The treatment consists of five steps:
Your referring clinician will have contacted our Neuro-Oncology team to request a review to confirm whether you will benefit from GammaKnife treatment. Having assessed and confirmed the benefits of treatment, you will be invited for an outpatient appointment with one of our consultants. You may also attend a pre-assessment clinic if necessary. At the pre-assessment clinic you will meet with our radiography and nursing staff. A blood sample may be taken and assessment of your requirements for the treatment day undertaken. This also provides an opportunity to visit the centre and we encourage all patients and their relatives, friends or carers attending to ask any questions they may have.
On the treatment day, you will be asked to come to the Queen Square Radiosurgery Centre (GammaKnife) at the National Hospital for Neurology and Neurosurgery early in the morning. For those needing to travel and wanting to stay locally, please contact us and we will try to help you with transport and accommodation.
At the centre, the team will meet you and will explain how the day will proceed. You will then be fitted with the stereotactic head frame. The lightweight frame allows the doctor to accurately pinpoint the target to be treated in your brain. It also prevents your head from moving during imaging and treatment procedures. The frame fitting involves a small degree of discomfort, but most patients tolerate it remarkably well. The application of the head frame requires four small injections to administer local anaesthetic (similar to having a dental treatment) in order to numb the sites where the 4 pins are to be used to secure the frame. The whole procedure takes about 5 – 10 minutes during which you may experience some minor discomfort from the wearing of the head frame but will quickly get used to this. With our latest GammaKnife system, there may also be the option to use a lightweight mask or even lighter Vantage frame which can be discussed with you either in advance or in the morning, of treatment.
After the head frame is in place, you will be transferred to the imaging team so that your planning images can be done. Planning is usually based on magnetic resonance imaging (MRI) scans or occasionally computed tomography (CT) scans. This imaging is required to determine the exact size, shape and position of the target in the brain.
During imaging, a coordinate box is placed on the head frame to provide reference points on the images for the treatment plan. After imaging, the coordinate box is removed.
Your scanning session typically lasts 30 minutes and may involve an injection of contrast dye to enable the best possible scan quality.
Once your scan is complete, you will be taken back to your room where you can have light refreshments and rest. During this time, the Medical Physicist along with a Consultant Neuro Radiologist uses a specially designed computer system to calculate a precise and accurate treatment plan based upon your scans.
This treatment plan is unique to you as every patient’s plan is individually designed to address the specific medical condition. Once complete, your Consultant Neurosurgeon reviews and accepts this plan and prescribes your treatment.
Once your treatment plan is complete and all necessary checks have taken place, the actual treatment can start. The treatment is similar to having a scan, and you will be lying down with your head frame supported to ensure that you are sufficiently still.
During the treatment, you will be awake and be able to communicate with the Treatment team through an audio and video connection. If necessary, breaks can be introduced into the treatment process to ensure your comfort whilst you are treated.
When your treatment is complete, the head frame will be removed and you will be returned to your room to rest. Some patients experience a mild headache or some minor soreness at the points where the head frame was attached, but most report no problems.
The majority of our patients return home the same day an hour or two after the treatment has finished, your doctor will tell you whether or not they want you to stay overnight for observation. The points where the frame was fitted should heal completely in 1-2 weeks, however you should be able to return to your normal routines in a day or so.