Centre Hospitalier Universitaire Vaudois upgrades to latest-generation Elekta radiosurgery systemLAUSANNE CH — Friday, September 16, 2016
On June 27, a 75-year-old male patient received frameless, mask-based radiosurgery on Centre Hospitalier Universitaire Vaudois’s (CHUV) Leksell Gamma Knife® Icon™, making him Switzerland’s first to receive treatment on the country’s first and only Icon system.
Icon is an upgrade from CHUV’s existing Leksell Gamma Knife® Perfexion™, which the center had been using since 2010. The first patient had a cavernous sinus meningioma that was touching his optical pathways, which required dividing his treatment into five lower-dose sessions throughout the week. The ability to use mask-based fixation of the patient’s head and accurately repeat the treatment several times is one of the key advantages of Icon.
“Using traditional frame-based radiosurgery wouldn’t have been possible for this patient due to the proximity of the tumor to the optical anatomy, which is an organ-at-risk,” says Marc Levivier, MD, PhD, Professor and Chief of Neurosurgery and Head of CHUV’s Gamma Knife program. “The capability to use Icon for either mask-based, multi-session treatment like we did for this patient, or customary single-session radiosurgery, gives us a great deal of flexibility when it’s needed most.”
So far, of the 53 cases CHUV has treated with Icon, eight have been mask-based treatments.
Key Icon technologies
For mask-based treatments, Icon is equipped with cone beam CT (CBCT) imaging and advanced motion management systems. These technologies ensure that the patient can be treated accurately and reproducibly over several therapy sessions – with the same gold standard precision as single-session frame-based Gamma Knife radiosurgery.
“For multi-session treatments, the patient comes to the hospital the week before to receive MR and CT scans of the tumor for planning purposes and for creation of a custom thermoplastic mask. Then a CBCT scan is taken of the patient with the mask in place and in treatment position on Icon and an accurate treatment plan is developed,” Dr. Levivier explains. “The following week the patient has another CBCT just before each treatment session to check his position. The system automatically adjusts the treatment plan to the current position before treatment can begin.”
For single-session mask-based treatment, image acquisition and creation of the mask are performed on the day of the treatment, therefore the patient needs to come only once, he adds.
For safety, the infrared motion management (IFMM) system of Icon monitors any voluntary or involuntary movement of the patient’s head throughout the treatment and the treatment stops automatically if movement is outside of a preset threshold.
“With the experience of Leksell Gamma Knife for radiosurgery treatments over many years, we are used to the high precision that Gamma Knife offers,” he says. “The advantage with Icon is that it allows for greater flexibility in using the most suitable immobilization for each patient, a frame or mask, with very high precision in both alternatives.”
To learn more about Leksell Gamma Knife Icon, visit www.careforthebrain.com.
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