CyberKnife NeuroRadiosurgery A practical Guide - 1st Edition Digital Download
CyberKnife NeuroRadiosurgery A practical Guide - 1st Edition Digital Download
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CyberKnife
NeuroRadiosurgery
A practical Guide
Editors
Alfredo Conti Pantaleo Romanelli
Associate Professor of Neurosurgery Scientific Director
Alma Mater Studiorum University AB Medica
of Bologna Milano, Italy
Bologna, Italy
Consultant and Scientific Director
IRCCS ISNB Istituto delle Scienze Neurosurgery and Brain Radiosurgery
Neurologiche di Bologna CyberKnife Center, CDI
Bologna, Italy Milano, Italy
Resident Research Scientist Visiting Scientist
Charité University European Synchrotron Radiation
Berlin, Germany Facility (ESRF)
Grenoble, France
Evangelos Pantelis
Assistant Professor, Medical Physics CyberKnife Center, CDI
Laboratory, Medical School Via Saint Bon 20
National and Kapodistrian Milano, Italy
University of Athens
Mikras Asias 75 Scott G. Soltys
Athens, Greece Associate Professor, Department
of Radiation Oncology
Young Hyun Cho Stanford University Cancer Center
Associate Professor, Department of 875 Blake Wilbur Drive
Neurosurgery and Radiosurgery Center Stanford, CA
Asan Medical Center, University of USA
Ulsan, College of Medicine
Seoul, Republic of Korea Michael Lim
Department of Neurosurgery
The Johns Hopkins University School
of Medicine
Baltimore, MD
USA
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
“Beautiful things have dents and scratches too”
This book is dedicated to Nathalie Chadeau for her immense
passion.
Foreword 1
vii
viii Foreword 1
These are all good reasons to welcome this book reporting the perspec-
tives of clinicians and physicists with a large experience in the field of SRS
gained through years spent in outstanding international institutions.
The rationale for the use of radiosurgery is highlighted by each contributor
in a very systematic discussion of personal data, an extensive literature review
with special reference to safety-effectiveness, and a final summary of indica-
tions and contraindications. The chapters cover different issues, an historical
review, physics, imaging, and a thorough essay of brain and spine tumors,
cerebral vascular lesions, and functional disorders. The structure of each
chapter is perfectly organized in order to provide a practical guide and to
make this book an excellent resource for residents, fellows, and practicing
neurosurgeons.
Definitely, I am impressed by the broad and deep insight into applications
of this novel robotic tool with different radiation doses and modalities. I am
confident that the invaluable scientific information delivered by this book will
benefit the international neurosurgical community. The editors and contribu-
tors are to be commended for their effort in making us aware of the current
possibilities and limitations of radiosurgery for the treatment of neurosurgical
disorders.
Francesco Tomasello, MD
University of Messina
Messina, Italy
Foreword 2
The concept of radiosurgery is, and always has been, a genuine neurosurgical
concept. The ability to treat and control neurosurgical pathologies with an
(invisible) sharp knife, at low risk, has been a success story since its introduc-
tion by neurosurgical pioneers. In addition, the therapeutic approach,
decision-making, perception of perilesional surgical anatomy, and the pre-
interventional risk assessment strongly benefit from decades of lessons
learned from open neurosurgical operations. While radiosurgery was initially
reserved for benign intracranial tumors, the indications have been broadened
over the years into vascular, functional, pediatric, and spinal arenas. This is
the reason why skull base, stereotactic, functional, and so on hybrid neurosur-
geons, active in radiosurgical and open neurosurgical fields, seem to have an
easier career pathway than endovascular/open vascular neurosurgical hybrids,
for unknown reasons (although I have my ideas). Being a hybrid neurosur-
geon or working in an interdisciplinary setting allows us to better appreciate
the advantages and disadvantages of each therapeutic modality that we are
able to offer to our patients. This will finally eliminate therapeutic bias from
the decision-making process. The patients will benefit most from this devel-
opment, and this is what counts. I am also a strong supporter of hybrid neu-
rosurgeons since a thorough dual training is the most effective strategy to
prevent therapeutic extremism, as we have observed in the past, also in the
field of radiosurgery. By this, not everything will look like a nail since one has
not only a single hammer. One reason for this smooth and successful develop-
ment in radiosurgery is the trustful collaboration with our friends and col-
leagues from radiooncology, to whom we are, and always will be, grateful for
their support and friendship.
This view, however, as appealing as it may sound, is currently regarded as
“romantic,” “unrealistic,” or “useless” by critical neurosurgeons and radiation
oncologists, even among my friends. This just demonstrates that many still
need to be convinced by science- and evidence-based success and progress in
the field, and maybe also by overcoming classical borders when it comes to
neurointerventions. The single most important aspect that will consolidate
the hybrid neurosurgical concepts is the thrive for high-end clinical and aca-
demic training in both fields, in order to tackle the argument that one person
cannot be good at both therapies. Admittedly, there is still room for improve-
ment in this field for the next years or so.
Having said all this, it is a pleasure to hold this textbook that comprises all
aspects of radiosurgery, traditional and innovative ones in my hands. The
ix
x Foreword 2
leaders in the field are discussing these aspects in a very balanced and scien-
tific way to highlight areas of opportunities, challenges, controversy, and
common sense. The real value of this book, however, is that all authors
involved fulfill my introductory remarks about hybrid neurosurgeons or expe-
rienced interdisciplinary teams. They stand for high-quality concepts and bal-
anced views, always struggling for the best outcome in our patients.
It is a pleasure to see Alfredo Conti, a role model of an academic hybrid
neurosurgeon and to whom the Charité CyberKnife Program is grateful for
his collaboration and expertise, as the editor of this book. I applaud him for
this masterpiece. In addition, it is a pleasure to have Francesco Tomasello as
author of the second foreword. Francesco, as a very prominent representative
of the Italian Neurosurgical Society, has always been a mentor and close
friend for me over many years, for what I am truly grateful. However, in the
midst of the COVID-19 pandemic and all the associated suffering (when
these words are printed), I cannot resist to acknowledge and congratulate the
entire Italian Neurosurgical Society for their dedication to all the positive
aspects of our neurosurgical life: friendship, positivity, humbleness, elegance,
innovation, family, and strong shoulders that carry on and come up with
excellent books like this.
Peter Vajkoczy, MD
Department of Neurosurgery
Charité-Universitätsmedizin Berlin
Berlin, Germany
Preface
xi
xii Preface
Part II Physics
Part III Imaging
xiii
xiv Contents
Part IV Radiobiology
Part V Oncology
Part VI Spine