title: Dynamic stereotactic radiosurgery using a linear accelerator.
abstract: We describe a system for stereotactic radiosurgery with a linear accelerator. This technique allows treatment of small (less than 40 mm diameter) intracranial lesions, including vascular malformations, and primary and metastatic tumors that are deep within the brain or in areas not amenable to open surgery. A beam of ionizing radiation (1800 to 2500 cGy) is focused on the center of the lesion, which is determined by stereotactic localization. "Dynamic rotation" of the linac gantry and table continuously about this predetermined point ensures that only the lesion receives the full radiation dose, while the normal structures in the head receive minimal amounts of radiation. The system combines, for the first time in one place, elements of radiosurgical technique developed at various centers. Testing for accuracy compares favorably with results at other centers using linac-based systems as well as comparing favorably with the gamma knife.
authors.affiliation: Department of Neurosurgery, Roper Hospital, Charleston, SC.
authors.forename: C
authors.initials: C
authors.lastname: Worthington
authors.forename: J M
authors.initials: JM
authors.lastname: Jenrette
authors.forename: J O
authors.initials: JO
authors.lastname: Fenn
authors.forename: G D
authors.initials: GD
authors.lastname: Frye
authors.forename: J D
authors.initials: JD
authors.lastname: Wise
authors.forename: C W
authors.initials: CW
authors.lastname: Starr
authors.forename: S J
authors.initials: SJ
authors.lastname: Nelson
authors.forename: R C
authors.initials: RC
authors.lastname: Schoer
authors.forename: R
authors.initials: R
authors.lastname: Miller
authors.forename: J
authors.initials: J
authors.lastname: Curé
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002533:Cerebral Angiography; D004806:Ependymoma / Q000601:surgery; D005500:Follow-Up Studies; D005910:Glioma / Q000601:surgery; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008961:Models, Structural; D009464:Neuroma, Acoustic / Q000601:surgery; D010315:Particle Accelerators; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods*; D011879:Radiotherapy Dosage; D013813:Therapy, Computer-Assisted