Gamma Knife Neurosurgery in the Management of Intracranial Disorders II

Preface
Contents
Subtotal Resection Followed by Adjuvant Radiosurgery for Large Vestibular Schwannomas: Outcomes with Regard to the Timing and Regimen of Irradiation
Introduction
Patients and Methods
Stereotactic Radiosurgery
Follow-Up, Tumor Volumetry, and Outcome Measures
Statistics
Results
Tumor Control and Volumetric Response to Radiosurgery
Preservation of Facial Nerve Function
Other Outcome Measures
Discussion
Conclusion
References
Preplanned Partial Surgical Removal Followed by Low-Dose Gamma Knife Radiosurgery for Large Vestibular Schwannomas
Introduction
Patients and Methods
Surgical Technique
Radiosurgical Technique
Follow-Up
Results
Preservation of Facial Nerve Function
Preservation of Hearing
Salvage Surgery
Complications
Discussion
Partial Surgical Removal of a Vestibular Schwannoma Before Radiosurgery
Timing of Radiosurgery After Partial Surgical Removal of a Vestibular Schwannoma
Outcome After Combined Treatment
Salvage Surgery After Radiosurgery for Vestibular Schwannomas
Conclusion
References
Outcome After Resection of Craniopharyngiomas and the Important Role of Stereotactic Radiosurgery in Their Management
Introduction
Patients and Methods
Main Surgical Group
Surgical Grading System for Craniopharyngiomas
Surgical Approach
Follow-Up
Supplementary Surgical Group and CyberKnife Radiosurgery
Statistics
Results
Clinical and Surgical Correlates of Craniopharyngioma Surgical Grades
Gamma Knife Radiosurgery
CyberKnife Radiosurgery
Discussion
Surgical Classifications and Grading Systems for Craniopharyngiomas
Gamma Knife Radiosurgery
CyberKnife Radiosurgery
Comparison of Gamma Knife and CyberKnife Radiosurgery
Conclusion
References
Gamma Knife Radiosurgery for Pituitary Adenomas Invading the Cavernous Sinus: Tokyo Women’s Medical University Experience
Introduction
Imaging for Evaluation of Cavernous Sinus Microanatomy
Advantages of CISS Images
Radiosurgery Treatment Planning
Clinical Results
Illustrative Case 1
Illustrative Case 2
Illustrative Case 3
Alternative Treatment Options
Remaining Questions and Future Perspectives
Is Selective Treatment Reasonable?
Conclusion
References
Stereotactic Radiosurgery for Pituitary Carcinoma
Introduction
General Characteristics of Pituitary Carcinomas
Radiotherapy and Stereotactic Radiosurgery for Pituitary Adenomas
Impact of Radiotherapy on Tumorigenesis of Pituitary Carcinomas
Radiotherapy for Pituitary Carcinomas
Efficacy of Combined Treatment
Stereotactic Radiosurgery for Pituitary Carcinomas
Conclusion
References
Evidence-Based Recommendations for Seizure Prophylaxis in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery
Introduction
Materials and Methods
Results
Risk of Seizures in Patients with Brain Metastases After Radiosurgery
Efficacy of Prophylactic Antiepileptic Therapy in Patients with Brain Metastases After Radiosurgery
Patterns of Clinical Practice for Prophylactic Antiepileptic Therapy in Patients with Brain Metastases After Radiosurgery
Discussion
Conclusion
References
Cumulative Intracranial Tumor Volume as a Prognostic Factor in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery
Introduction
Prognostic Scales for Radiosurgery-Treated Patients with Brain Metastases
Caveats About Terminology
The Recursive Partitioning Analysis Classification
Modified Recursive Partitioning Analysis Subclassifications
The Basic Score for Brain Metastases
The Score Index for Radiosurgery
The Graded Prognostic Assessment
The Diagnosis-Specific Graded Prognostic Assessment
Prognostic Value of the Cumulative Intracranial Tumor Volume
The Cumulative Intracranial Tumor Volume Versus the Largest Intracranial Tumor Volume
Supportive Clinical Data
Incorporating the Cumulative Intracranial Tumor Volume into the Diagnosis-Specific Graded Prognostic Assessment
Future Directions
Conclusion
References
Treatment Options for Leptomeningeal Metastases of Solid Cancers: Literature Review and Personal Experience
Introduction
Diagnosis of Leptomeningeal Metastases
Magnetic Resonance Imaging
Cerebrospinal Fluid Examination
Therapeutic Options for Leptomeningeal Metastases
Systemic Chemotherapy
Intrathecal Chemotherapy
Radiation Therapy
Stereotactic Radiosurgery
Immunotherapy
Molecular Targeted Therapy
Treatment Response Assessment
Personal Experience
Case 1
Case 2
Case 3
Case 4
Conclusion
References
Stereotactic Radiosurgery to Prevent Local Recurrence of Brain Metastasis After Surgery: Neoadjuvant Versus Adjuvant
Introduction
Controlling Brain Metastases with Surgery and Whole-Brain Radiation Therapy
Stereotactic Radiosurgery
Adjuvant Radiosurgery
Prospective, Randomized Trials
Technical Nuances of Target Contouring
Timing
Neoadjuvant Radiosurgery
Advantages and Disadvantages
Alternatives to Single-Session Radiosurgery
Which Treatment Strategy Is Better?
Interplay of Immunomodulation and Radiosurgery
Conclusion
References
Redistributing Central Target Dose Hot Spots for Hypofractionated Radiosurgery of Large Brain Tumors: A Proof-of-Principle Study
Introduction
Materials and Methods
Generalized Biologically Effective Dose Formula
Comparative Analysis
Results
Discussion
Conclusion
References
Possible Overcoming of Tumor Hypoxia with Adaptive Hypofractionated Radiosurgery of Large Brain Metastases: A Biological Modeling Study
Introduction
Materials and Methods
Dose Escalation in the Target and Control for Irradiation of Normal Brain Tissue
Accounting for Tumor Hypoxia
Comparative Analysis
Results
Discussion
Conclusion
References
Differentiating Radiation-Induced Necrosis from Tumor Progression After Stereotactic Radiosurgery for Brain Metastases, Using Evaluation of Blood Flow with Arterial Spin Labeling (ASL): The Importance of Setting a Baseline
Introduction
Materials and Methods
Results
Discussion
Differentiating Radiation-Induced Effects from Tumor Progression
Advantages of Perfusion Imaging with Arterial Spin Labeling
Importance of Perfusion Measurements at Baseline
Conclusion
References
Gamma Knife Radiosurgery for Symptomatic Cavernous Malformations: Tokyo Women’s Medical University Experience
Introduction
Materials and Methods
Results
Annual Hemorrhage Rates
Seizure Control
Illustrative Cases
Case 1
Case 2
Discussion
Conclusion
References
Gamma Knife Thalamotomy for a Medically Refractory Tremors: Longitudinal Evaluation of Clinical Effects and MRI Response Patterns
Introduction
Patients and Methods
Radiosurgical Technique
Clinical and Radiological Evaluations
Results
MRI Response Patterns
Associations Between MRI Response Patterns and Clinical Effects
Complications
Discussion
Conclusion
References
Pituitary Radiosurgery for Management of Intractable Pain: Tokyo Women’s Medical University Experience and Literature Review
Introduction
Physiological Mechanisms of Hypophysectomy for Management of Pain
Current Indications for Pituitary Radiosurgery
Metastatic Bone Disease
Disseminated Cancer Without Bone Involvement
Poststroke Thalamic Pain
Pituitary Radiosurgery Treatment Planning
Radiosurgical Target
Treatment Dose
Protection of the Anterior Visual Pathways and Other Critical Structures
Clinical Results
Side Effects and Complications
Histopathological Changes After Pituitary Radiosurgery
Remaining Questions and Future Research Perspectives
Effects of High-Dose Irradiation on the Hypothalamic–Pituitary Axis
Conclusion
References
Feasibility and Significance of Dose Adaptation via Linear Couch Translations to Correct for Rotational Shifts During Frameless Brain Radiosurgery with the Gamma Knife Icon™
Introduction
Materials and Methods
Image Processing
Corrected Translation of Isocenters
Data Analysis
Results
Illustrative Case
Discussion
Conclusion
References
Impact of the Skull Size on the Normal Brain Radiation Dose During Gamma Knife Radiosurgery: Results of a Pilot Study
Introduction
Materials and Methods
Results
Discussion
Conclusion
References
Respiratory Monitoring During Gamma Knife Radiosurgery: Anesthesiological Aspects
Introduction
Potential Risks of Gamma Knife Radiosurgery
Patient Monitoring During Sedation
Assessment of Respiratory Status
Pulse Oximetry
Capnography
Conclusion
References
The Proud History of Psychosurgery in the USA
Introduction
Public Psychiatric Care at the Time
Development of Prefrontal Lobotomy
Results of Prefrontal Lobotomy
Patient Selection for Psychosurgery
Further Technical Developments: From Transorbital Lobotomy to Stereotaxis
The Dark Side of the Story
The Decline of Psychosurgery
Conclusion
References
Author Index
Subject Index