Biomedical subjects

L Kihlström

Publications and source records attributed to L Kihlström.

23 records · Page 2Linked to original sources

PubMed1993

Gamma Knife surgery for cerebral metastases. Implications for survival based on 16 years experience.

Our experience with radiosurgery of brain metastases is based on 160 patients with 235 tumors treated over a 16-year period. In this material, 94% growth control was achieved. Radiosurgery appears to be an effective, low-morbidity substitute for surgical resection followed by whole brain radiotherapy and even indicated for multiple metastases and distant new tumors. More patients receive an effective treatment with less neurologically related deaths.

Brain↗

PubMed1991

Gamma knife surgery for cerebral metastasis.

Twenty-six cerebral metastatic tumours treated with the Gamma knife employing a large single dose were followed by repeated clinical and CT examinations. In most cases Gamma knife surgery was the only treatment. The follow up time has been longer than 6 months with a median follow up of 9 months. In all but one of the cases a remarkable progressive shrinkage of the tumour started 2-4 months after the therapy. The therapeutic results indicate that radiosurgery used even as the only form of treatment is the best treatment alternative for cerebral metastasis presently available.

Aged↗

PubMed1991

Functional neurosurgery--a future for the gamma knife?

The Gamma Knife is currently the only radiosurgical device which has been used in functional neurosurgery. This mode of utilization is possible because the instrument can make lesions in normal brains with a volume as small as 50 mm3. The experience of functional radiosurgery accumulated at the Karolinska Institute over 21 years is reviewed, and the possible implications of the new developments in imaging techniques for the future of functional radiosurgery are considered. The review covers gamma thalamotomy for pain and tremor, radiosurgery for trigeminal neuralgia, gamma capsulotomy for severe anxiety and obsessive-compulsive neurosis, and Gamma Knife surgery for focal epilepsy. The important role of stereotactic MRI localization in functional radiosurgery is pointed out, and a preliminary report of the recent experience with stereotactic magnetoencephalography combined with stereotactic MRI for physiological and anatomic target localization is given. It is concluded that functional radiosurgery should only be performed with radiation of very small volumes of brain, as the very high doses required would be devastating if delivered to even small volumes.

Adult↗

PubMedDate not supplied

Recurrent tumor vs radiation effects after gamma knife radiosurgery of intracerebral metastases: diagnosis with PET-FDG.

OBJECTIVE: Our objective was to differentiate radiation effects from tumor progression in metastases stereotaxically irradiated with the multi-cobalt unit (Gamma Knife). MATERIALS AND METHODS: Eleven patients with stereotaxically irradiated cerebral metastases were examined with PET using [18F]fluorodeoxyglucose (FDG) to differentiate recurrent tumor from radiation effects. RESULTS: Six patients had increased uptake of FDG, and clinical, radiological, and pathological findings confirmed the diagnosis of recurrent metastases. These patients had an unfavorable prognosis and were all dead within 54 weeks after radiosurgery. Five patients had lesions without an increased accumulation of FDG. Four of these patients were alive after a total follow-up of 1.7 years, while one patient died of a peptic ulcer 56 weeks after radiosurgery. CONCLUSION: Positron emission tomography with FDG was of obvious prognostic value in this small series of patients and was clearly superior to CT and MR in the distinction between tumor recurrence and radiation effects (verified necrosis in one case).

Adult↗

PubMedDate not supplied

Stereotaxic angiography in gamma knife radiosurgery of intracranial arteriovenous malformations.

Gamma knife radiosurgery is an effective alternative to embolization or microsurgical removal of small arteriovenous malformations, particularly in eloquent areas of brain tissue. Stereotaxic angiography is a useful diagnostic and targeting adjunct to gamma knife radiosurgery, and the authors present their experience (1,100 patients) with methods and technique, and show how the nidus of the arteriovenous malformation can be defined angiographically. Dose planning employing digitization of the subtraction image enables determination of the spatial coordinates of the lesion by means of an interactive computer program.

Cerebral Angiography↗