Patient perspectives on frame versus mask immobilization for gamma knife stereotactic radiosurgery

Tolerability and Stability of Mask Fixation in Gamma Knife Stereotactic Radiosurgery: Predictors of Treatment Interruptions

“…[2][3][4] Frame placement can be stressful, painful, anxiety-provoking or traumatic. [5][6][7][8] Possible complications include small risks of bleeding, numbness, persistent pain, pressure headaches, infection, and slippage. [6][7][8][9][10] The care of framed patients requires dedicated nursing and physician support and often extended periods of time in the department, especially after conscious sedation.…”

“…[5][6][7][8] Possible complications include small risks of bleeding, numbness, persistent pain, pressure headaches, infection, and slippage. [6][7][8][9][10] The care of framed patients requires dedicated nursing and physician support and often extended periods of time in the department, especially after conscious sedation. 8,[10][11] Frame use also places time constraints on the clinical team to complete imaging, planning and delivery in the same day.…”

“…[7][8]10 Imaging with the frame on can result in pin-related artifacts, especially if CT alone is used. 11 Prior craniotomy defects and shunts must be avoided; 11 repeated or recent neurosurgical procedures make frame placement challenging, [5][6] as does intolerance of local anesthetics. [5][6] The Gamma Knife ICON (Elekta AB, Stockholm, Sweden), FDA-approved in 2015, is the sixth generation GK unit.…”

“…11 Prior craniotomy defects and shunts must be avoided; 11 repeated or recent neurosurgical procedures make frame placement challenging, [5][6] as does intolerance of local anesthetics. [5][6] The Gamma Knife ICON (Elekta AB, Stockholm, Sweden), FDA-approved in 2015, is the sixth generation GK unit. It allows use of a thermoplastic mask with an infrared high-definition motion management system (HDMM) for non-invasive immobilization.…”

“…Beam pauses and repeat CBCT scans prolong a patient's time on the GK couch and disrupt overall unit workflow. [17][18] Frameless techniques are generally more comfortable for the patient, 6,16,19 and provide more flexibility in the treatment planning process. Mask construction and treatment planning imaging can be performed in advance.…”