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Case Study
 Imagine…
 You’re an undergrad at NU…
 As you approach Finals Week you acquire the following symptoms:
 Headaches
 Nausea
 Searle? à Mono
 Evanston Northwestern Healthcare à MRI
Diagnosis and Treatment
 Diagnosis: Benign Brain Tumor
 Treatment:?
 Chemo/Immuno therapy
 Invasive brain surgery
 Non-invasive radiotherapy
Non-invasive stereotactic radiosurgery
 Diagnosis: Benign Brain Tumor
 Treatment:?
 Chemo/Immuno therapy à Blood Brain Barrier
 Invasive brain surgery
 Non-invasive radiotherapy
 Non-invasive stereotactic radiosurgery
 Diagnosis: Benign Brain Tumor
 Treatment:?
 Chemo/Immuno therapy à Blood Brain Barrier
 Invasive brain surgery à High Risk
 Non-invasive radiotherapy
 Non-invasive stereotactic radiosurgery
 Diagnosis: Benign Brain Tumor
 Treatment:?
 Chemo/Immuno therapy à Blood Brain Barrier
 Invasive brain surgery à High Risk
 Non-invasive radiotherapy à Too Non-Specific
 Non-invasive stereotactic radiosurgery
 Diagnosis: Benign Brain Tumor
 Treatment:?
 Chemo/Immuno therapy à Blood Brain Barrier
 Invasive brain surgery à High Risk
 Non-invasive radiotherapy à Too Non-Specific
 Non-invasive stereotactic radiosurgery
What is Stereotactic Radiosurgery?
 Method to non-invasively & specifically treat benign/malignant tumors and tissue abnormalities
 Uses methods of stereotactic 3-D localization of surgical site
 Uses radiosurgical techniques to perform the “surgery”
3-D Stereotactic Localization
 Goal: To target the tissue of interest with as much accuracy as possible
 Use imaging and 3-D mapping techniques to target tissue of interest
 4 general medical imaging modalities used:
 X-Ray
 PET
 MRI
 Digital Subtracted Angiography
 Use the patient as a reference for the localization
 2 general methods:
 Frame stereotactic localization (old school)
 Frameless stereotactic localization (new school)
The Imaging Modalities
 Tomographic Techniques:
 PET (CT) and MRI
 Good for tumor pathologies
 Use multiple layers to get 3-D image
 X-ray-based Techniques:
 X-ray and Digital Subtracted Angiography
 Good for vascular imaging (for treatment of vascular malformations)
 Use pins and depth perception methods to get 3-D localization