How Do You Prepare Before Radiosurgery?
Before radiosurgery takes place, the following preparations need to be taken:
- Preparation at Home: The patient should fast overnight before the procedure, if not advised otherwise by the doctor. No hair cream/spray should be used if brain radiotherapy is planned. Jewelry or makeup should not be worn.
- Preparation at the Medical Center: A medical history will be taken to gain information about general health, current medications, any allergy to the anesthetic/contrast media to be used or if any metallic prosthetics/implants are present within the body. The patient will be advised to take off eyeglasses/contact lenses and dentures. After changing into a hospital gown, an intravenous (IV) line will be attached through which medicines, contrast media and fluids will be delivered.
- Immobilization of the Patient: In case of radiosurgery of the brain, a head frame is attached by means of four pins. Before attachment of the head frame, a local anesthetic is injected at the four points on the head where the pins will be fixed. Alternatively, a thermoplastic mask may be used to cover the face, which is attached to a frame and clamped to the radiotherapy platform.
- Treatment Planning: The CT/MRI scans will be analyzed by using advanced computer software to customize the radiation beams that are to be delivered by the robot to the lesion/tumor during the procedure. This planning phase may take a couple of hours.
What are the Tests Required Before Radiosurgery?
Imaging is carried out to visualize the shape, size and location of the tumor/lesion along with the surrounding vital structures, which should be avoided. The following imaging procedures are carried out:
This uses X-rays to take multiple photos of the head from various angles. Then these multiple images are processed and aligned using a computer to generate the final images as “slices” at various levels of the brain. In case of radiosurgery, a special type of CT called CT/Simulation is used.What Happens During Radiosurgery?
During radiosurgery, the following procedures are involved:
- Positioning of the Patient: The patient lies down on a moveable platform that is capable of sliding into the machine that delivers the radiation. The head frame is attached to the platform. A mild sedative may be administered to relax the patient.
- Alignment of the Target Site: An automated robotic arm is used to move the platform so that the operating field is properly aligned and oriented for accurate targeting of the radiation beam.
- Delivery of the Radiation: During the procedure, the medical team operates the robot through a computer interface from an adjacent room with the help of video imaging. The Gamma Knife® or CyberKnife® is used to deliver the radiation. The radiation beam is accurately focused on the lesion/tumor with the help of the robotic arm. The image guidance system continuously compares the X-rays with the CT/MRI images in real-time and simultaneously sends signals to the robotic arm for precisely targeting the beam.
- Treatment Duration: Generally, each treatment session using a Gamma Knife® or CyberKnife® takes about 1-2 hours. Usually, SRS involves only one treatment session, while SRT requires 4-5 sessions to complete the treatment.
Advertisement
What Happens After Radiosurgery?
After the radiosurgery, an assessment is made before discharge:
- Assessment of the Patient: After radiosurgery, the patient’s condition is assessed by a doctor to see if he/she is fit enough to be discharged.
- Supportive Care: Some patients may experience tenderness, swelling or minor bleeding at the pin sites. Bandages are placed over these sites, which are taken off the following day.
- Discharge of the Patient: If a frame is used for the radiosurgery, the patient may be sent to the ward for recovery before discharge, while in case of a mask, the patient may go home after the procedure. In either case, the patient is advised not to resume work before 24 hours.
