Pittsburgh, May 23, 2002 -- On May 23, 2002, the Center for Image Guided Neurosurgery performed gamma knife radiosurgery on its 5000th patient. Much has happened in the field of radiosurgery since the first patient had the procedure on August 14, 1987.

Over the last 15 years, no center in this country has managed more patients, and no center has performed more research, nor published more reports than the University of Pittsburgh group. The initial team of Dr. L. Dade Lunsford, Dr. John Flickinger, David Bissonette, and physicist Ann Maitz still work daily in the program. Dr. Doug Kondziolka joined the group in 1989.

Gamma knife radiosurgery achieves destruction of an intracranial target through the precise focus of image-guided radiation. Radiosurgery is one of several "minimally invasive" techniques for brain disorders, and has received great interest as an alternative to either conventional surgical resection, or to fractionated radiation therapy.

Surgery using the gamma knife is safer than many existing procedures because patients need not undergo risky, open-skull procedures and adult patients do not require general anesthesia. It causes few side effects, and patients usually leave the hospital within 24 hours.

Presently, radiosurgery is used for the management of patients with benign or malignant brain tumors, intracranial arteriovenous malformations (AVMs), trigeminal neuralgia, and selected movement disorders such as disabling tremor. It has become widely used for patients with acoustic neuromas and brain metastases because of the excellent clinical and imaging outcomes achieved.

The University of Pittsburgh has housed the first U.S. model U Gamma Knife (1987), model B unit (1996), and the new robotic model C unit (2000). Pittsburgh is the only facility in the country with two machines allowing treatment of approximately 600 patients annually.

The recently introduced robotic model C unit with automatic patient positioning system (APS) permits greater accuracy in radiation-dose planning, provides faster treatment and allows more flexibility in dose delivery, according to a study published in the February issue of Neurosurgery.

The study also found that because of the APS system, multiple uses of different sizes of collimator helmets --used to focus the radiation -- were not needed, saving time and making the procedure more comfortable for patients.

"We found the accuracy of the robotic system allows us to use greater numbers of smaller and narrower beams of radiation," says Dr. Kondziolka. "This results in steeper falloffs of the radiation outside the target area, resulting in a more conformal dose plan and a potentially better outcome for the patient,"

Important collaborators in the radiosurgery program include faculty in neuroradiology (Drs Emanual Kanal, and Carolyn Meltzer), radiation oncology (Drs. Melvin Deutsch, John Varlotto, Jr., Shalom Kalnicki), medical oncology (Drs. John Kirkwood, Sanjiv Agarwala, Adam Brufsky, Chandra Belani, Joseph Baar, Barry Lembersky, David Friedland), neurology (Dr. Mark Scheuer), and many others.

A dedicated nursing team (Jonet Vacsulka, Donna Brenlove, and Cheryl Rogers), and administration (Charlene Baker, Grace Yum, Michael Habeck, Peggy Schmitt, Maryann Vincenzini, Katie Benchoff) have been the key to the care of so many patients.

Visiting fellows and residents from over 20 different countries have worked on a broad array of basic and clinical research projects in this field. Many now direct gamma knife radiosurgery programs in their own countries.

The department also offers a quarterly training course attended by neurosurgeons, radiation oncologists and medical physicists from around the world.