X-Knife
The X-Knife is a computerized radiosurgery system that uses a linear accelerator (LINAC) to produce beams of X-ray radiation to treat brain disorders such as:
- Arteriovenous malformations (AVMs)
- Brain metastases
- Gliomas
- Acoustic neuromas
- Cavernous angiomas
- Intractable seizures
- Pediatric brain tumors
- Recurrent brain tumors
- Pituitary adenomas
- Meningiomas
- Craniopharyngiomas
- Low grade astrocytomas
- Oligodendrogliomas
- Certain functional brain disorders
X-Knife Stereotactic Radiosurgery
Unlike traditional surgery, the X-Knife is non-invasive and does not use a scalpel, but rather, uses an "invisible blade" of radiation; this makes the procedure bloodless while reducing the discomfort and complications of invasive surgery. Image scans of the patient are analyzed in the X-Knife computer and the X-Knife team carefully plans the radiation beams used to treat the disease site (or "lesion") to avoid any critical structures in the brain. The X-Knife stereotactic instruments on the LINAC immobilize the patient and guide the X-ray beams precisely to the lesion, as the patient lies comfortably on the LINAC treatment couch.
X-Knife Stereotactic Radiotherapy
In addition to treating patients with Stereotactic Radiosurgery, the X-Knife system can also be used to deliver lower levels of focused radiation over a series of treatment sessions called "multiple fractions." This technique is particularly important in cases where tumors are adjacent to radiosensitive tissues such as the brain stem, eyes, or optic nerves, or in cases of pediatric tumors. By treating the lesion with lower dose fractionated therapy, spaced over multiple sessions, this method enhances the desired effect on the tumor while reducing the amount of radiation to nearby critical structures.
Procedure Description
An X-Knife procedure is a team effort, requiring a neurosurgeon, radiation oncologist, physicist, dosimetrist, and radiation technician.
On the day of treatment, the neurosurgeon attaches the head frame to the patient. The head frame will remain on the patient for the entire procedure, providing a reference platform for the location of the patient's anatomy and tumor during imaging. It will also serve to immobilize the patient during treatment. After the frame is in place, a series of CT and/or MR scans are taken. Depending on the type of tumor, angiographic films may also be ordered.
Treatment Planning
In many cases the patient can read, watch television or even eat while the planning takes place. After the scan is taken, the imaging data is transferred to the X-Knife computer system and is used to produce a 3-dimensional model of the tumor and nearby critical anatomical structures, such as the optic nerves or brain stem. The computer system determines the precise target position, dosage and configuration of radiation beams. This positioning optimizes the dose to the tumor, while minimizing the exposure of healthy tissue. Once the treatment plan is approved by the physician, the LINAC undergoes a series of quality assurance checks, and then treatment can begin.
Treatment
The patient is positioned comfortably on a specially designed couch. After positioning the couch and the LINAC, treatment begins. The actual dose administration can take as little as 30 minutes. This involves the movement of the LINAC around the patient as the focused radiation beams converge on the target. The invisible radiation is not felt at all. After the treatment, the head frame is removed. If no complications are observed, many patients are then free to leave the hospital the same afternoon.
Contact Us
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Phone
(866) 426-7787
(212) 746-4684
Office Hours
Monday - Friday, 9:00 AM to 5:00 PM
Emergency Department,
NewYork-Presbyterian/Weill Cornell
(212) 746-5026
