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With radiosurgery technology, it’s a game of precision
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The BrainLab technology used at Northeast Georgia Medical Center now allows oncologists to use pinpoint radiation to better target where they administer radiation to a tumor in the brain or along the spinal cord. - photo by Scott Rogers
Technology and software previously used by neurosurgeons during brain surgery have led to extremely precise applications in radiation therapy, treating tumors in the brain at sub-millimeter precision. 

Dr. Craig Baden, who works on the radiation oncology team for Northeast Georgia Physicians Group, said they started using Brainlab technology earlier this year as a way to deliver radiation treatment in a complex field that seeks precision, accuracy and efficiency. 

"As a group, we're always looking for new advances or incremental advances in radiation treatment technology, and the Brainlab system is one of the most recent additions to the technology that we're using here,” Baden said. 

Baden said neurosurgeons were previously using the technology to navigate ahead of and during brain surgery. 

The new software offered by Brainlab allows them a higher precision and accuracy than previously available in radiation oncology, he said. 
"Previously, we've been able to do imaging immediately prior to radiosurgery, but this technology allows us to complete real-time imaging both immediately prior to doing the radiation delivery and also during the treatment delivery,” Baden said. “What that allows us to do is we can now pinpoint specific areas within the brain with sub-millimeter accuracy." 

It is often used to treat primary brain tumors or cancer that has spread to the brain. Baden and the team need to deliver a high dose of radiation to the tumor to control it while avoiding the brain stem or cranial nerves, which are sensitive to radiation. 
"We need to have confidence that we can give a really high dose of radiation to the tumor in order to control it, but at the same time, we have to protect the immediately adjacent, sensitive normal tissue so that we can preserve all normal brain and nerve function,” Baden said. 

Baden said it begins with the patient going through a CT simulation or radiation treatment planning session, where a specialized mask or hold is made to hold the patient still. 

The patient is scanned, and that result is fused with a high-resolution MRI. 

Brainlab then allows the doctors to delineate between the tumor and the healthy tissue. 

During the treatment delivery, the patient then gets into the exact position they need to be on a treatment table. The radiation machine will rotate around the patient delivering pinpoint radiation. 

"During the treatment procedure, we have the capability to do imaging actually as the treatment is being delivered,” Baden said. “If a patient were to shift a millimeter one direction or the other, we can immediately hold the treatment and make an adjustment as appropriate." 

As radiosurgery has advanced, Baden said it has become more patient friendly. It is more likely the tumor can be controlled while avoiding negative side effects for the patient. 

It is also less taxing on the patient, who can be in and out of the treatment room in less than 15 minutes without sedation.