Ian Paddick, a Consultant Physicist at specialist in radiation oncology, Amethyst Radiotherapy, discusses some of the challenges, practicalities, design considerations, and logistics, of installing a Gamma Knife radiosurgery machine into medical facilities, with a particular focus on the Queen Square Radiosurgery Centre within the University College Hospital in central London.
Gamma Knife has become a recognised treatment for small-medium-sized tumours and vascular disorders that develop in the brain and skull base, including secondary metastasised tumours and arteriovenous malformations (AVMs), for example. As a form of stereotactic radiosurgery, it presents a treatment option for complex cases where open surgery would carry significant risk. Gamma Knife uses 192 precisely focused beams of radiation, which converge to produce a high dosage of radiation to a highly focused target. This means that it is capable of treating complexly located lesions without damaging the surrounding healthy brain tissue.
This year marks the 10-year anniversary of the Gamma Knife installation at the Queen Square Radiosurgery Centre (QSRC) within the University College Hospital (UCH) in central London – a centre of clinical excellence that operates within the National Hospital of Neuroscience and Neurology (NHNN). Providing stereotactic radiosurgery treatment options using Gamma Knife for complex lesions in the brain, this centre has been consistently listed as one of the world’s top three centres for neuroscience and neurology. However, the process of actually installing the Gamma Knife at QSRC was complex – and involved tonnes of equipment and live radioactive sources being fitted into the basement of UCH (where the QSRC is located), entailing the use of cranes, a prefabricated breakout wall, and temporarily moving a steel staircase.
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