In the past 10 years, modern technology has made deep seated obscure lesions visible. With development of computer technology and various stereotaxic techniques, many new procedures, refinement of old procedures, and development of new applications are possible. The authors are intended to provide a detailed description of our experience with the Brown-Roberts-Wells (BRW) stereotactic system in the evaluation and management of 90 patients with intracranial lesions, and to provide cases presentation of various inaccessible intracranial lesions.
Humans ; Stereotaxic Techniques

Animals ; Macaca mulatta ; surgery ; Magnetic Resonance Imaging ; Neuronavigation ; standards ; Stereotaxic Techniques ; standards

An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm3; total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could be considered as a safe tool for seizure control and neuropsychological improvement in patients with MTLE.
Adolescent ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Intellectual Disability ; Male ; Radiosurgery* ; Seizures ; Stereotaxic Techniques ; Temporal Lobe*

An 18-year-old left-handed male harbored intractable medial temporal lobe epilepsy (MTLE) underwent fractionated gamma knife surgery (GKS) instead of open surgery, considering the mental retardation and diffuse cerebral dysfunction. GKS treatment parameters were: target volume, 8.8 cm3; total marginal dose, 24 Gy in 3 fractionations at the 50% isodose line. The patient has been free from seizures since 9 months after GKS, with notable improvement in cognitive outcome. Fractionated GKS could be considered as a safe tool for seizure control and neuropsychological improvement in patients with MTLE.
Adolescent ; Epilepsy ; Epilepsy, Temporal Lobe* ; Humans ; Intellectual Disability ; Male ; Radiosurgery* ; Seizures ; Stereotaxic Techniques ; Temporal Lobe*

External beam radiotherapy can be used to treat cutaneous squamous cell carcinomas (SCC). Acute skin toxicity is the most common adverse event. In this case study we report on an elderly patient with nasal root cutaneous SCC treated with stereotactic technique using a dedicated linear accelerator (CyberKnife system). Grade 3 skin toxicity was observed but it was resolved after 6 weeks. The use of stereotactic radiotherapy permitted a clinical remission of SCC with good cosmetic results.
Aged ; Carcinoma, Squamous Cell* ; Humans ; Particle Accelerators ; Radiosurgery ; Radiotherapy ; Skin ; Skin Neoplasms ; Stereotaxic Techniques* ; Vitamin E

Surgical navigation system is a system that processes medical images by computer graphics and image processing technique, reconstructs 2D or 3D medical image models. It builds a real-time loop among the eyes of doctor, the surgical device and the head of patient by several of space localization technique, so that to realize displaying the localization of surgical devices real-time. The history and research status of surgical navigation system is summarized and the system configuration and the key techniques are expatiated emphatically in this paper. The key techniques include localization in space, image processing and displaying technique, system registration technique and head location technique. At last the progress direction of navigation systems is given.
Computer Graphics ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Neuronavigation ; methods ; Stereotaxic Techniques ; Surgery, Computer-Assisted ; methods

In this paper, we introduce a slip-coordinate system that applied in the extra-cranial stereotactic radiosurgery treatment system (by the name of extra-cranial X-Knife), and make an analysis about the correlative formula.
Equipment Design ; Humans ; Immobilization ; Radiosurgery ; instrumentation ; methods ; Radiotherapy, Computer-Assisted ; Stereotaxic Techniques ; instrumentation ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the clinical value of stereotactic radiosurgery (SRS) for uveal melanoma.

METHODSFrom Jan, 1996 to March, 2004, 16 patients with uveal melanoma were treated with SRS, two by one session (35 Gy, 25 Gy) and fourteen by fractionated SRS (30-55 Gy/2-4F/4-16D). The follow-up period ranged from 3 to 100 months (median: 66 months).

RESULTSAll 16 patients were still alive though all were blind in the diseased eye during recent follow-up. Local control rate was 93.4%, 5-year survival rate of 13 patients who have been followed for more than 5 years, was 100% (13/13). However, 7 patients received eyeball enucleation due to corneal ulcer (n = 2), suspicion for uncontrolled tumor (n = 2) and secondary glaucoma (n = 3). One patient developed distant metastasis, though still alive.

CONCLUSIONFractionated radiosurgery is safe and effective for uveal melanoma. It is indicated for lesions of limited size (longest diameter < 20 mm, depth < 15 mm) located in the posterior pole or behind the equator at the back of the eyeball.

Adult ; Aged ; Eye Enucleation ; methods ; Female ; Humans ; Male ; Melanoma ; surgery ; Middle Aged ; Radiosurgery ; Stereotaxic Techniques ; Uveal Neoplasms ; surgery

In order to analyze the image noise effect on the results of Gamma knife dosimetry parameter test, we tested the dosimetry parameters of the Gamma knives according to GBZ 168-2005. Radiological protection standards of X (gamma)-ray stereotactic radiosurgery for head treatment. Dose analysis software was applied to examine the testing film before and after image denoising, and SPSS 11.0 software was used for statistical analysis. The results showed that there was a significant difference in the results of the maximum deviation between radiation field size and its nominal value (t = 7.600, P < 0.01) and the radiation field's penumbra region width of collimators also had significantly different sizes (t = 5.334, P < 0.01) before and after image denoising. This study indicated that the image noise could influence the results of testing Gamma knife dosimetry parameters, so as to cause deviations.
Algorithms ; Artifacts ; Gamma Rays ; Head ; surgery ; Humans ; Radiometry ; instrumentation ; Radiosurgery ; instrumentation ; Radiotherapy Planning, Computer-Assisted ; methods ; Stereotaxic Techniques

OBJECTIVESTo evaluate the efficacy of integration of metabolism images into multimodal neuronavigation for frameless stereotactic biopsy.

METHODSFrom January to December 2012, 32 patients with brain lesions underwent frameless stereotactic biopsy guided by positron emission tomograph (PET) and proton magnetic resonance spectroscopy ((1)H-MRS)-based multimodal neuronavigation and intraoperative magnetic resonance imaging (iMRI). The cohort consisted of 16 male and 16 female patients, with a mean age of 45 years (range: 7 - 62 years). Biopsy targets were identified according to PET and (1)H-MRS. Biopsy was performed with Varioguide frameless biopsy system. Diagnostic yield and complications were assessed.

RESULTSMetabolism images-based multimodal neuronavigation and iMRI were successfully implemented in all cases. iMRI confirmed accuracy of biopsy targets. All the specimens obtained pathological diagnosis, the diagnostic yield was 100%. In 1 patient, iMRI found small hematoma (< 5 ml), surgical evacuation wasn't needed with intraoperative complication rate 3.1%. With the help of multimodal neuronavigation, no patients had new or worsened neurologic deficits.

CONCLUSIONSIntegration of metabolism images into multimodal neuronavigation provide not only anatomical, but also metabolic and functional information for frameless stereotaxy, increasing diagnostic yield and avoiding postoperative neurologic deficits.

Adolescent ; Adult ; Biopsy ; methods ; Brain ; pathology ; Brain Neoplasms ; pathology ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neuronavigation ; Positron-Emission Tomography ; Stereotaxic Techniques ; Young Adult