensions through MRI, CT, and angiography. The stereotaxic collar immobilizes the patient’s head during surgery and must remain in place from the beginning to the end of the procedure. The imaging images taken are reconstructed in three dimensions, which the surgeon uses to determine the extent and intensity of radiation, taking into account critical tissues such as the optic nerve around the tumor.
The surgery is performed with the patient lying on the operating table and receiving a fixed dose of radiation according to pre-planned coordinates. There is no pain or noise, and the patient is free to move the rest of the body, except for the head, during the procedure. The surgery can take anywhere from 30 minutes to several hours, depending on the size and shape of the tumor, and at the end of the procedure, the stereotaxic brace is removed and the patient is stabilized and discharged home.
There are some clear differences between radiosurgery and traditional surgery. Surgical procedures can provide immediate results because they directly remove the tumor, but there are significant risks associated with opening the brain and cutting through tissue. Radiosurgery, on the other hand, removes tumors in a non-invasive way, so there is little risk of bleeding or infection. However, patients may need to be patient, as surgery can remove the tumor in a single procedure, while radiosurgery involves a slow process of shrinking the tumor, requiring patients to observe the results over several months.
The simplicity of the Gamma Knife procedure compared to surgical intervention reduces the burden on the patient in several ways. First and foremost, there is no need to make an incision in the skull, so patients can undergo surgery with only local anesthesia, and they can go home the same day after surgery, reducing the financial and psychological burden. In addition, the Gamma Knife delivers precisely calculated radiation by computer, making it the most precise radiosurgery device available today.
Of course, there is still work to be done. The main limitation of Gamma Knife surgery is that it can only treat the inside of the skull. If the tumor is located below the neck, it is difficult to perform radiosurgery. This is because the rib cage and internal organs move as the patient breathes, making it difficult to get accurate radiographic images. However, the makers of the Gamma Knife are working to overcome this limitation, and it is expected that more precise radiosurgery will be possible in the future.
As medical technology advances in the future, radiosurgery such as Gamma Knife is expected to become more precise and have a wider range of applications. Currently, researchers are investigating how radiosurgery can be used to treat not only tumors, but also neurological diseases of the brain, cardiovascular diseases, and more. In addition, new imaging technologies combined with artificial intelligence could enable personalized treatment for patients. In the coming years, radiosurgery is likely to become even more precise, making non-invasive treatments commonplace for a wide range of conditions outside the skull and throughout the body. Further research into radiosurgery, including the Gamma Knife, could lead to medical breakthroughs that remove tumors without cutting through the skin.
