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Perfexion Gamma Knife Therapy

Indiana University Health offers a robust program of care for challenging brain disorders like epilepsy and tremors as well as difficult-to-treat tumors including malignant gliomas/astrocytomas, low-grade gliomas, meningiomas, medulloblastomas, ependymomas and metastatic brain tumors that have spread to the brain from primary cancers in other parts of the body, including the breasts, lungs, skin, ovaries, renal cells and colon. 

One of the targeted therapies offered at IU Health for patients who need radiation for brain metastasis and other brain diseases is called Perfexion Gamma Knife Therapy—the only system of its kind in Indiana.  Although it is called Perfexion Gamma Knife, the device is not what the name implies. Instead of a scalpel, it uses a set of precisely-focused radiation beams. The individual beams are too weak to damage healthy tissue, so it affects only the target. The procedure is painless and allows patients to return to their normal routines much quicker and with fewer side effects than other radiation therapies.

There are many ways to deliver radiation therapy.  Perfexion is just one of them. Simply put, it is an advanced technology that delivers high-dose radiation in just a single dose or a handful of radioactive treatments. 

Perfexion can effectively treat many kinds of brain disease, but its most common use is for patients whose cancers start in the body and spread to the brain. For that reason, our patients often have complex treatment plans based on their specific diagnosis. 

Who benefits from Perfexion Gamma Knife Therapy?

Several types of patients are suited for Perfexion including:

  • People who have only recently received a cancer diagnosis that is accompanied by a brain metastasis, but have not yet received any therapy for their primary cancer.
  • People who have been successfully treated for cancer in the past, but later develop a brain metastasis.
  • People who have had a previous brain metastasis treated with daily radiation to the whole brain. These patients cannot receive the same form of radiation therapy again. They need something much more focused to protect good brain tissue from radiation.
  • People with meningiomas, which are benign tumors in the lining of the brain. Those may occur in tough locations, in elderly patients or in people who do not want to have an open surgery.
  • People with low-grade brain tumors that are not at risk of spreading quickly, such as vestibular (acoustic) schwannomas, pituitary tumors, pineal region tumors, hemangioblastomas and some astrocytomas.
  • People with benign conditions and functional disorders, including tremors, epilepsy, arteriovenous malformations or a severe kind of facial pain called trigeminal neuralgia.

In all these cases, Perfexion radiostatic surgery may be a very effective form of treatment.

The advantages of Perfexion treatment

Perfexion Gamma Knife therapy has at least three important benefits for patients with brain diseases.

  • Safety and accuracy. Perfexion technology squeezes high-doses of radiation into very precise places in the brain. No other radiosurgery platform can deliver such high doses of radiation with such precision. This accuracy means we can treat tumors and brain diseases that were once too risky for radiation therapy because of their location in a critical area of the brain.  Patients treated with Perfexion have a lower risk of long-term cognitive impairments than patients who have whole-brain radiation. Although whole-brain radiation may reduce the chance of additional lesions for patients with brain tumors, it has several drawbacks, including fatigue, short-term and long-term memory loss, mood swings, diminished attention and processing speed, and a decreased ability to multi-task.
  • Non-invasive. Although its name suggests an incision and a scalpel, Perfexion Gamma Knife therapy is attractive to patients and physicians because of its effectiveness in treating brain tumors in a non-invasive way. It is relatively pain-free, and does not require an incision.
  • Primary cancers get quicker treatment. Perfexion technology also allows metastatic patients to receive earlier chemotherapy for cancer in their bodies. The alternative—several weeks of whole brain radiation—often causes severe fatigue that delays important chemotherapy treatment for the body’s primary cancer.

What to expect  

Patients who are referred for this type of treatment will be seen by an IU Health medical oncologist, radiation oncologist and/or a neurosurgeon to determine:

  • The type and location of the cancer  
  • The patient’s existing brain disease
  • Other existing medical conditions
  • Any underlying cognitive dysfunction where whole brain therapy would not be a desirable option

We also will want to know what treatment options the patient’s medical oncologist is considering for primary cancer. With input from this medical oncologist, we can attend to the patient’s most urgent needs and decide how to manage the individual circumstances. If, for example, a patient’s cancer outside the brain is not symptomatic, it may be better to start chemotherapy first.

Most metastatic patients start radiation therapy first because the medical oncologist typically wants to manage brain disease before chemotherapy. When there is an urgent need for chemotherapy, we can schedule patients quickly and administer a single dose of radiation using the Perfexion Gamma Knife. Twenty-four to 48 hours later, patients can be ready for systemic chemotherapy.

What’s involved in a Perfexion Gamma Knife Treatment?

Perfexion Gamma Knife Therapy is a well-established, non-invasive treatment, which can be used either as an alternative to open surgery or as a complement to it. Since no incision is made, the risk of complications is low. Rather than radiating the whole brain, we can be more exact with this technology.

Perfexion uses a sophisticated positioning system to map the brain’s structure to one tenth of a millimeter in accuracy. With a coordinating grid and MRI imaging, we plan as few as one to five treatments and deliver radiation to the exact spot in your brain where it belongs. An MRI scan allows us to see the brain with extraordinary detail, providing the accuracy that makes Gamma Knife Perfexion Therapy a safer alternative for many conditions.

This educational video explains what to expect during Perfexion Gamma Knife Therapy.

For more information or to schedule an appointment, please call 317.962.3172.


Who benefits from Perfexion Gamma Knife Therapy?

Several types of patients are suited for Perfexion including:

In all these cases, Perfexion radiostatic surgery may be a very effective form of treatment.

The advantages of Perfexion treatment

Perfexion Gamma Knife therapy has at least three important benefits for patients with brain diseases.

What to expect  

Patients who are referred for this type of treatment will be seen by an IU Health medical oncologist, radiation oncologist and/or a neurosurgeon to determine:

We also will want to know what treatment options the patient’s medical oncologist is considering for primary cancer. With input from this medical oncologist, we can attend to the patient’s most urgent needs and decide how to manage the individual circumstances. If, for example, a patient’s cancer outside the brain is not symptomatic, it may be better to start chemotherapy first.

Most metastatic patients start radiation therapy first because the medical oncologist typically wants to manage brain disease before chemotherapy. When there is an urgent need for chemotherapy, we can schedule patients quickly and administer a single dose of radiation using the Perfexion Gamma Knife. Twenty-four to 48 hours later, patients can be ready for systemic chemotherapy.

What’s involved in a Perfexion Gamma Knife Treatment?

Perfexion Gamma Knife Therapy is a well-established, non-invasive treatment, which can be used either as an alternative to open surgery or as a complement to it. Since no incision is made, the risk of complications is low. Rather than radiating the whole brain, we can be more exact with this technology.

Perfexion uses a sophisticated positioning system to map the brain’s structure to one tenth of a millimeter in accuracy. With a coordinating grid and MRI imaging, we plan as few as one to five treatments and deliver radiation to the exact spot in your brain where it belongs. An MRI scan allows us to see the brain with extraordinary detail, providing the accuracy that makes Gamma Knife Perfexion Therapy a safer alternative for many conditions.

This educational video explains what to expect during Perfexion Gamma Knife Therapy.

For more information or to schedule an appointment, please call 317.962.3172.