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Frameless Image Guidance in Stereotactic Radiosurgery

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Stereotactic and Functional Neurosurgery

Abstract

Stereotactic accuracy and target engagement largely rely on rigid immobilization of the skull. However, advanced imaging, image reconstructions, and adaptive treatment algorithms have made frameless image guidance without rigid immobilization a mainstay of stereotactic radiosurgery and radiotherapy deliveries. While these methods for achieving stereotactic precision require some immobilization, these obviate the need for an invasive head ring fixation. Because these approaches allow the target to still move to some degree and this movement must be compensated for, frameless image guidance requires intra-treatment imaging and target tracking and, critically, requires verification of accuracy. In this chapter, the different approaches are described, including key technological features of various frameless image-guided approaches. The anticipation is that these methods, which are primarily used for stereotactic radiosurgery, will continue to evolve to incorporate other imaging modalities, such as MRI, and eventually be generalized to other stereotactic procedures.

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Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, USA

    Nzhde Agazaryan, Stephen Tenn & Tania Kaprealian

  2. Department of Radiation Oncology, University of California Davis, Sacramento, CA, USA

    Sonja Dieterich

  3. Department of Radiotherapy, Universitair Ziekenhuis Brussel (UZB), Brussels, Belgium

    Thierry Gevaert

  4. Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Thierry Gevaert

  5. Medical Physics, San Diego Gamma Knife Center, La Jolla, CA, USA

    Steven J. Goetsch

Authors
  1. Nzhde Agazaryan
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  2. Stephen Tenn
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  3. Sonja Dieterich
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  4. Thierry Gevaert
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  5. Steven J. Goetsch
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  6. Tania Kaprealian
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Editors and Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Nader Pouratian

  2. Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA

    Sameer A. Sheth

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Agazaryan, N., Tenn, S., Dieterich, S., Gevaert, T., Goetsch, S.J., Kaprealian, T. (2020). Frameless Image Guidance in Stereotactic Radiosurgery. In: Pouratian, N., Sheth, S. (eds) Stereotactic and Functional Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-34906-6_4

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  • DOI: https://doi.org/10.1007/978-3-030-34906-6_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-34905-9

  • Online ISBN: 978-3-030-34906-6

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