title: Introduction of an adaptor to fix Y/Z slides during Leksell gamma knife radiosurgery to treat concomitant bilateral far-lateral lesions.
abstract: OBJECTIVE
  The authors develop and introduce an adaptor in gamma knife radiosurgery to fix the Y/Z slides inside the Leksell coordinate G frame for the treatment of concomitant bilateral far-lateral intracranial lesions.
  
  
  METHODS
  The new adaptor was used to treat a 60-year-old woman with renal cell carcinoma and multiple brain metastases. She experienced sudden onset of left-sided weakness and disturbed consciousness. Brain computed tomographic scans showed a large right temporal intracerebral hematoma. After a craniectomy for the removal of the hematoma, she received a complete course of whole brain radiotherapy. However, several new tumors were detected on the follow-up brain magnetic resonance imaging scan.
  
  
  METHODS
  The longest distance of these far-lateral lesions on the x axis was approximately 108 mm. It was not possible to treat some of these tumors in one session with the normal use of the Y/Z slides in the trunnions mode. We developed a new adaptor to fix the Y/Z slides inside the G frame. By using the adaptor, the far-lateral located tumors were treated successfully in a single session.
  
  
  CONCLUSIONS
  This newly developed adaptor can fix the Y/Z slides inside the G frame. It increases the range of the coordinates on the x axis from 52 to 148 mm to 30 to 170 mm. Using the adapter, gamma knife radiosurgery is a simple and accurate procedure for the treatment of bilateral far-lateral lesions in one session, particularly for lesions that cannot be approached with the normal use of the Y/Z slides in the trunnions mode.
authors: Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. ed100183@edah.org.tw
authors: Cheng-Loong
authors: CL
authors: Liang
authors: Meng-Wei
authors: MW
authors: Ho
authors: Li-Chiang
authors: LC
authors: Lin
authors: Han-Jung
authors: HJ
authors: Chen
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008846:Micromanipulation / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D016634:Radiosurgery / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000379:methods*