Radioneurosurgery using the LINAC scalpel: technique, indications, and literature review

Two available commercial units for radiosurgery are the modified linear accelerator (LINAC scalpel) and the gamma knife. Advantages of the LINAC scalpel over the gamma knife are its greater accuracy, the availability of a wide range of collimator sizes that allow for a more homogeneous field of radiation for large lesions, state-of-the-art computer software programs, and lower expense. Radiosurgery does not require an incision, is painless, and can be performed on an outpatient basis. It is ideally suited for the treatment of inaccessible, deep intracranial lesions that are radioresistant to conventional forms of radiotherapy, such as arteriovenous malformations, meningiomas, vestibular schwannomas, selected primary brain tumors, and cerebral metastases. Radiosurgery is an attractive treatment alternative to conventional neurosurgery for several intracranial lesions.