To help expand patient groups that could benefit from Leksell gamma knife perfexion

University of Virginia (UVA) has acquired new Elekta technology, Elekta Extend. The new ‘frameless’ device for use with Leksell gamma knife perfexion systems will benefit patients with overly large benign skull base tumors, lesions too close to critical anatomy and those with multiple brain metastases.

The Extend program will enable UVA Health System clinicians to non-invasively fix or immobilise the patient’s head position over two to five radiosurgery sessions, making it more practical for these cases, said the company.

According to the company, UVA acquired Leksell Gamma Knife in 1989. In 2007, it was the first US medical center to install Leksell Gamma Knife Perfexion. UVA has performed Gamma Knife surgery on about 7,000 patients.

The company claims that UVA is the first US center to acquire Extend. The key components of Extend include patient-friendly fixation devices, such as a vacuum assisted bite block and head support with vacuum pillow. Accurate repeat fixation is ensured with a one-time use of a CT box to obtain precise stereotactic reference points, followed by repeat checks using reposition check instruments for each Gamma Knife session.

Jason Sheehan, associate professor in both departments and co-director of Gamma Knife Center at UVA, said: “Team members from both the neurosurgery and radiation oncology departments made the decision to acquire Extend. We wanted to expand the versatility of the Perfexion system to allow multi-session radiosurgery.

‚ÄúThis will enable us to treat lesions immediately adjacent to critical structures, such as the optic apparatus, in addition to targets that are simply too large for single session radiosurgery. It also creates the potential to treat brain metastases, which in many cases might not require the precision provided by a very rigid frame.”

James Larner, professor and chair of radiation oncology at UVA, said: “There’s no question that Extend broadens the potential for Gamma Knife Perfexion. First, fractionating therapy under certain circumstances cases in which a small tumor abuts a critical structure, for example provides a greater anti-tumor effect for a given level of normal tissue toxicity. Second, Extend is a non-invasive fixation alternative for Gamma Knife.”