Maitz A H, Lunsford L D, Wu A, Lindner G, Flickinger J C
Department of Radiation Oncology, University of Pittsburgh, School of Medicine, PA.
Int J Radiat Oncol Biol Phys. 1990 Feb;18(2):469-76. doi: 10.1016/0360-3016(90)90117-3.
On August 14, 1987, the first stereotactic radiosurgical procedure using the gamma knife was performed in North America. Located in a self-contained radiosurgical suite in the basement of Presbyterian-University Hospital in Pittsburgh, Pennsylvania. This device uses 201 highly focused beams 60Co for the single-treatment closed-skull irradiation of brain lesions localized by stereotactic techniques (radiosurgery). One hundred and fifty-two patients with intracranial arteriovenous malformations or brain tumors were treated in the first year of operation. The Presbyterian University Hospital of Pittsburgh gamma knife is the first such unit in which the 60Co sources were loaded on-site. This effort required us to solve some difficult and unusual problems encountered during site preparation, delivery, and loading of the unit in a busy hospital setting. The solutions developed enabled installation and use of the gamma knife with minimal disruption of hospital activities while maintaining acceptable levels of exposure to radiation. Environmental surveys performed during the loading of the 201 radioactive sources (total, 219 TBq) confirmed that on-site loading is possible and practical. Our experience in the design, construction, and implementation of the first North American gamma knife supports the practicality and safety of on-site loading and may be of value in the planning and development of future gamma knife installations.
1987年8月14日，北美首例使用伽玛刀的立体定向放射外科手术在宾夕法尼亚州匹兹堡长老会大学医院地下室的独立放射外科手术室进行。该设备使用201束高度聚焦的60钴射线对通过立体定向技术（放射外科）定位的脑病变进行单次治疗的闭合颅骨照射。在手术的第一年，对152例颅内动静脉畸形或脑肿瘤患者进行了治疗。匹兹堡长老会大学医院的伽玛刀是首个在现场装载60钴源的此类设备。这项工作要求我们解决在繁忙的医院环境中设备的现场准备、运输和装载过程中遇到的一些困难和特殊问题。所开发的解决方案使得伽玛刀能够在对医院活动干扰最小的情况下进行安装和使用，同时保持可接受的辐射暴露水平。在装载201个放射源（总计219太贝克勒尔）期间进行的环境调查证实了现场装载是可行且实际的。我们在设计、建造和实施北美第一台伽玛刀方面的经验支持了现场装载的实用性和安全性，可能对未来伽玛刀装置的规划和开发具有价值。
