Department of Radiation Oncology, School of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia.
Int J Radiat Oncol Biol Phys. 2012 Jan 1;82(1):102-6. doi: 10.1016/j.ijrobp.2010.08.054. Epub 2010 Oct 30.
To illustrate some of the potential pitfalls of cranial stereotactic radiosurgery (SRS) and its planning based on prospectively gathered data from a 17-year experience at the Royal Adelaide Hospital.
More than 250 treatments have been planned since 1993 using previously described standard SRS techniques for intracranial benign and malignant lesions.
Five case studies are presented (1 meningioma, 1 acoustic neuroma, 2 solitary brain metastasis, 1 arteriovenous malformation), each of which demonstrates at least one salutary lesson.
Because SRS delivers a highly conformal dose distribution, it is unforgiving of any geographic miss due to inaccurate outlining and thus dependent on neuroradiological expertise and collaboration. There are also potentially significant implications of misdiagnosis in SRS cases without histological proof--in particular, presumed brain metastases.
通过在皇家阿德莱德医院 17 年的前瞻性数据，举例说明颅立体定向放射外科（SRS）及其规划可能存在的一些缺陷。
自 1993 年以来，我们使用以前描述的标准 SRS 技术，为颅内良性和恶性病变规划了 250 多次治疗。
呈现了 5 个病例研究（1 个脑膜瘤，1 个听神经瘤，2 个单发脑转移瘤，1 个动静脉畸形），每个病例都至少说明了一个有益的教训。
由于 SRS 提供了高度适形的剂量分布，因此对于任何由于不准确勾画而导致的地理缺失都无法原谅，因此依赖于神经放射学专业知识和协作。在没有组织学证据的情况下，SRS 病例中的误诊也可能存在潜在的重大影响 - 特别是假定的脑转移瘤。
