Abstract
The indications and techniques for the treatment of intracranial lesions continue to evolve with the advent of novel technologies. The Gamma Knife Icon™ (GK Icon™) is the most recent model available from Elekta, providing a frameless solution for stereotactic radiosurgery. At our institution, 382 patients with 3,213 separate intracranial lesions have been treated with frameless stereotactic radiotherapy using the GK Icon. The wide range of diagnoses include brain metastases, meningiomas, arteriovenous malformations, acoustic neuromas, pituitary adenomas, and several other histologies. The ability to perform both frame and frameless treatments on the GK Icon has significantly increased our daily volume by almost 50% on a single machine. Although the frameless approach allows one to take advantage of the precision in radiosurgery, the intricacies regarding treatment with this frameless system are not well established. Our initial experience will help to serve as a guide to those wishing to implement this novel technology in their practice.
Highlights
In the 1950s, Lars Leksell established the basic principles surrounding stereotactic radiosurgery (SRS), eventually leading to the development of the Gamma Knife (GK) system [1]
Our initial experience will help to serve as a guide to those wishing to implement this novel technology in their practice
We prefer SRS over whole brain radiotherapy in patients with limited brain metastases as it is associated with less cognitive toxicity and improved quality-of-life [6,7]
Summary
In the 1950s, Lars Leksell established the basic principles surrounding stereotactic radiosurgery (SRS), eventually leading to the development of the Gamma Knife (GK) system [1]. A key component of the delivery of radiosurgery is the management of intrafraction tumor motion, which has been traditionally accomplished through rigid immobilization. As with previous models (U, B, C, and 4C), the automated GK PerfexionTM uses a stereotactic frame for rigid immobilization and localization. The GK IconTM (Elekta, Stockholm, Sweden) is the sixthgeneration and most recent commercial model. This latest upgrade includes a cone-beam computed tomography (CBCT) module, permitting non-invasive immobilization utilizing frameless treatments without compromising sub-millimeter accuracy [2,3]. We describe one of the first experiences with frameless treatments on the GK Icon
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