Radio-neurosurgery is a major development in the treatment of conditions affecting the nervous system, making it possible to intervene with millimetre precision and without incision. This technique, which uses a high-precision linear accelerator emitting X-rays beams of very small-diameter, makes it possible to focus these rays with extreme precision on the area to be treated, mainly within the brain, but also in other areas of the cranium and the spine. Through careful planning and cutting-edge technology, this method ensures effective targeting of the area to be treated while preserving the surrounding healthy tissue.
At Hôpital de La Tour, the NeuroKnife Center, which brings together experts in the fields of neurosurgery, radiation oncology and medical physics, puts this cutting-edge technology to work for patients requiring high-precision treatment, thereby reducing risks and significantly improving their quality of life.
Our mission
Hôpital de La Tour is committed to providing excellent care by incorporating the latest technological advances to ensure optimal, personalized treatments. High-precision linear accelerator radio-neurosurgery meets the needs of patients with both benign and malignant brain tumours, vascular malformations and other specific neurological conditions, such as certain forms of neuralgia. It can also be used to treat some diseases of the spine and of the spinal cord.
Using a multidisciplinary approach, we combine the skills of neurosurgeons, radiotherapists and medical physicists to ensure safe and effective treatment
Our services
At the NeuroKnife Center, our specialized multidisciplinary team guides each patient through a carefully structured care pathway. Radio-neurosurgery enables brain or spinal lesions to be treated in one or more sessions, avoiding the need for invasive surgery.
Thanks to our latest-generation linear accelerator, we are able to adapt the radiation precisely to the shape of each tumour, either by using fixed collimators of very fine diameter, or by using a micro-multileaf collimator that modulates the shape of the radiation beam in real time. This technology offers an effective and safe alternative to conventional treatments, particularly for open neurosurgical procedures requiring trepanation or opening of the spine
Medical conditions
Radio-neurosurgery is indicated for a wide range of intracranial and spinal conditions, such as:
- Malignant tumours, in particular brain and spinal metastases
- Vestibular schwannomas (acoustic neuromas)
- Meningiomas
- Pituitary adenomas
- Other benign tumours of the nervous system
- Vascular malformations, in particular arteriovenous malformations (AVMs) and cavernomas
- Trigeminal neuralgia, a condition causing severe facial aching, and other forms of facial pain
- Severe essential tremor and Parkinson's disease, and certain forms of epilepsy, when drug treatments are ineffective and other types of intervention are not possible or contraindicate
Each indication is studied on a case-by-case basis to determine the feasibility of the treatment and optimize the chances of success.
The treatment process
Consultation(s):
The indication for radio-neurosurgery is generally evaluated during an initial consultation, or a follow-up neurosurgery or radio-oncology consultation, depending on the condition. The diagnosis has often already been made by a colleague (medical oncologist, neurologist, ENT specialist, endocrinologist, ....), who will then refer the patient for treatment at one of our specialist consultations at the NeuroKnife Center.
Treatment simulation:
The patient is seen again in a multidisciplinary consultation at the NeuroKnife Center. The patient is then fitted with a positioning mask, followed by a CT scan and MRI, the aim of which is to accurately determine, in a comfortable and reproducible position for the treatment, the boundaries of the target to be treated and the surrounding organs to be protected.
Treatment planning:
The aim of this stage is to determine the appropriate parameters to apply to the linear accelerator to deliver the prescribed dose to the target to be irradiated with millimeter precision, while minimizing the dose to the surrounding healthy tissue. Once the optimum configuration has been obtained, the dose calculations are validated jointly by the medical physicist and the medical team.
Treatment:
Each treatment is personalized, and the number of sessions varies from patient to patient. Radio-neurosurgery treatments are most often carried out in a single session, but depending on the size of the tumour, the radiation tolerance of the surrounding structures and the location of the target, the medical team may propose carrying out the treatment in several sessions (usually a maximum of five).
The treatment is generally carried out on an outpatient basis. At each session, you will be taken care of by medical radiology technicians (MRTs) who will set you up on the treatment table, then ensure and validate with the doctor that the treatment is carried out according to the parameters determined during the simulation and planning stages.
Cutting-edge technology: the Varian EDGE™ linear accelerator used at the NeuroKnife Center
Hôpital de La Tour is equipped with the latest generation linear accelerator, incorporating real-time imaging guidance and intensity modulation technologies.
Unlike other radiosurgery platforms, such as the Gamma Knife, which uses fixed beams of gamma rays, the equipment at the NeuroKnife Center constantly adjusts irradiation to suit the precise morphology of each target.
The advantages of this technology are numerous:
- Greater precision thanks to the micro-multileaf collimator, which adjusts the shape of the beam
- Treatment possible on larger tumours
- Mainly frameless procedure, improving patient comfort
- Treatment can be split to better protect healthy tissue
For certain very specific cases, the NeuroKnife Centre's linear accelerator will be equipped with a conical collimator of a few millimetres in diameter, enabling a very fine beam to be delivered to a very precise point target (for example, to target the trigeminal nerve).
When should you contact the Doctor?
It is recommended to consult a specialist if a brain tumour is newly diagnosed or if previous treatment requires an additional approach. Patients with other benign conditions or functional neurological disorders may also benefit from specialist assessment.
A specialist consultation with a neurosurgeon or radiotherapist at the NeuroKnife Center will enable to evaluate the relevance of a radio-neurosurgical treatment as well as a suitable care plan to be assessed.