Three medical centres in the UK and Germany have ordered and are now planning upgrades to Elekta’s latest generation stereotactic radiosurgery system for the brain, Leksell Gamma Knife Icon, to provide advanced brain radiosurgery treatments for their patients.
The centres are University Medical Centre Mannheim, Mannheim, Germany, Bristol Gamma Knife Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK, and the Leeds Gamma Knife Centre at St James’s Institute of Oncology, Leeds, UK.
Leksell Gamma Knife Icon integrates advanced motion management, dose delivery and imaging technologies, enabling clinicians to treat a wider variety of tumour types and sizes. Elekta says that the system provides caregivers increased flexibility in how radiosurgery is delivered, by allowing doctors to choose either frame-based or frameless methods to immobilise the patient’s head, in addition to the option to perform the treatment in a single session or multiple sessions. Icon also permits physicians to choose the degree of precision needed for each patient case, ranging from traditional high radiosurgery accuracy to ultra-precise microradiosurgery.
The ability to deliver multi-fraction Gamma Knife radiosurgery to spare organs-at-risk was important to clinicians at University Medical Centre Mannheim, according to Frederik Wenz, professor and chairman, Department of Radiation Oncology.
“The steep dose gradients and mechanical stability offered by Gamma Knife Icon allow sparing of normal tissue adjacent to the target,” he says. “In clinical situations with sensitive structures within the target volume, sparing of organs-at-risk can only be achieved by fractionation. By fractionating the dose, we can use Icon in many clinical scenarios in which the tumour is infiltrating normal tissue.” Wenz anticipates treating the first patients with Gamma Knife Icon in late August.
Alison Cameron, clinical lead for the Bristol Gamma Knife, says: “Icon will allow Bristol to offer an intracranial stereotactic service without any compromises. The system has the flexibility to ensure that the patient receives the level of radiosurgery that they require clinically, whilst optimising their experience through flexibility in immobilisation, scheduling and treatment. This will lead to increased efficiency with improved quality, a truly transformational service development.” The team in Bristol expect to treat the first patient in September.
At the Leeds Gamma Knife Centre, Paul Hatfield, consultant clinical oncologist, observes that the frameless immobilisation and accurate intrafraction monitoring of patient position are particularly valuable features of Icon.
“These features will enable fractionated treatment for targets that would normally be too large to treat, or where dose reductions would typically be required, for safety reasons, that could potentially compromise treatment effect,” Hatfield says. “The cone beam CT also will allow confirmation of setup, which is an important part of modern radiotherapy. All of these benefits combined will undoubtedly enhance the patient experience.”
“The Leeds Gamma Knife Centre, as part of Nova Healthcare, has always been integrated within our busy radiotherapy and neuroscience department,” adds Nick Phillips, consultant neurosurgeon. “We operate as a close collaboration between oncology, neurosurgery, medical physics and radiographers. Our department is a leader in many stereotactic radiotherapy techniques and we are keen to push forward this technology in the UK.” The Gamma Knife Icon system is expected to be operational at the Leeds Gamma Knife Centre by the end of 2015.