Radiosurgery Nomenclature: A Confusion of Tongues

Abstract

Since the time of its inception within neurosurgery, the practice of radiosurgery has grown and evolved with the introduction of new technologies and the involvement of other disciplines. Currently, radiosurgery practices involve neurosurgery, radiation oncology, medical physics and, in many centers, neuroradiology. Various commercially available radiosurgical devices are used, including the conventional linear accelerator, CyberKnife, Gamma Knife, and even particle therapy units. The historical roots of each radiosurgery practice affect the terminology and procedures applied for treatment planning and delivery, resulting in wide variability in image acquisition, planning, and verification practices across the community. This organic development has led to a “confusion of tongues,” challenging our ability to interpret the published scientific literature in a meaningful way and hindering the radiosurgery community’s ability to collaborate effectively to advance the science and practice of radiosurgery. The broader radiation therapy literature contains a growing body of evidence that the quality of radiation delivery has a significant impact on clinical outcomes. This was highlighted in a secondary report of a large multicenter phase 3 trial of head and neck cancer, which showed