title: Intracranial radiosurgery: an effective and disruptive innovation in neurosurgery.
abstract: Physicians are guided by the teachings of their chosen field, standards of accepted practice, peer pressure, prior training, and other sources of bias. When potential bias begins to impact recommendations for care in the field of tumor management, physicians may fail to realize the importance of emerging medical innovations. Some of these ultimately turn out to be 'disruptive innovations.' These innovations are more often than not both low risk and cost effective. But the leaders in the field often initially ignore these newer technologies in favor of more mature existing technologies. However, over time these technologies gradually improve and become mainstream management practices. Intracranial radiosurgery is one such innovation which was not embraced by the neurosurgical community in the beginning. Nowadays, a wide variety of brain and body disorders are treated with radiosurgery. Acoustic neuromas and brain metastases are examples of rapidly growing indications of radiosurgery. In this report, the authors describe the emergence of stereotactic radiosurgery as a disruptive innovation in the field of medicine.
authors.affiliation: Department of Neurological Surgery, The School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. niranjana@upmc.edu
authors.forename: Ajay
authors.initials: A
authors.lastname: Niranjan
authors.forename: Ravindranath
authors.initials: R
authors.lastname: Madhavan
authors.forename: Peter C
authors.initials: PC
authors.lastname: Gerszten
authors.forename: L Dade
authors.initials: LD
authors.lastname: Lunsford
mesh_terms: D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery; D003362:Cost-Benefit Analysis; D006801:Humans; D009464:Neuroma, Acoustic / Q000601:surgery; D009493:Neurosurgery / Q000191:economics / Q000379:methods / Q000639:trends*; D016634:Radiosurgery / Q000191:economics / Q000379:methods / Q000639:trends*; D035703:Therapies, Investigational / Q000191:economics / Q000379:methods / Q000639:trends*; D014481:United States