Advances and Technical Standards in Neurosurgery by J. W. Berkelbach van der Sprenkel, N. M. J. Knufman, P. C.

By J. W. Berkelbach van der Sprenkel, N. M. J. Knufman, P. C. van Rijen, P. R. Luyten (auth.), L. Symon, L. Calliauw, F. Cohadon, J. Lobo Antunes, F. Loew, H. Nornes, E. Pásztor, J. D. Pickard, A. J. Strong, M. G. Yaşargil (eds.)

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Pituitary Dependent Cushing's Disease................................... Acromegaly ................................................................ Nelson's Syndrome........................................................ Prolactin-Secreting Tumours .............................................. Tumours in the Pineal Region ............................................ Meningiomas .............................................................. Acoustic Neuromas .......................................................

More recently gadolinium-enhanced MRI has been used more and more frequently for visualization of tumours and similar computing techniques are also available for MRI. MRI offers the advantage of orthogonal imaging in three different, or even any, arbitrary plane. There are several pitfalls in performing coordinate determinations from MRI images. One problem is the lack of homogeneity of the magnetic field which may cause distortion, particularly in the periphery of the visualized field and thus interfere with Radiosurgery 37 the accuracy of the coordinate calculation, since the fiducial markers on the stereotactic frame are peripherally located.

Radiosurgery 33 Radiosensitivity of Vessels In radiosurgery, a dose-distribution with a steep gradient at the borderline of the target volume, in the neighborhood of the 50% isodose curve should be used. The center dose is then chosen so that the desired degeneration in the target volume occurs at a convenient time, say 1-6 months after irradiation. The precision at which this delay can be predicted is partly dependent on individual variations of radiosensitivity, within the group of patients under consideration.

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