Stereotactic radiosurgery is an excellent treatment option for many patients with brain and skull base conditions, including brain tumors. Though the name may sound like a surgical procedure, stereotactic radiosurgery is actually an advanced form of radiation therapy that uses multiple focused beams of radiation to target a highly specific area. Gamma Knife® and CyberKnife® are different radiosurgical technologies used to treat tumors of the brain and other neurological disorders.
Because it is so focused, stereotactic radiosurgery does not affect as much of the surrounding tissue as traditional radiation therapy, such as whole brain radiation, resulting in fewer side effects. Additionally, because it is completely noninvasive, stereotactic radiosurgery does not carry any of the risks associated with surgery, has less post-procedural pain and has a minimal recovery period. This makes it an excellent treatment choice for patients who are not surgical candidates due to the nature of their condition or other health factors. Patients at The Valley Gamma Knife Center often ask, “What is the difference between the two, and why do you use Gamma Knife technology instead of CyberKnife?”
The answer lies in the fact that The Valley Gamma Knife Center specializes in the treatment in a wide range of both benign and malignant brain diseases. Many of the conditions we treat require extreme accuracy and precision due to delicate locations within the brain. The Gamma Knife is a unique radiosurgery platform that has been refined over 40 years to focus on conditions within the brain and skull base and is considered to be the gold standard by medical professionals worldwide for performing brain radiosurgery. More than 600,000 people all over the world have undergone Gamma Knife treatment. Its success has been documented in over 3,000 peer-reviewed articles, which have demonstrated the technology’s effectiveness, safety and benefits to patients.
The Gamma Knife Treatment Process
Though both are forms of stereotactic radiosurgery, the Gamma Knife and CyberKnife systems operate very differently. When you are treated using Gamma Knife technology, the first step involves immobilization where either a rigid head frame or custom mask will be made to ensure your head and neck are stable through the procedure. The choice of immobilization technique will depend upon individual factors such as the condition being treated, specific location, and number of treatments to be delivered. Next, your doctor will obtain a high-resolution MRI in order to plan your treatment. In certain situations, this MRI may be obtained prior to immobilization.
Once your treatment plan has been finalized, you will be brought into the Gamma Knife suite and positioned on a special table where your head frame or mask will be used to secure your head for the treatment. The only moving part of the Gamma Knife is the table on which you are positioned. There are 192 tiny beams of radiation which may be delivered simultaneously and remain focused on a single calibrated point. The intended treatment target is moved to that position by the table. This minimization of moving parts results in the most precise and reliable treatment possible. During the treatment you are awake and able to communicate with your doctor at any time. An infrared imaging device (delivering no radiation) may constantly monitor your position so that even subtle movements in the case of a mask-based treatment can be detected and accounted for during your treatment. The treatment lasts between 15 minutes to a couple of hours, depending on the size and location of the area being treated. Once the treatment has completed, your head frame or mask will be removed and you can go home.
The CyberKnife Treatment Process
By contrast, the CyberKnife system involves a mobile radiation delivery system mounted on a robotic arm, which travels around you while you lay on a movable table. The CyberKnife only has the option of mask immobilization and pairs of X-rays (extra radiation) must be taken several times per minute during treatment to verify your position. Only a single beam of radiation may be delivered at any given time and must move from point to point instead of remaining focused at a fixed calibrated point. This flexibility allows the CyberKnife system to target areas all over the body, whereas the Gamma Knife is designed specifically for the treatment of the brain and skull base. Treatment with CyberKnife typically takes between 30 to 90 minutes, depending on the condition being treated.
Gamma Knife Vs. CyberKnife – Pros and Cons
Because the Gamma Knife was created specifically for the treatment of the brain and skull base, it offers certain advantages over the CyberKnife. These are some of the reasons why we chose the Leksell Gamma Knife® Icon™ system over CyberKnife:
|Gamma Knife||CyberKnife||Whole Brain Radiation|
|Treats conditions of the brain and skull base.||X||X||X|
|Does not require an overnight hospital stay.||X||X||X|
|Precisely targets the intended lesion in the brain.||X||X|
|Specifically designed and built to treat cancers and other diseases of the brain only.||X|
|Over 40 years of proven results from millions of treatments around the world.||X|
|Few moving parts, resulting in more accurate treatment delivery.||X|
|Flexible immobilization options, including frame-based or mask-based radiosurgery.||X|
|Treatment planning directly on high-resolution MRI, reducing targeting uncertainties.||X|
|Continuous monitoring for patient motion using an infrared stereoscopic camera, without extra radiation exposure.||X|
Side Effects of Both Procedures
Though stereotactic radiosurgery does carry less risk and result in fewer side effects than traditional radiation methods, there are still side effects to be aware of. These include:
- Headache and nausea, which typically only lasts a few days and can be alleviated with medication.
- Delayed swelling following treatment of the brain, which can be treated using prescription medications.
Recovery Time for Both Procedures
Both Gamma Knife and CyberKnife stereotactic radiosurgery are done in an outpatient setting, which means you do not have to stay overnight in the hospital. Because it is completely noninvasive, there is virtually no recovery period and you will be free of major activity restrictions. Most patients are released from the treatment center within a few hours of completing treatment and can resume normal activities that same day.
Gamma Knife Advantages
Our Leksell Gamma Knife® Icon™ system, the latest generation Gamma Knife and the most advanced on the market today, offers patients these benefits:
Bloodless, painless, incision-free stereotactic radiosurgery
Fast, precise treatment of one or more sites within one session
Can be used to re-treat areas of the brain in the future
Ideal for hard-to-treat tumors or for patients who cannot undergo neurosurgery
Does not require anesthesia nor an overnight hospital stay and a return to normal activities usually within 24 hours
192 beams of highly focused radiation, which converge to target the tumor and spare healthy, surrounding tissue
Gamma Knife & Your Condition
Gamma Knife can be used to treat a variety of conditions, ranging from metastatic tumors to malformations of blood vessels in the brain. Though your doctor will help you determine whether Gamma Knife is appropriate for your condition based on personal factors, most patients with the following conditions may be great candidates.
Gamma Knife Vs. CyberKnife for Acoustic Neuromas
An acoustic neuroma, also known as vestibular schwannoma, is a benign tumor that arises from the vestibulocochlear nerve. This is the cranial nerve responsible for hearing and balance. Because of the precise targeting of Gamma Knife, it is ideal for treating these tumors with reduced risk of hearing damage or other neurological effects. While both systems are proven to be safe and effective the Gamma Knife system has been used longer than the CyberKnife and has the option of using head frame-based stabilization during treatment. This stabilization allows for precision of a fraction of a millimeter – the width of just two human hairs – reducing dose to healthy surrounding tissues.
Gamma Knife Vs. CyberKnife for Trigeminal Neuralgia
Patients suffering from trigeminal neuralgia experience severe, chronic pain to everyday activities, such as eating and speaking. For those patients whose condition cannot be managed with medications alone, Gamma Knife may be an excellent choice. Because the procedure involves treating very delicate nerve tissue in a critical region of the brainstem, precision is of vital importance. The Gamma Knife system has the ability to perform this treatment using a rigid stereotactic head frame for immobilization, allowing for submillimeter precision. The treatment is also directly planned off of the MRI that is used to visualize the trigeminal nerve. The CyberKnife system does not offer these options.
Gamma Knife Vs. CyberKnife for Meningioma
A meningioma is a tumor that grows from the meninges, the protective layer that covers the brain and spinal cord. Most are benign, but they may also be aggressive and may recur. Your doctor can use the Gamma Knife system alone or in combination with surgery to stop the meningioma from growing. Meningiomas can be treated with Gamma Knife or CyberKnife, however, Gamma Knife has the ability to perform frame-based treatment, where submillimeter precision is achievable in locations where sensitive uninvolved brain tissue is directly next to targeted area.
Gamma Knife Vs. CyberKnife for Brain Tumors
Other brain tumors, such as brain metastases, pineal tumors and skull base tumors can also be treated with Gamma Knife or CyberKnife. Framed treatment used by the Gamma Knife system allows for submillimeter precision in locations where healthy brain tissue is adjacent to the targeted area. This makes the Gamma Knife system an excellent option for many patients with brain tumors.
Our Highly Skilled Team
Gamma Knife technology is only as good as the radiation oncology team who uses it. The team at Valley has more than 10 years of experience using Gamma Knife to treat patients from all over the metropolitan New Jersey-New York area. Simply stated, the Leksell Gamma Knife Icon is the “fastest, most accurate technology on Earth for treating brain tumors and multiple metastases,” says Gamma Knife Center Co-Director Anthony D’Ambrosio, M.D.
A Full Gamut of Radiation Therapy Options
In addition to state-of-the-art Gamma Knife technology, the Radiation Oncology Department at The Valley Hospital’s Daniel and Gloria Blumenthal Cancer Center provides the following modalities for radiation therapy:
- TomoTherapy Image-Guided Radiation Therapy
- Intensity-Modulated Radiation Therapy
- External Beam Radiation Therapy
- Stereotactic Radiosurgery for Spine, Lung, Prostate and Other Cancers
- 3-D CT Simulation and Treatment Planning
- Remote Afterloading High Dose Rate Brachytherapy
- Intraoperative Radiation Therapy for Breast Cancer
- Image-Guided Radiation Therapy