Originally created 02/11/00

Hospital may soon start using radiation 'knife'



For now it sits quiet in a darkened room, its radioactive core hidden behind heavy, thick doors. But in two months, the first patients at Medical College of Georgia Hospital and Clinics will be ushered in to the Leksell Gamma Knife for brain surgery without opening up the head.

"We've been working on this for 13 years," said a smiling Dr. Joseph Smith, director of stereotactic and functional neurosurgery at MCG. "It's taken a long time to get it."

It is the only gamma knife in North America affiliated with a children's hospital, the MCG Children's Medical Center, said Dr. Mark Lee, chief of the section of neurosurgery at MCG.

Patients lie on a track that guides them headfirst through the radiation-shielded doors into the center of the machine. The patient's head is encased in special helmets with tiny holes to direct 201 coordinated beams of cobalt 60 radiation to intersect at a precise spot within the brain to destroy tissue, such as a tumor. Because the radiation is spread among so many pathways, it has less effect on the tissue it passes through so higher doses of radiation can be used safely, Dr. Smith said.

The procedure will allow doctors to operate in areas where it is risky to do open surgery, operate on patients whose health precludes surgery and also offer patients a less invasive procedure, Dr. Lee said

The first patient, suffering from trigeminal neuralgia or excruciating pain in the facial area supplied by the trigeminal nerve, is scheduled for April 24, Dr. Smith said.

In some operations, such as lesions on the brain stem, the gamma knife gives doctors an option that lessens the risk of paralysis, Dr. Lee said.

The biggest number of patients will likely be metastatic brain tumors caused by cancer elsewhere in the body. MCG has a three-year grant to try the gamma knife on temporal lobe epilepsy patients, a procedure that has been done in Europe successfully but has not yet received approval from the Food and Drug Administration, Dr. Smith said.

MCG is hoping to treat 100 patients with the gamma knife the first year and eventually average 250 a year, Dr. Lee said. Most will be outpatient procedures, which will be considerably less expensive and less trying for the patients, Dr. Lee said.

"Most of them will come in in the morning and leave in the afternoon," Dr. Smith said.

"And go back to work the next day," Dr. Lee added.

Reach Tom Corwin at (706) 823-3213.