Prof. Lars Leksell (1907-1986), inventor of the radiosurgical instrument that bears his name and a faculty member of Karolinska University Hospital (Solna, Sweden), performed the world’s first Gamma Knife® surgery at nearby Sophiahemmet Hospital, the location of the first Leksell Gamma Knife. Karolinska University Hospital recently acquired Elekta’s fifth generation radiosurgery system, Leksell Gamma Knife® Perfexion™. Since January, Karolinska clinicians have been using the system to treat more patients per day and tumors that used to be hard to reach. Physicians also are much more easily treating multiple metastases in a single session.
While Karolinska clinicians are currently treating traditional Gamma Knife indications (metastases, meningiomas, arteriovenous malformations, dural fistulas, acoustic neuromas), the immediate impact Perfexion has made is the ease with which physicians can treat two or more metastases in one session.
“We treat five to ten metastases on a regular basis, because the automated collimator makes it possible to rapidly plan and treat multiple tumor isocenters,” Karolinska neurosurgeon Dr. Ernest Dodoo explains. “Suddenly, it is feasible to treat everything we see. Now, the question is not ‘Is it technically possible?’ but rather ‘Does it make sense clinically from a therapy standpoint?’”
Perfexion improves radiosurgery workflow
Leksell Gamma Knife Perfexion replaced two earlier generation Leksell Gamma Knife® 4C systems, one at Sophiahemmet Hospital and the other at Karolinska University Hospital. Each had been treating about 250 patients per year for the last three years. Since the late 1960s, Karolinska has used Gamma Knife surgery for approximately 10,000 patients, according Dr. Dodoo.
On January 11, Karolinska used Leksell Gamma Knife Perfexion to treat its first case, a patient with a glioblastoma. Since then, Karolinska has treated 120 patients with Perfexion and this single system already rivals the daily patient volume of the previous systems by virtue of its unique features. “We treated five patients in one day last week, including two quite complex cases,” he recalls. “With either of our previous systems that would have been logistically difficult. With Perfexion, up to five patients per day is absolutely realistic.”
In addition to the system’s automated collimator, the enhanced planning system for Leksell Gamma Knife Perfexion also is boosting the efficiency of Karolinska’s radiosurgery practice.
“Planning is a lot easier, more intuitive and very user friendly,” Dr. Dodoo notes. “We can visualize the isodose lines simultaneously as we trace them and the dynamic shaping makes dose planning much simpler. It really has changed our approach.”
The sophisticated automation that Perfexion brings to the clinic has transformed radiosurgery from a hands-on, technical procedure to one in which enhancing dose plans is the key objective, he adds. “Perfexion has allowed us to shift the focus from the technical, time-consuming part of treatment—changing collimators and adjusting table positions in half-millimeter steps—to creating the best dose plan for the patient.”
Editor’s note: Images and streaming video of Leksell Gamma Knife® Perfexion™ are available in Elekta’s Media Resources Center.