Nuclear Oncology

• Stereotactic radiosurgery with gamma knife

Radiosurgery with gamma knife involves four phases: placement of the device for the head imaging to locate the tumor, computed dose planning and radiation delivery.

In the first phase, a nurse puts a small needle into the hand or arm in order to give medications and contrast if necessary, for the shooting. A neurosurgeon uses local anesthesia to numb the front two points and two points on the back of the head. He was placed on his head a box-shaped device with screws specially designed to immobilize the head until the treatment session is over. This piece of lightweight aluminum is also a device to guide and ensure that the beams of the Gamma Knife are focused exactly where you need treatment.

Then take you to a shooting area where there will be an exploration of magnetic resonance imaging (MRI) to see the exact location of the tumor in relation to the device head. In some cases, you can do a computerized tomography (CT) instead of or in addition to, an MRI scan. If you are receiving treatment for an arteriovenous malformation, can also receive angiography.

In the next stage you can relax for an hour or two while the treatment team identifies (the) tumor (s) for treatment and makes a treatment plan using specialized computer software to give the optimal radiation to the tumor and minimize the dose the surrounding normal tissues.

Then lie on the couch of the Gamma Knife and is coupled device head to the machine before starting treatment. It will make you feel comfortable with a pillow or wedge-shaped sponge below the knees and a blanket over you. The treatment team then goes to the control area outside the treatment room to begin treatment. You can talk to the doctor through a microphone built into the hull, and there is a camera that lets you see the professional team / a at all times. The stretcher is lying / to be moved back and inside the machine gamma knife. You do not feel the treatment and the machine is very quiet. According to the model of Gamma Knife and the treatment plan, the entire treatment can be performed without interruption or can be divided into multiple smaller parts. The total treatment can last less than an hour or up to four hours. After treatment, a bell rings and the stretcher is placed back in its original position. As soon as the treatment is over you can sit back and takes off his helmet head. In most cases, you can go home soon after.

• Radiosurgery using linear accelerator

Radiosurgery with linear accelerator (LINAC) is similar to the procedure with Gamma Knife and its four phases: placement of the device head, imaging, computerized dose planning and radiation delivery. Unlike the gamma knife, which remains still during the procedure, part of the LINAC machine called a gantry rotates around the patient and delivers radiation beams from different angles. In comparison with the gamma knife, the linac can use a higher X-ray beam, allowing you to treat larger tumors more uniformly, and can be used for fractionated radiosurgery or stereotactic radiotherapy using a device reposionable, which means advantage for large tumors or particularly critical locations.
• Radiosurgery using the CyberKnife

No helmet head is needed for the treatment of CyberKnife. Instead, there will be a plastic mesh mask to keep the head in position and a detailed CT scan is performed with the mask on. Scan may also have to align with this MRN CT scanning in treatment planning computer. The imaging, treatment planning and the first treatment can be distributed over multiple days. You may have up to five treatments during the week or week and a half. For treatment you will lie down and place the mask over his head. They take X-ray images to ensure that you are in the correct position and then start treatment. The radiation therapist monitors at all times from outside the treatment room. The robotic arm rotates around the target to go from a hundred or hundreds of addresses. His head does not have to be absolutely still during treatment, X-ray images taken almost every minute they detect any small movement of your head and the robot makes adjustments to these small movements to ensure accuracy during treatment. Treatment may last from one to two hours.
• SBRT

SBRT is typically one to five treatment sessions within a period of one to two weeks.

First you may be asked to allow placement of a marker referenced or near the tumor. Depending on the location of the tumor, radiation oncologist can work with a pulmonologist, gastroenterologist or radiologist to place one to four reference markers near the tumor. Not all patients need to reference markers. The placement of these markers is usually an outpatient procedure.

Then, the radiation oncologist determines the method to align your body with the beams of the linear accelerator, which is called simulation. Often used to align restraints patients with high accuracy. Some of these systems can keep you busy as well, so from informing the doctor if you suffer from claustrophobia. After creating a restraint device for you, a CT scan performed on the treated area. Doctors can also perform a “4DTC” where a CT scan obtained information on how the tumor moves as you breathe. This is very common for tumors in the lungs or liver. After completing the scan, you can return home.

The third part of course planning. The radiation oncologist will work with a radiation dosimeter and a doctor plan the physical arrangement that suits you best for your tumor. They may incorporate other imaging techniques such as MRI or PET / CT. Using specialized software, the team will review hundreds of different combinations of beams to better estimate which of these combinations would be best for your situation. For radiotherapy planning for SBRT takes up to two weeks.

The administration of SBRT radiation is done with a linear accelerator. Normally there are no restrictions on what can eat or drink, although some patients can take anti-inflammatory medication, antinausea or anxiety before treatment. You will be placed in the restrainer. X-rays are taken to align the tumor areas before starting treatment. The radiation therapist will position you to guide the radiation oncologist based on these X-ray The radiation therapist administers the treatment time. Sometimes x-rays taken during treatment to control the position of the tumor. Treatment can last up to an hour.