Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion
CPT4 code
Name of the Procedure:
Stereotactic Radiosurgery (SRS) - Particle Beam, Gamma Ray, or Linear Accelerator for One Simple Cranial Lesion
Summary
Stereotactic radiosurgery (SRS) is a non-invasive medical procedure used to treat abnormalities in the brain. Despite its name, it is not a surgical operation but rather a form of precise radiation therapy. SRS can target a small area with high doses of radiation while sparing surrounding healthy tissue.
Purpose
Stereotactic radiosurgery is primarily used to treat small, well-defined cranial lesions such as tumors, arteriovenous malformations (AVMs), and other brain abnormalities. The goal of the procedure is to destroy or shrink the lesion with minimal impact on nearby healthy tissue.
Indications
- Small brain tumors (benign or malignant)
- Arteriovenous malformations (AVMs)
- Trigeminal neuralgia
- Acoustic neuromas
- Meningiomas
Patients who are good candidates typically have small, well-defined lesions, and may seek SRS as an alternative to traditional surgery or when other forms of treatment are not suitable.
Preparation
- Patients may need to fast for several hours before the procedure.
- Detailed imaging tests such as MRI or CT scans are conducted to map the exact location of the cranial lesion.
- Patients may need to adjust certain medications as advised by their healthcare provider.
Procedure Description
- The patient is positioned on a table, and a custom head frame or face mask may be used to keep the head still.
- Advanced imaging techniques (CT, MRI) help create a precise 3D map of the lesion.
- A treatment plan is developed using specialized computer software to determine the exact dose and direction of the radiation beams.
- Using a particle beam, gamma ray, or linear accelerator, high-dose radiation is delivered to the lesion from multiple angles.
- No incisions are made, and the radiation delivery takes place over a single session or a few sessions depending on the lesion's complexity.
Anesthesia or sedation might be used if required to keep the patient comfortable, though often it is not needed.
Duration
The procedure typically takes 1 to 4 hours, depending on the complexity and size of the lesion.
Setting
Stereotactic radiosurgery is usually performed in a specialized room within a hospital, an outpatient clinic, or a surgical center equipped with advanced radiation technology.
Personnel
- Radiation oncologist
- Neurosurgeon
- Medical physicists
- Radiologic technologists
- Nurses
Risks and Complications
- Mild headache
- Nausea
- Fatigue
- Swelling at the site leading to temporary neurological symptoms
- Rarely, more serious complications such as radiation necrosis or damage to nearby tissues
Benefits
- Non-invasive
- Precisely targets the lesion, minimizing damage to healthy tissue
- Shorter recovery time compared to traditional surgery
- Outpatient procedure
- Can be repeated if necessary
Recovery
- Most patients can go home the same day.
- Some mild side effects like headache or fatigue can be expected.
- Follow-up imaging tests are usually scheduled to monitor the effectiveness of the treatment.
- Patients typically resume normal activities within a few days but may need to avoid strenuous activities as advised by their doctor.
Alternatives
- Traditional brain surgery (craniotomy)
- Whole brain radiation therapy
- Chemotherapy (for applicable cases)
- Observation and periodic monitoring
Each alternative has its own set of advantages and disadvantages, which should be discussed with a healthcare provider to choose the best option.
Patient Experience
During the procedure, the patient typically feels little to no discomfort, especially due to the use of immobilization devices. Post-procedure, patients may experience mild headache or fatigue, but pain management and comfort measures are provided to ensure a smooth recovery.
By understanding the details and involved steps of stereotactic radiosurgery, patients can feel more confident and prepared for the procedure.