Same-day stereotactic aspiration and Gamma Knife surgery for cystic intracranial tumors

Liu, Xiaomin; Yu, Qi; Zhang, Zhiyuan; Zhang, Yipei; Li, Yanhe; Liu, Dong; Jia, Qiang; Ligao, Zheng; Xu, Desheng

doi:10.3171/2012.7.gks121019

Cited by 22 publications

(20 citation statements)

References 20 publications

(20 reference statements)

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“…After the procedure, a single cyst provides an effective target for cyst volume reduction using stereotactic radiotherapy. Stereotactic cyst aspiration and gamma knife radiosurgery may be achieved on the same day using one stereotactic frame application for cystic glial tumors or craniopharyngiomas, as reported recently (22). The authors of the study performed repeated aspiration via Ommaya reservoir with 14 of 77 patients (18.2%).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 95%

Neuroendoscopy Followed by Radiotherapy in Cystic Craniopharyngiomas—a Long-Term Follow-Up

et al. 2015

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Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 95%

Neuroendoscopy Followed by Radiotherapy in Cystic Craniopharyngiomas—a Long-Term Follow-Up

et al. 2015

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“…3). 14,26,33 Debates Although the beneficial effect of radiation in the treatment of craniopharyngiomas has been well recognized, 2 critical issues remain sources of significant controversy: 1) the merits of GTR versus subtotal resection followed by irradiation given the surgical morbidity and mortality rates associated with aggressive resection and 2) the role of RT immediately after resection without first monitoring for tumor progression and the role of RT in the absence of resection (up-front or salvage treatment).…”

Section: Cyst Development and Enlargement During Radiation Therapymentioning

confidence: 99%

Gamma Knife surgery for craniopharyngioma: report on a 20-year experience

Lee

Yang

Chen

et al. 2014

JNS

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ObjectAlthough craniopharyngiomas are benign intracranial tumors, their high recurrence rates and intimate associations with surrounding neurovascular structures make gross tumor resection challenging. Stereotactic radiosurgery has been introduced as a valuable adjuvant therapy for recurrent or residual craniopharyngiomas. However, studies with large patient populations documenting long-term survival and progression-free survival rates are rare in the literature. The current study aims to report the long-term radiosurgical results and to define the prognostic factors in a large cohort of patients with a craniopharyngioma.MethodsA total of 137 consecutive patients who underwent 162 sessions of Gamma Knife surgery (GKS) treatments at the Taipei Veterans General Hospital between 1993 and 2012 were analyzed. The patients' median age was 30.1 years (range 1.5–84.9 years), and the median tumor volume was 5.5 ml (range 0.2–28.4 ml). There were 23 solid (16.8%), 23 cystic (16.8%), and 91 mixed solid and cystic (66.4%) craniopharyngiomas. GKS was indicated for residual or recurrent craniopharyngiomas. The median radiation dose was 12 Gy (range 9.5–16.0 Gy) at a median isodose line of 55% (range 50%–78%).ResultsAt a median imaging follow-up of 45.7 months after GKS, the rates of tumor control were 72.7%, 73.9%, and 66.3% for the solid, cystic, and mixed tumors, respectively. The actuarial progression-free survival rates plotted by the Kaplan-Meier method were 70.0% and 43.8% at 5 and 10 years after radiosurgery, respectively. After repeated GKS, the actuarial progression-free survival rates were increased to 77.3% and 61.2% at 5 and 10 years, respectively. The overall survival rates were 91.5% and 83.9% at the 5- and 10-year follow-ups, respectively. Successful GKS treatment can be predicted by tumor volume (p = 0.011). Among the 137 patients who had clinical follow-up, new-onset or worsened pituitary deficiencies were detected in 11 patients (8.0%). Two patients without tumor growth had a worsened visual field, and 1 patient had a new onset of third cranial nerve palsy.ConclusionsThe current study suggests that GKS is a relatively safe modality for the treatment of recurrent or residual craniopharyngiomas, and it is associated with improved tumor control and reduced in-field recurrence rates. Acceptable rates of complications occurred.

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“…Liu et al exploited needle aspiration to 77 patients with cystic intracranial tumors, followed by Gamma Knife surgery. 85 88.3% of patients showed improved symptoms immediately after cyst aspiration. The authors found that such a reduction of the volume of tumors improved the effectiveness of the Gamma Knife by enabling a higher radiation dose, while lowering the risk of complications.…”

Section: Stereotactic Needle-based Aspirationmentioning

confidence: 91%

<p>Robotically Steered Needles: A Survey of Neurosurgical Applications and Technical Innovations</p>

Audette¹,

Bordas²,

Blatt³

2020

RSRR

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This paper surveys both the clinical applications and main technical innovations related to steered needles, with an emphasis on neurosurgery. Technical innovations generally center on curvilinear robots that can adopt a complex path that circumvents critical structures and eloquent brain tissue. These advances include several needle-steering approaches, which consist of tip-based, lengthwise, base motion-driven, and tissue-centered steering strategies. This paper also describes foundational mathematical models for steering, where potential fields, nonholonomic bicycle-like models, spring models, and stochastic approaches are cited. In addition, practical path planning systems are also addressed, where we cite uncertainty modeling in path planning, intraoperative soft tissue shift estimation through imaging scans acquired during the procedure, and simulation-based prediction. Neurosurgical scenarios tend to emphasize straight needles so far, and span deep-brain stimulation (DBS), stereoelectroencephalography (SEEG), intracerebral drug delivery (IDD), stereotactic brain biopsy (SBB), stereotactic needle aspiration for hematoma, cysts and abscesses, and brachytherapy as well as thermal ablation of brain tumors and seizure-generating regions. We emphasize therapeutic considerations and complications that have been documented in conjunction with these applications.

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Same-day stereotactic aspiration and Gamma Knife surgery for cystic intracranial tumors

Cited by 22 publications

References 20 publications

Neuroendoscopy Followed by Radiotherapy in Cystic Craniopharyngiomas—a Long-Term Follow-Up

Neuroendoscopy Followed by Radiotherapy in Cystic Craniopharyngiomas—a Long-Term Follow-Up

Gamma Knife surgery for craniopharyngioma: report on a 20-year experience

<p>Robotically Steered Needles: A Survey of Neurosurgical Applications and Technical Innovations</p>

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