All patients underwent stereotactic frame placement after the application of a local anesthetic, supplemented with conscious sedation as needed. Afterward, all patients un-derwent thin-slice stereotactic MRI with and without contrast administration. Radiosurgery was performed using Leksell Gamma Knife Model U, Model 4C, or a Perfexion unit (Elekta Instruments, Inc.), depending on the technology available at that time and site. The radiosurgical parameters investigated were lesion volume or size, number of isocenters, isodose line, maximum radiation dose, and margin dose. Additionally, if a discrete adenoma could not be visualized on stereotactic MRI, the entire sellar contents were included in the treatment volume and this information was recorded. Radiosurgical plans were devised in a multidisciplinary fashion with a neurosurgeon, radiation oncologist, and medical physicist. Critical structure tolerances such as those to the optic apparatus were established locally, but generally followed QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic) and literature-based recommendations. 21 Radiosurgery was delivered in a single fraction for all patients.
Model 4c
Manufactured by Elekta
The Model 4C is a laboratory equipment product designed for general laboratory use. It serves as a core functional device within the laboratory setting.
Automatically generated - may contain errors
Lab products found in correlation
3 protocols using model 4c
1
Stereotactic Radiosurgery for Pituitary Adenomas
2
Gamma Knife Radiosurgery for MBM
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Radiosurgery was performed using the Model 4-C or Perfexion GK (Elekta Inc., Stockholm, Sweden) with GammaPlan software. A Leksell stereotactic headframe was applied with local anesthesia, and high-resolution brain MR images were taken at 1-mm slices with gadolinium contrast. Additional new MBM discovered on the planning images were targeted with SRS in the same session. Per institutional standards, post-SRS follow-up brain MRI was obtained approximately every 2 months for 1 year and then every 3 months afterward.
3
Leksell Stereotactic Radiosurgery Protocol
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The Leksell Model G frame (Elekta AB) was secured on the skull for patient immobilization under local anesthesia. Digital subtraction angiography (DSA), thin-slice (1–2 mm) MRI, and MRA have been used for all patients since 1993 to facilitate target delineation. SRS was performed with the Leksell Unit Model B from 1993 to 2006, Model 4C from 2006 to 2013, and Perfexion thereafter (Elekta AB). The radiosurgical parameters and dose planning were determined by the treating neurosurgeon in consultation with a medical physicist and radiation oncologist.
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