role of srs in benign cns pathology - beacon...
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![Page 2: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/2.jpg)
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Brain Stereotactic Radiosurgery (SRS):
Clinical Applications
Tumours Vestibular Schwannomas
MeningiomasPituitary AdenomasOther
Vascular Malformations AVMs
Other
Functional Applications Trigeminal Neuralgia
EpilepsyMovement disorders
Extending Applications : Hybrid Techniques
![Page 3: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/3.jpg)
Technique: Usually Cone based for Metastatic
• Dedicated Linac: Trilogy Tx
![Page 4: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/4.jpg)
Technique: Frameless intracranial positioning
![Page 5: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/5.jpg)
![Page 6: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/6.jpg)
Technique: Frame-based intracranial positioning
![Page 7: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/7.jpg)
Tumours: Vestibular Schwannomas(Acoustic Neuromas)
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• <3cm• Control rate 90-97%• Hearing preservation 55-70%• Facial nerve palsy 0-5%• Dose 12Gy
![Page 8: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/8.jpg)
Tumours: Vestibular Schwannomas(Acoustic Neuromas)
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![Page 9: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/9.jpg)
Tumours: Vestibular Schwannomas(Acoustic Neuromas)
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![Page 10: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/10.jpg)
• <3cm
• Distant from optic nerves
• Discussion of surgical choice
• Patient’s preference and age
• Medical condition
• Observation and surgery are alternatives
• Reasonable option for residual tumour post op or recurrence
Tumours: Meningiomas
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Technique:Cone based or micromultileaf based on size, shape and location
![Page 11: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/11.jpg)
Tumours: Meningiomas
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![Page 12: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/12.jpg)
Tumours: Meningiomas
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![Page 13: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/13.jpg)
Dose constraints based on optic nerves, chiasm and tract
Tumours: Pituitary Adenomas
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![Page 14: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/14.jpg)
OtherTumours: Gliomas, Glomus Tumours etc.
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![Page 15: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/15.jpg)
Vascular Malformations: AVMs
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![Page 16: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/16.jpg)
• Presentation: Haemorrhage, Seizures, Neuro, Incidental
• Rx: Observation, Surgery, Embolisation, Radiosurgery
Arteriovenous Malformations
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![Page 17: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/17.jpg)
Beam shaping has allowed treating more irregular shaped lesions
Fractionation has allowed treating larger lesions
Fractionation has allowed treating lesions in areas with poor
radiation tolerance
Extending Applications: Fractionation & Hybrid Strategies
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![Page 18: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/18.jpg)
AVM: Large and irregular
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![Page 19: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/19.jpg)
AVM: Large and irregular
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![Page 20: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/20.jpg)
AVM: Large and irregular
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![Page 21: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/21.jpg)
AVM: Large and irregular
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![Page 22: Role of SRS in Benign CNS Pathology - Beacon Hospitalbeaconhospital.ie/...SRS_for_benign_CNS_pathology.pdf · Christopher R. Mascott, M.D.,FRCS(C), FAANS Brain.Tumour.Help@gmail.com](https://reader034.vdocuments.net/reader034/viewer/2022042206/5ea807260e6d2006700c420d/html5/thumbnails/22.jpg)
Meningioma in the Optic Nerve
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Meningioma in the Optic Nerve
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Meningioma in the Optic Nerve
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Thank You
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