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Stereotactic Radiosurgery Program

Overview

    Stereotactic Radiosurgery Program Physician
  • The UCLA Stereotactic Radiosurgery Program is collaborative practice with special expertise in brain and spine imaging, dosimetry and radiation therapy.
  • The program coordinates individual care through a multidisciplinary approach involving specialists in radiation oncology, neurosurgery, neurology, neuro-ophthalmology and neuroradiology.
  • The procedure allows high focal radiation to be delivered to the lesion without damaging vital areas of the brain and spine.
  • Stereotactic radiosurgery is a noninvasive, outpatient operation that offers treatment possibility for patients with the following disorders:
  • Thousands of patients throughout the world have been treated by radiosurgery with good results and a very low rate of complication.

Features

  • UCLA's Novalis Shaped Beam Surgery system now considered the Gold Standard for shaped-beam radiosurgery—uses stereotactic technology as well as highly specialized computer software for radiation therapy planning.
    • Uses an "invisible blade," making this painless, noninvasive procedure bloodless.
    • Avoids many of the co-morbidities common to invasive surgery, such as infections, hemorrhage and other complications.
    • Enables treatment of intracranial lesions once considered inoperable due to proximity to eloquent or critical structures.
    • Performed on an outpatient basis.
    • Delivers narrow, well-defined beams that conform to the lesion(s) for both single and multiple dose treatments. (The Gamma Knife is limited to delivering single-dose treatments.)
      • Delivering multiple or "fractionated doses" provides a therapeutic advantage for treating tumors or arteriovenous malformations that abut or include cranial nerves or critical regions of the brain.
      • Research studies estimate that about one-half of all radiosurgery treatments would be better treated with multiple small doses.

Background

  • Stereotactic surgery was first developed to help surgeons introduce probes into the brain to operate with great precision.
  • The UCLA Stereotactic Radiosurgery Program was formed in 1980 when the Karolinska Institute of Stockholm, Sweden, donated one of two "Gamma Knife" units in existence at the time for the purpose of collaborative research.
  • Since that time the UCLA radiosurgery team has worked with the Gamma Knife, LINAC Scalpel, XKnife and, more recently, with Novalis, the most advanced development in radiosurgery to date.

How radiosurgery works

  • A stereotactic ring is attached to the patient's head under local anesthesia and imaging studies such as computed tomography, angiogram and magnetic resonance imaging scans are obtained.
  • The ring serves as a reference for calculating target coordinates and dose distribution as well as for fixing the patient's head to the radiosurgical apparatus.
  • Selected patients are treated by stereotactic radiotherapy using a ring secured to a thermoplastic mask molded to the back of the head and the face.

Treatment Services

  • Outpatient evaluations are provided by UCLA faculty members in the UCLA Medical Plaza.
  • Patients needing hospitalization for additional testing or neurosurgical treatment are admitted to Ronald Reagan UCLA Medical Center.
  • Second opinions or follow-up evaluations for patients receiving treatment at other facilities are available.
  • The UCLA program encompasses three areas of special emphasis:
    • Radiosurgery for benign brain tumors, such as acoustic neuromasmeningiomasglomus jugulare, pinealoma, and pituitary tumors, when removal by conventional microsurgery is not possible or as an alternative to surgery in selected cases. The treatment goal is to stop tumor growth and shrink tumor size to preserve the function of important structures of the brain and/or allow for improvement of impaired function.
    • Radiosurgery for malignant brain tumors (glioblastoma multiforme and anaplastic astrocytoma) and metastatic tumors to change the genetic code of the malignant tumor cells so that they die instead of proliferate. Radiosurgery can be used as an adjuvant or primary form of treatment in selected cases.
    • Radiosurgery for arteriovenous malformations (AVMs) is a less invasive treatment than surgical resection or embolization, and has a low rate of complication. However, radiosurgery usually takes two years to obliterate the AVM, during which time the patient runs the same risk of having an intracranial bleed as untreated AVM.

Faculty

Neurosurgery

 

Radiation Oncology

Antonio De Salles, MD
Daniel Lu, MD
Nancy McLaughlin, MD
Nader Pouratian, MD
Bob Shafa, MD
Isaac Yang, MD
  Tania Kaprealian, MD
Pat Kupelian, MD
Phil Beron, MD
Michael Selch, MD 

 

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