• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3271-3276
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• 2016

Background: Intracranial nonvestibular schwannomas arising from various cranial nerves excluding CN VIII are uncommon. Recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) have been widely reported as effective treatment modalities for nonvestibular schwannomas. The purpose of this study was to study the long term clinical outcome for nonvestibular schwannomas treated with both X-Knife and CyberKnife (CK) radiosurgery at one institution. Materials and Methods: From 2004 to 2013, fifty-two nonvestibular schwannoma patients were included in this study, 33 patients (63%) were treated with CK, and 19 (37%) were treated with X-Knife. The majority of the tumors were jugular foramen schwannomas (38%) and trigeminal schwannomas (27%). HSRT was given for 45 patients (86%), whereas CSRT was for 6 (12%) and SRS for 1 (2%). Results: The median pretreatment volume was $9.4cm^3$ (range, $0.57-52cm^3$). With the median follow up time of 36 months (range, 3-135), the 3 and 5 year progression free survival was 94 % and 88%, respectively. Tumor size was decreased in 13 (25%), stable in 29 (56%), and increased in 10 (19%). Among the latter, 3 (30%) required additional treatment because of neurologic deterioration. No patient was found to develop any new cranial nerve deficit after SRS/SRT. Conclusions: These data confirmed that SRS/SRT provide high tumor control rates with low complications. Large volume tumors and cystic expansion after radiation should be carefully followed up with neurological examination and MRI, because it may frequently cause neurological deterioration requiring further surgery.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.391-396
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• 2007

Objective : This study was performed to review the clinical characteristics and operative results of brain abscess in order to define the therapeutic strategy for this disease. Methods : We reviewed the medical records and radiology images of brain abscess patients treated in our hospital during the last 16 years. A total of 35 cases included 23 males and 12 females, with the mean age of 48 years old. We excluded cases of postoperative, post traumatic, and fungal abscess. All patient underwent at least one surgical treatment such as stereotactic aspiration or craniotomy with excision. Results : Twenty seven [77.1%] patients presented with symptoms of increased intracranial pressure. The frontal lobe was the most common anatomical place, and streptococcal species were the most frequently encountered pathogens. The chronic pulmonary diseases and chronic otitis media are common underlying condition. Eighteen patients underwent stereotactic aspiration and 17 patients had excision of their abscess as an initial treatment. Seven patients had a repeated surgery, 6 of them had been treated with aspiration initially. At discharge, 60.0% patients showed a favorable outcome. Conclusion : The stereotactic drainage would be more suitable for the brain abscess located in deep and eloquent area. A large, solitary, and well-encapsulated lesion of superficial location could be best treated with complete excision, and this procedure was more definite because it is associated with less repeated surgery and showed more favorable outcome compared to aspiration surgery.

• Investigative Magnetic Resonance Imaging
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• v.4 no.1
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• pp.7-13
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• 2000

Purpose : To assess the distortion of MRI with the Leksell stereotactic radiosurgery system in variable pulse sequence and imaging plane through phantom study, to find most adequate imaging plane and pulse sequence for stereotactic radiosurgery system. Materials and methods : We made the phantoms for MRI and get images in variable conditions and analyzed the image distortion using image analysis program, and statistically using paired student t-test. Results : The transeverse plane images had acceptable error ranges bless than 1.5mm) in all pulse sequence in both the analysis of fiducial marker in stereotactic G-frame and the phantom study. The coronal plane images had unacceptable large errors (more than 1.7mm) in the analysis of fiducial marker in the stereotactic G-frame, but had corrected small errors (less than 1.5mm) in the phantom study. Conclusion : We find from the phantom study that the present MR machines are adequate for stereotactic surgery system in frequently used pulse sequences, and imaging planes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.1
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• pp.65-68
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• 2004

CyberKnife is a stereotactic radiosurgery system which could be used to treat many tumors and lesions. It provides the surgeon unparalleled flexibility in targeting using a compact light linear accelerator mounted on a robotic arm. Advanced image guidance technology tracks patient and target position during treatment, ensuring accuracy without the use of an invasive head frame. CyberKnife with Dynamic Tracking Software is cleared to provide radiosurgery for lesions anywhere in the body when radiation treatment is indicated. It has often been used to radiosurgically treat otherwise untreatable tumors and malformations. Moreover, this instrument treats tumors at body sites, most of which are unreachable by other stereotactic systems. Compared with conventional radiotherapy, it is fundamentally different that using non-invasive, frameless, no excessive radiation exposure to normal tissue. In oral malignant neoplasm, surgical excision and radiation therapy should be tried first, additionally chemotherapy could be considered. However, after failure of conventional therapies, patients had poor systemic condition and surgical limitation. So, CyberKnife could be a suitable therapy. A 49 years man was referred in recurred mandibular cancer treated by radiotherapy. The tumor was considered inoperable, because of extensive invasion and was not expected to good response to conventional therapies. We experienced a case of CyberKnife after 4 cycle chemotherapies, so we report it with review of literature.

• Journal of Yeungnam Medical Science
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• v.36 no.3
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• pp.192-200
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• 2019

Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.71-74
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• 2014

Cancer-related facial pain refractory to pharmacologic management or nondestructive means is a major indication for destructive pain surgery. Stereotactic mesencephalotomy can be a valuable procedure in the management of cancer pain involving the upper extremities or the face, with the assistance of magnetic resonance imaging (MRI) and electrophysiologic mapping. A 72-year-old man presented with a 3-year history of intractable left-sided facial pain. When pharmacologic and nondestructive measures failed to provide pain alleviation, he was reexamined and diagnosed with inoperable hard palate cancer with intracranial extension. During the concurrent chemoradiation treatment, his cancer-related facial pain was aggravated and became medically intractable. After careful consideration, MRI-based stereotactic mesencephalotomy was performed at a point 5 mm behind the posterior commissure, 6 mm lateral to and 5 mm below the intercommissural plane using a 2-mm electrode, with the temperature of the electrode raised to $80^{\circ}C$ for 60 seconds. Up until now, the pain has been relatively well-controlled by intermittent intraventricular morphine injection and oral opioids, with the pain level remaining at visual analogue scale 4 or 5. Stereotactic mesencephalotomy with the use of high-resolution MRI and electrophysiologic localization is a valuable procedure in patients with cancer-related facial pain.

• Journal of Korean Society for Quality Management
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• v.34 no.4
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• pp.40-50
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• 2006

The authors aimed to analyze the quality improvement efficiency of wound dressing with 2-octyl cyanoacrylate(2-OCA) in stereotactic image guided linear or sigmoid incisions in a cohort of consecutive craniotomy patients, and to compare clinical results with those of iodine-dressing and silk sutured patients underwent conventional craniotomy surgery with large pedicle flap incisions without stereotactic guidance. In methods, 26 patients were involved as the study group at one hospital. We retrospectively compared their results with those of 38 consecutive control patients at the same unit. The suggested new medical material, 2-octyl cyanoacrylate(2-OCA), resultantly decreased or prevented the contaminated fluid influx from scalp outside. The mean infection rate for the control group (7.89%) was relatively higher than that of the study group (3.85%). In addition, the use of stereotactic image guided craniotomy was significant to reduce operation time, to simplify operative procedures and to decrease potential risk factors.

• The Journal of Korean Society for Radiation Therapy
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• v.6 no.1
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• pp.146-153
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• 1994

A modified irradiation technique utilizing a linear accelerator for radiation surgery within the brain was performed in 41 cases of patients with anteriovenous malformation(AVM), astrocytoma, meningioma. etc. The treatment planning and dosimetry of small field for stereotactic radiosurgery with 10 MV X-ray isocentically mounted linear accelerator will be presented dose with field size, the central axis persent depth dose and the combined moving beam dose distribution. The three dimensional dose planning of stereotactic focusing irradiation on small size tumor region was perfomed with dose planning computer system(Therac 2300) and was verified with film dosimetry. The more the number of strip and the wider the angle of arc rotation, the larger were the dose delivered on tumor and the less the dose to surrounding the normal tissues. In this study, the using machine and method was as fellowing. 1) Apparatus : NELAC-1018 10MV X-ray 2) Strip No. : Select the 5-7 strips 3) Cone and field size are from $1{\times}1cm^2$ to $3.5{\times}3.5cm^2$, and special circular cone designed for the purpose of minimized the risk to normal tissue and those size are $0.7{\~}3.6cm{\phi}$.

• Proceedings of the Korean Information Science Society Conference
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• 1998.10c
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• pp.612-614
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• 1998

뇌정위 수술(Stereotactic Surgery)은 컴퓨터 단층영상과 자기공명 영상 같은 3차원 영상을 이용하여 뇌병변의 위치를 입체적으로 정확히 파악하여 정상 뇌에 대한 손상을 최소화하며 병변을 수술하는 기법이다. 본 논문에서는 수술 받을 환자의 컴퓨터 단층영상과 자기공명 영상 등 다양한 종류의 3차원 볼륨 데이터를 전처리한 다음 동일한 3차원 공간 내에서 정렬시켜 선택적 또는 동시적으로 3차원 영상을 가시화 하는 기법을 제안한다. 또한 3차원 영상에서 뇌정위 수술의 삽입점과 목표점을 지정할 수 있는 기능을 지원하며 수술 경로에 따른 가상 수술의 시뮬레이션을 통하여 수술 경로의 안전성을 검증할 수 있게 하였다.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5171-5174
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• 2014

Background: The increase in breast cancer awareness and widespread use of mammographic screening has led to an increased detection of (non-palpable) breast cancers that cannot be discovered through physical examination. One of the methods used in the diagnosis of these cancers is vacuum-assisted core biopsy, which prevents a considerable number of patients from undergoing surgical procedures. The aim of this study was to present the results of stereotactic vacuum-assisted core biopsy for suspicious breast lesions. Materials and Methods: Files were retrospectively scanned and data on demographic, radiological and pathological findings were recorded for patients who underwent stereotactic vacuum-assisted core biopsy due to suspicious mammographic findings at the Interventional Radiology Centre of the Florence Nightingale Hospital between January 2010, and April 2013. Statistical analysis was carried out using Pearson's Chi-square, continuity correction, and Fisher's exact tests. Results: The mean age of the patients was 47 years (range: 36-70). Biopsies were performed due to BIRADS 3 lesions in 8 patients, BIRADS 4 lesions in 77 patients, and BIRADS 5 lesions in 3 patients. Mammography elucidated clusters of microcalcifications in 73 patients (83%) and focal lesions (asymmetrical density, distortion) in 15 patients (17%). In terms of complications, 1 patient had a hematoma, and 2 patients had ecchymoses (3/88; 3.3%). The histopathologic results revealed benign lesions in 63 patients (71.6%) and malignant lesions in 25 patients (28.4%). The mean duration of the procedure was 37 minutes (range: 18-55). Although all of the BIRADS 3 lesions were benign, 22 (28.6%) of the BIRADS 4 lesions and all of the BIRADS 5 lesions were malignant. Among the malignant cases, 80% were in situ, and 20% were invasive carcinomas. These patients underwent surgery. Conclusions: In cases where non-palpable breast lesions are considered to be suspicious in mammography scans, the vacuum-assisted core biopsy method provides an accurate histopathologic diagnosis thus preventing a significant number of patients undergoing unnecessary surgical procedures.