Gamma Knife radiosurgery techniques

Pioneered by Lars Leksell during the 1960s, stereotactic radiosurgery (SRS) uses radiation to treat intracranial conditions through the intact skull. Early SRS focused on functional disorders and utilised protons from a synchrocyclotron, but the need for a solution better suited to routine use led Leksell to develop a dedicated device based upon narrowly-collimated photon beams from a large number of 60Co sources arranged around a hemisphere. All coincident through a common isocentre, these photon beams combine to produce a dose rate high at their intersection, but falling rapidly from that focus. The radiation is targeted by reference to a stereotactic coordinate system defined by a frame screwed to the skull, which rigidly immobilises intracranial anatomy to ensure accuracy. By combining multiples of these highly-focused radiation isocentres, treatments can deliver distributions of high dose that tightly conform to the target while sparing surrounding tissue.

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