The Gamma Knife is a revolutionary piece of technology that treats neurological conditions, such as brain tumours, without the need for invasive surgery.
With one of only two Gamma Knives in Australia, MQ Health is proud to offer Gamma Knife surgery to all suitable patients.
Gamma Knife is a form of stereotactic radiosurgery that uses computer planning software to locate and treat brain tumours with radiation therapy. It delivers intense radiation with extreme precision to the tumour location without needing to touch the surrounding tissue.
With the ability to treat many other brain conditions that may have previously required invasive surgery, Gamma Knife surgery has revolutionised brain tumour management.
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Gamma Knife treatment is delivered through MQ Health's neurosurgeons in partnership with an expert radiation oncology team at Genesis Cancer Care. We've combined our expertise in neurosurgery and radiation oncology to provide a high quality, cost-effective radio-surgical service for patients.
Our experts in Gamma Knife radiosurgery can treat the following brain disorders:
Dr John Fuller, a neurosurgeon at Macquarie University Hospital, and his team were able to treat 26 tumours in a single day using new minimally-invasive Gamma Knife radiosurgery technology. “Patients with multiple brain metastases are often still of...
Learn moreFind out more about Gamma Knife surgery at MQ Health.
At MQ Health, we adopt a multidisciplinary team (MDT) approach to care for patients needing Gamma Knife surgery.
Our team meets regularly to discuss individual cases and determine the best treatment approach for all patients being treated with the Gamma Knife.
The team includes clinicians from different specialist areas including neurosurgeons, radiation oncologists, medical physicists, radiation therapists and nurses.
At the team meetings, we discuss every case referred and explore all possible treatment options before Gamma Knife treatment is approved.
Our expert team includes:
MQ Neurosurgery is one of the largest academic neurosurgery groups in Australia. Our team includes neurosurgeons and a dedicated neurosurgery research laboratory.
Our researchers are trying to understand the physiological origins and behaviour of a wide range of conditions in order to develop treatments that deliver optimal patient outcomes.
Our Gamma Knife research projects are focused on improving treatment outcomes through non-invasive pathways. One of the ways we do this is through neurovascular simulations.
Some of our current research projects include looking at the use of Gamma Knife therapy combined with pharmaceuticals, and developing simulation software that determines the most effective surgical intervention for neurological conditions.
As leaders in Gamma Knife treatment, we train surgeons and oncologists to develop specialty skills and knowledge in Gamma Knife and the management of cases they would not see anywhere else.
We are always seeking to engage with clinicians dedicated to the pursuit of patient-centred excellence and interested in supporting the teaching and training of students during clinical placements.
Our team also offers opportunities to engage in clinical and/or laboratory research, including formal or honorary appointments with the Faculty of Medicine and Health Sciences (dependant on skills, experience and desired commitment). Contact us to learn more.
Before you have treatment your doctor will explain the entire process to you, and answer any questions you may have. Gamma Knife “surgery” does not require any cutting or shaving of your hair. The nurse will contact you prior to treatment to discuss any further questions or concerns.
An essential component to the Gamma Knife treatment procedure is the use of a specialised precision head frame. The head frame performs two important functions. Firstly it allows the doctors to very precisely and accurately pinpoint the target area requiring treatment. Secondly, the frame ensures you remain completely still throughout the procedure. The head frame is attached to your head via four pins using local anaesthetic.
Once the head frame has been fitted, a series of tests will be performed to determine the exact size and location of the target area. This includes imaging techniques such as MRI, CT or angiography.
The information gained from the imaging in step 3 is used by your doctors with the assistance of highly trained medical physicists to develop an accurate and customised treatment plan. Every plan is unique and tailored to the specific requirements of each patient.
Once the treatment plan has been completed by the team of professionals your treatment can begin. With your head frame attached you will be positioned on the treatment couch. The procedure is completely painless (indeed it can be considered boring) and you will remain awake throughout the procedure with the treatment team monitoring you the whole time. The length of the treatment will vary from patient to patient and depends on the size and shape of the target area. The treatment time can be from one to three hours. The entire Gamma Knife procedure – frame on to frame off – therefore takes approximately two to eight hours.
Following treatment, the head frame and pins will be removed. Generally you will feel no effects of the treatment; however some patients may experience a mild headache or minor swelling from where the frame was attached.
An appointment will be made for you to see either your treating or referring doctor. Should you have any queries following treatment, please contact your consultant or the nursing staff at Radiation Oncology.
The effectiveness of your Gamma Knife treatment will be evaluated over time. The radiation treatment is designed to stop the growth of tumours or dysfunctional tissue, therefore it may take weeks or even months before the full benefit of the treatment may be realised.
It may be necessary to have follow-up imaging such as MRI or CT to assess your progress over time.
Gamma Knife surgery (GKS) is a safe, effective and non-invasive procedure that uses radiation to treat conditions in and around the brain. It is sometimes used as a replacement for conventional surgery, but at other times it may be effective in situations where there is no conventional surgical alternative available. The radiation treatment is delivered with great precision to the target tissue within or around the brain, whilst at the same time minimising any dose to surrounding healthy tissue. The name ‘Gamma Knife’ is in some ways misleading – no knife or cutting implement is actually involved at any stage. The term ‘Gamma Knife’ is intended to convey the idea that this radiation treatment is in some ways delivered as though it were an actual knife, because it offers a similar sort of precision and targeting to that offered by actual surgery. It uses radiation in much the same way as a surgeon uses a knife.
If you are unsure if Gamma Knife would be a suitable treatment for your condition or you would like to find out more please contact us. Someone will be in touch to tell you more about the treatment and if it is potentially suitable for you. The multidisciplinary Gamma Knife team meet regularly to discuss new cases and are happy to review your scans. There is no cost for this service. The team includes a neurosurgeon, radiation oncologists, medical physicist and nurses. Once your case has been discussed we will be in contact shortly afterwards to let you know if Gamma Knife is an option for you or if not we may be able to advise on other treatments. It can be a very valuable second opinion free of charge.
Radiation damages the DNA in the cells of the tumour or other abnormality being treated, such that the cells that make up the targeted tissue can no longer divide. Eventually, when these cells come to the end of their natural life span, they find that they are unable to divide and replace themselves because the DNA essential to this process is no longer functioning properly. Some lesions which are very inactive in terms of cell function may take up to 2 or 3 years or more to respond to treatment – this is typically the case for instance with blood vessels, and arterio-venous malformations (AVM) which usually resolve over this sort of time period.
Yes – in terms of the risk of damage to tissue around the target area. GKS risks can nearly always be brought down to very low levels – one of the more common reasons for recommending GKS is that the overall risk compared to open surgery is frequently much lower. This is sometimes so much the case that the surgical alternative may actually carry a higher overall risk than that of the condition being treated, thereby rendering it effectively inoperable other than by radiosurgery. The precise nature and magnitude of any risk will vary with the size, nature and position of the lesion being treated. You should ask your treating doctor to elaborate on the details of this with respect to your own individual situation – they will be more than happy to give you a very full explanation of all that is involved. As with any form of surgical or radiation treatment, there will always be some small risk attached and this can never be reduced to zero.
Serious complications of GKS are very unusual. Minor side effects, which generally resolve within a few hours, are sometimes seen and do not usually present the patient (or the doctor) with a significant problem.
It is fair to say that the large majority of patients suffer no side effects whatsoever, apart perhaps from a feeling of being a bit tired and ‘washed out’ at the end of a busy day’s treatment!
We tend to think of complications in terms of those which may occur early i.e. soon after treatment, and those which can occur at a later stage, some weeks or months following GKS:
Common:
Uncommon:
These complications tend to relate only to treatment for particular conditions. Your treating doctor will be able to elaborate on the details of this with respect to your own individual situation.
The stereotactic frame is fitted under local anaesthesia. This involves the administration of 4 small injections around the circumference of the head, in order to numb the sites where the 4 pins are to be used to secure the frame.
The experience of these is the same as when visiting the dentist for the purpose of having a tooth put to sleep for filling. The same local anaesthetic drug is used in both instances. Very quickly, after a brief stinging sensation, these areas will go numb.
The frame is then attached. As the pins are secured you will feel a strange “pressure” sensation which quite soon passes. The whole procedure takes about 5 – 10 minutes, and after the frame is fitted you will gradually get used to the sensation. After a short while you will no longer feel this, and you will almost forget that the frame is there at all!
Frame fitting involves a small degree of discomfort, but most patients tolerate it remarkably well, and tend to comment that it was much preferable to the idea of having a major surgical procedure performed.
At the end of the procedure the frame is removed. This only takes a minute or two, and is not traumatic. Some patients experience headaches after frame removal which can be treated with simple pain relief.
No. All radiation stays within the treatment room. The Gamma rays used in the treatment do not remain in the body.
In the postoperative period some tumours may swell a little as a result of being injured by a dose of radiation. This may show as a slight increase in apparent size of the tumour as assessed by MRI or CT scanning at about 6-9 months post treatment.
This appearance must not be misinterpreted as tumour growth. It is self-limiting, and will soon be followed by reduction back to original size, or even smaller.
If this temporary swelling (which actually indicates that the treatment is starting to work) causes any symptoms, then a short course of steroids or other medication is sometimes used to treat the swelling.
The vast majority of patients have no risk whatsoever of losing any hair at all. Furthermore, even in those few cases where hair loss is a possibility, such hair loss will never involve the entire scalp – as typically happens with whole brain radiotherapy.
Only a small number of patients will have tumours sufficiently close to the scalp to carry the risk of any hair loss at all. If a lesion to be treated is very close to the inside of the skull, it is possible that enough radiation will be delivered to the scalp to cause a patch of hair the size of a 10 or 20 cent coin to be lost. This hair usually grows back, though it may be a little lighter in colour and finer in texture than previously.
Most patients feel just as well as they did at the beginning of the day. Some tiredness is quite common, especially if the treatment has occupied most of the day. A little discomfort at the pin sites and a mild headache are also quite common – this may persist for up to a day or two. Mild nausea may also occur during the first 48 hours following treatment. Mild anti-nausea and headache medication is routinely prescribed for patients who may require it. Patients are observed for one to two hours post treatment.
As soon as you feel well enough. There is no reason why you should not go back to work the following day – some patients have even been known to return to work later the same day, but you should not feel pressured to return to work too quickly. It is fair to say that most people return to work within less than a week.
Again, as soon as you feel well enough. There is no reason why you could not travel the following day, or even some time later on the actual day of treatment. Any driving restrictions already in place will continue to apply.
Designed specifically for and dedicated to the brain, Gamma Knife surgery is widely recognised as the gold standard in stereotactic radiosurgery. Advantages of Gamma Knife surgery include:
Conditions for which Gamma Knife surgery is considered most effective are:
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