CHAINED LIGHTNING

Author:

Hoh Daniel J.1,Liu Charles Y.1,Chen Joseph C.T.2,Pagnini Paul G.3,Yu Cheng1,Wang Michael Y.4,Apuzzo Michael L.J.1

Affiliation:

1. Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

2. Departments of Radiation Oncology and Neurological Surgery, Southern California Permanente Medical Group, Los Angeles, California

3. Department of Radiation Oncology, Keck School of Medicine, University of Southern California, Los Angeles, California

4. Miller School of Medicine, University of Miami, Miami, Florida

Abstract

Abstract RADIOSURGERY IS FUNDAMENTALLY the harnessing of energy and delivering it to a focal target for a therapeutic effect. The evolution of radiosurgical technology and practice has served toward refining methodologies for better conformal energy delivery. In the past, this has resulted in developing strategies for improved beam generation and delivery. Ultimately, however, our current instrumentation and treatment modalities may be approaching a practical limit with regard to further optimizing energy containment. In looking forward, several strategies are emerging to circumvent these limitations and improve conformal radiosurgery. Refinement of imaging techniques through functional imaging and nanoprobes for cancer detection may benefit lesion localization and targeting. Methods for enhancing the biological effect while reducing radiation-induced changes are being examined through dose fractionation schedules. Radiosensitizers and photosensitizers are being investigated as agents for modulating the biological response of tissues to radiation and alternative energy forms. Discovery of new energy modalities is being pursued through development of microplanar beams, free electron lasers, and high-intensity focused ultrasound. The exploration of these future possibilities will provide the tools for radiosurgical treatment of a broader spectrum of diseases for the next generation.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Surgery

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