Radiosurgery is a radiotherapeutic procedure in which high-energy X-rays are directed at a defined area of tissue in order to treat it. The term radiosurgery was introduced by Lars Leksell in 19511. This procedure can be used to treat pathologies that are difficult to access surgically, such as tumors or vascular malformations. Target structures measuring less than 3cm generally qualify for a radiosurgical procedure2; however, larger structures can also be treated, such as large-volume AVMs. In contrast to radiotherapy, radiosurgery delivers the dose in a single session; according to the AANS definition, it may also be divided over a maximum of five sessions3. Radiosurgery is performed using specialized equipment such as the Gamma Knife or a linear accelerator.
Volume Staged Radiosurgery (VS-SRS)
In Volume Staged Radiosurgery, the area to be irradiated is divided into different volumes, as may be necessary for large-volume arteriovenous malformations. The resulting subvolumes are then treated in successive sessions.
Dose Staged Radiosurgery (DS-SRS)
In Dose Staged Radiosurgery, the radiation dose to be delivered is divided over successive sessions. As with Volume Staged Radiosurgery, this may be necessary because the target structure to be irradiated is too large.
References
Leksell L. The Stereotaxic Method and Radiosurgery of the Brain. Acta Chir Scand. 1951;102:316-319. ↩ ↩
Stereotactic radiosurgery and radiotherapy. In: Greenberg M, ed. Handbook of Neurosurgery. 9th Edition. Thieme; 2019. ↩ ↩
Barnett, Gene H., et al. "Stereotactic radiosurgery—an organized neurosurgery-sanctioned definition." Journal of neurosurgery 106.1 (2007): 1-5. ↩ ↩