The ISRS webinar program features presentations by global experts on a wide array of topics related to SRS/SBRT clinical practice, research and technological advancements. All webinars are archived and are available to members. Access the library here.
Gamma Knife for Obsessive Compulsive Disorder: Historical Evolution of Treatment Protocols
Alessandra GORGULHO, MD, MSc
August 12, 2020
Surgical treatment of refractory and severe psychiatric diseases is not new nor recent. Yet, it has been restricted to few centers, available only for a minority of patients. Obsessive-Compulsive disorder (OCD) is currently the best-established psychiatric condition amenable for surgical intervention. Radiosurgery, radiofrequency ablation and deep brain stimulation are stereotactic techniques used in well selected cases.
This webinar will review the historical evolution of Radiosurgery treatment for severe refractory OCD, including indication, treatment protocols and its relation to clinical results and treatment related complications. Dr. Gorgulho will also discuss the most recent pathophysiological models of affected networks and how this knowledge has and will continue to impact on radiosurgery protocols advancement. Exquisite imaging visualization of anatomical structures and brain connectivity are paving the way of modern treatment approach in multiple domains such as radiation dose, irradiated volume, refinement in isocenter positioning and dosimetry distribution. Lastly, the webinar will discuss the next steps in the development of treatment algorithm to improve SRS effectiveness and safety.
Radiosurgery: What I Know Now That I Wish I Knew Back Then?
Douglas KONDZIOLKA, MD, MSc, FRCSC, FACS
August 25, 2020
In this presentation I will review the science and practice of stereotactic radiosurgery for brain disorders, and focus on the changes that have occurred over the past 30 years. Learning continues for all clinicians, physicists and industry partners, and this review will set the stage for what needs to come.
John R. ADLER, JR., MD
September 08, 2020
Since its inception, stereotactic radiosurgery has been used for treating functional disorders by ablation, truncating brain circuits at the treated point. Modern understanding of the brain circuits and new applications for implantable deep brain stimulation, point the way to a new radiosurgery in which brain targets are not ablated, but modulated in their activity level. I will review the recent animal work performed by my extended research group.
Radiation Necrosis/ARE: Difficulties with Diagnosis and Treatment
Samuel CHAO, MD
September 25, 2020
Radiation necrosis is one of the most feared complication of stereotactic radiosurgery. With increasing utilization of stereotactic radiosurgery, the incidence of radiation necrosis is also increasing. Historically, diagnosis had been difficult since surgery or biopsy is not often done and imaging had been imperfect. More recently, however, perfusion MRI has emerged as helpful modality to help distinguish radiation necrosis from tumor recurrence. There are other promising modalities currently being investigated, including amino acid PET and radiomics. Steroids and surgery had been the treatment of choice, but more recently, bevacizumab and laser interstitial thermal therapy have emerged as excellent treatment options for radiation necrosis. Due to better diagnostic and treatment options, perhaps radiation necrosis should be less feared. This webinar will review the diagnosis and treatment of radiation necrosis, and discuss future investigations.