The $6 million Gamma Knife Perfexion dramatically reduces treatment time and can completely eradicate tumors non-surgically

Photo/Jon Nalick

HSC Weekly     07/25/2008

State-of-the-art radiosurgical tool promises faster, better treatment

By Meghan Lewit

The Keck School of Medicine Department of Neurological Surgery is among the first in the nation to acquire a powerful new tool in the fight against serious brain disorders.

The cutting-edge instrument—which focuses multiple beams of concentrated radiation onto a targeted area—will more rapidly and effectively treat a myriad of serious neurological problems, said Michael Apuzzo, professor of neurological surgery at the Keck School of Medicine and holder of the Todd-Wells Professorship in Neurosurgery.

“It’s an enormous breakthrough for neurological surgery at USC.” Apuzzo said. “This instrument represents the epitome of what modern medicine has at its disposal.”

The instrument, called the Gamma Knife Perfexion, will usher in the next generation of stereotactic radiosurgery, Apuzzo said. Stereotactic radiosurgery is a highly precise form of radiation therapy that is commonly used to treat tumors and other brain abnormalities. The patient is awake and under only a local anesthetic during the treatment.

The $6 million instrument is one of the first to begin operating in the U.S. Only two major university medical centers on the West Coast currently have the technology, Apuzzo said.

The Gamma Knife Perfexion is fully robotic and increases the speed and accuracy of the radiation treatment by eliminating the need to manually adjust settings while patients are undergoing treatment, Apuzzo said.

Previous models required patients to be fitted with a 500-pound helmet that directed radiation beams through tiny tunnels, called collimators, while blocking others. Treatments that had to be done by multiple tedious manual alignments now can be robotically completed in a fraction of the time, he said.

Using automated, pinpoint accuracy, the new Gamma Knife model reduces treatment time by more than 30 percent and can completely eradicate tumors non-surgically, Apuzzo said. He anticipates that 400 patients a year will be treated with Perfexion Gamma Knife for a number of neurological disorders, including tumors, arteriovenous malformations and facial pain

“From a patient’s standpoint, it’s a significant leap forward,” Apuzzo said, adding that USC University Hospital is the first in Los Angeles to give patients access to this technology.

The Department of Neurological Surgery was one of the earliest pioneers of stereotactic radiosurgery and the employment of imaging as a navigational basis for brain surgery. In 1975, the first hospital-based computed tomographic (CT) scanner in Los Angeles was installed at USC. The current practice of stereotactic radiosurgery began to take shape globally over the next two decades, led by the team at the Keck School of Medicine. The first Gamma Knife unit was installed at University Hospital in 1994. Over a 25-year period, approximately 7,000 patients at USC have been treated with stereotactic radiosurgery.

“Stereotactic radiosurgery has changed the face of neurosurgery, and for 25 years the Department of Neurological Surgery at the Keck School has been a pace-setter in the field,” Apuzzo said. “We are continuing that trend with the acquisition of this new instrument. However, previous experience and operating personnel are key factors in its use.”

“Looking at how far we’ve come since 1984 to now treating patients with this unit, my principle thought is, ‘Where can we go next?’”