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Ann B. Barshinger Cancer Institute

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Select your question from the drop down:

Q. What is Gamma Knife® Radiosurgery?

A. Gamma Knife® (a registered trademark of Elekta Radiosurgery of Atlanta, GA) Radiosurgery replaces the surgeon’s scalpel with a single, high dose of gamma radiation. Like the surgeon’s scalpel, the Gamma Knife®treats the diseased area with a safe and effective approach. The patient wears a lightweight head frame that attaches to a helmet, through which 201 beams of gamma radiation precisely focus at a single target. Only the target volume receives a very high dose of radiation while the surrounding tissue remains unharmed.

The procedure is usually performed under local anesthesia with mild sedation. Although the entire procedure takes several hours, the actual treatment takes just 30 minutes to two hours, depending on the size of the lesion being treated. If there are multiple tumors or if the tumor spreads to another area, radiosurgery can be delivered those areas.

Q. Is it cost effective?

A. Cost studies have shown Gamma Knife® Radiosurgery to be less expensive than conventional neurosurgery because it eliminates lengthy post-surgical hospital stays, expensive medication and sometimes months of rehabilitation. Importantly, there are virtually no post-surgical disability and convalescent costs with this procedure.

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Q. Who determines if Gamma Knife® Radiosurgery is appropriate?

A. Medical necessity can be determined by a neurosurgeon, radiation oncologist or other medical specialist after evaluating the patient’s medical condition. Treatment options are then determined and discussed with the patient and family, so an informed decision can be made.

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Q. Will my insurance cover Gamma Knife® treatment?

A. Gamma Knife® Radiosurgery is reimbursed by most insurance companies, PPO’s, HMO’s, and Medicare. Each plan is different. You should check your individual policy for coverage prior to the treatment.

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Q. Is it Effective?

A. Over 70,000 patients worldwide have chosen Gamma Knife® Radiosurgery for treatment of benign tumors such as acoustic neuromas, meningiomas, pituitary adenomas, pineal tumors, malignant tumors like metastatic tumors, astrocytomas and glioblastomas. The Gamma Knife® has also been used to eradicate arteriovenous malformations (AVM) and to relieve pain from trigeminal neuralgia. Treatment protocols are under investigation for certain functional disorders such as epilepsy, chronic pain, and Parkinson’s disease.

Patients may be eligible for Gamma Knife® Radiosurgery even if they have previously had brain surgery, radiation therapy, chemotherapy, or in the case of AVM, embolization procedure. Results have proven to be superior or comparable to conventional neurosurgery, depending on the specific condition treated.

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Q. What can the Gamma Knife® treat?


  • Metastatic tumors
  • Meningiomas
  • Trigeminal Neuralgia
  • Acoustic Neuroma
  • Pituitary and pineal tumors
  • Glial and astrocytoma tumors
  • AVM’s and other vascular malformations
  • Other benign and malignant tumors

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Q. How safe is the Gamma Knife® Procedure?

A. Gamma Knife® Radiosurgery is unique because no surgical incision is made. Consequently, the risk of surgical complications does not exist. Patients are routinely administered a mild sedative, eliminating the side effects of general anesthesia.

Gamma Knife® patients generally return home the same day as the procedure and are back to their normal routine in a day or two.

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Q. How is Gamma Knife® surgery performed?


  • After administering local anesthesia and sedation, a stereotactic frame is attached to the patient’s head
  • A CT or MRI is completed while the patient wears the stereotactic frame. For vascular malformations, an angiogram is obtained as well.
  • The patient returns to the Gamma Knife® Center while a treatment plan is developed using the brain images.
  • This is done by the coordinated efforts of the neurosurgeon, radiation oncologist and radiation physicist.
  • The completed plan outlines the dose of radiation and location within the brain for each treatment.
  • The patient lies on the treatment bed of the Gamma Knife® unit while the frame is attached to the appropriate collimator helmet. The helmet collimates the radiation.
  • The treatment table is moved into the Gamma Knife® during each treatment. The treatment is painless.
  • The patient may move in and out of the Gamma Knife® so minor adjustments in the stereotactic frame and collimator can be made during the treatment session.
  • After Gamma Knife® surgery the head frame is removed and the patient is observed for a short period of time. After this time most patients are sent home.
  • Your physician will arrange periodic follow-up examinations and brain imaging to follow the effects of treatment. 

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Q. What’s involved in treatment?

A. On the day of the treatment, the Gamma Knife® patient will have a lightweight frame attached to the head. Local anesthesia is used before the frame is secured in place. The frame is used in conjunction with an imaging procedure to accurately locate the area to be treated.

With the frame in place, the patient has either a MRI or CT imaging study or, in the case of arteriovenous malformations, an angiogram, in order to precisely locate the area to be treated.

Information from the imaging study is transferred to the Gamma Knife® computer system. While the patient rests, the Gamma Knife® Center team develops a 3D treatment plan. This takes one to several hours to complete depending on the size and location of the abnormality.

When the individualized treatment plan is completed, the patient is placed on the Gamma Knife® couch and is precisely positioned. The couch then moves automatically, into the Gamma Knife Unit and treatment begins.

Treatment typically lasts from 30 minutes to two hours, during which time the patient feels nothing unusual. At the completion of the treatment the patient is automatically moved out of the Gamma Knife® Unit and the head frame is removed.

Usually the patient will return home with family shortly after a period of observation.

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Q. What are the results of Gamma Knife® surgery?


  • The majority of brain tumors selected for treatment will disappear or stop growing over time.
  • 80% of patients with trigeminal neuralgia will have decreased pain.
  • After one year 40% of arteriovenous malformations are cured increasing to 80% two years after treatment.

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Q. When will I get better?

A. The effects of Gamma Knife® Radiosurgery occur over a period of time that can range from days to several years, depending on the type of medical condition treated. Some abnormalities dissolve gradually, eventually disappearing. Others exhibit no further growth or shrink gradually.

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Q. What are the advantages of Gamma Knife® Radiosurgery?


  • Gamma Knife® surgery is different from conventional radiation therapy of the brain because it is precisely directed to the target and spares unnecessary treatment of adjacent, normal brain. 
  • Treatment is completed in one day.
  • It can be used in conjunction with surgery or conventional radiation therapy as a boost.
  • It can be used in cases previously considered inoperable.
  • Gamma Knife® surgery can replace brain surgery in some patients with brain tumors and vascular malformations…ask your doctor about these options.
  • An individual who would be at high risk for complications by conventional surgery may be a candidate for Gamma Knife® surgery.
  • No risk of infection from a surgical incision.
  • It can be used when prior surgery or radiation therapy has failed to control the disease process.
  • Cost effective.
  • Return to normal activities within days of treatment.
  • Established effectiveness after 25 years of worldwide experience with few complications.

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