A new stereotactic X-ray knife.

For many years, the irradiation of small volumes of tissue in the brain to necrotizing doses has been investigated as a "non-invasive" alternative to neurosurgery. We propose a new system in which a precisely machined helmet serves as a multi-port focussed X-ray collimator when it is itself irradiated by a conventional medical linear accelerator run in the electron mode. When the collimator is attached to a stereotactic frame, the geometric accuracy of delivering small radiation fields to the brain is limited primarily by the accuracy of the stereotactic localization, and is relatively independent of the positional stability of the accelerator. Field sizes as small as two millimeters are readily achievable. The problem of low dose rate associated with these small fields is overcome by the use of high electron beam currents.