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Updated: Feb 16, 2026

Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
A technique for achieving submillimeter accuracy of volume-staged stereotactic radiosurgery
Lijun Ma1, Shannon Fogh1, Nalin Gupta1
1Department of Radiation Oncology, University of California, San Francisco, California, USA.
Abstract:
A technique for delivering high-precision volume-staged stereotactic radiosurgery has been developed with Leksell Gamma Knife Perfexion for treating large arteriorvenous malformations (AVMs). The technique employs a hybrid method of combining landmark registration and voxel-based 3D image registration to enable multiple staged partial-volume treatments that accommodate repeated stereotactic frame placements. The technique was clinically implemented at our institution and the results were analyzed for a series (n=14) of large AVM cases treated since 2007. Overall, an averaged 0.34±0.09 mm in matching procedural accuracy versus standard single-fraction radiosurgery was found for these treatments. Such a result is a factor of 3-4 times lower than those previously reported, and it approaches the physical accuracy of the latest Leksell Gamma Knife Perfexion system. In conclusion, volume-staged radiosurgery has been demonstrated to be deliverable with the same level of accuracy as standard single-fraction radiosurgery.
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