Gamma Knife surgery: past to Perfexion

1 The 14th International Meeting of the Leksell Gamma Knife Society was held in Quebec City, Canada, in May of 2008. This supplement to the Journal of Neurosurgery contains some of the most rigorous scientific research presented at the meeting. Since its inception in the 1950s, stereotactic radiosurgery has matured from a fringe therapy to a mainstream treatment for intracranial vascular malformations and benign and malignant tumors. In the process, this discipline has revolutionized the fields of neurosurgery and radiation oncology. There are, however, significant areas that remain to be explored. The field of spinal radiosurgery is relatively new, and the benefits of MR imaging– guided planning and precise radiosurgical dose planning with Leksell Perfexion represent intriguing possibilities. Movement disorders are currently targets of neuromodulation/stimulation procedures and stem cell research. With the combination of highly detailed anatomical images (functional MR imaging, 3-T and higher–field strength MR imaging, and magnetoencephalography), it will soon be possible to either lesion or modulate affected areas of the brain using radiation with great precision. Although the Gamma Knife (GK) has always been a dedicated neurosurgical tool, most centers have long adopted a team approach to GK surgery. Conference attendance and participation by neurosurgeons, radiation oncologists, medical physicists, and other medical specialists such as neuroendocrinologists and neuropsychologists are a testament to this type of approach. Radiosurgery has consistently taken advantage of expertise from diverse areas of medicine including neurosurgery, radiology, physics, and radiation oncology. The multidisciplinary approach affords optimal patient selection, treatment, and follow-up care. Research from these diverse groups of participants is further refining and, in some instances, redefining intracranial stereotactic radiosurgery. The scientific program at the meeting represented a mixture of honoring the past and examining ways to enhance the future outcomes of patients undergoing radiosurgery. The GK Perfexion was the focus of some of the scientific presentations and appears to represent a quantum leap in terms of GK technology. Improvements in clinical outcomes and expanding indications (for example, extracranial or fractionated approaches) with the Perfexion will require further study. The present supplement consists of peer-reviewed manuscripts from the Leksell Gamma Knife Society meeting. Each of these manuscripts details work presented at the meeting. The scientific works reflect a snapshot of current GK pursuits. With hope, this written record from the meeting will lead to widespread dissemination of important studies presented at the conference and to collaboration and innovations for future GK research. (DOI: 10.3171/JNS/2008/109/12/S1) J Neurosurg 109:1

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