Toxicity of Gamma Knife Radiosurgery in the Treatment of Intracranial Tumors in Patients With Collagen Vascular Diseases or Multiple Sclerosis Dot Lowell,

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Toxicity of Gamma Knife Radiosurgery in the Treatment of Intracranial Tumors in Patients With Collagen Vascular Diseases or Multiple Sclerosis Dot Lowell, M.D., Stephen B. Tatter, M.D., Ph.D., J. Daniel Bourland, Ph.D., Allan F. deGuzman, Ph.D., Kenneth E. Ekstrand, Ph.D., Thomas L. Ellis, M.D., James F. Lovato, M.S., Kevin P. McMullen, M.D., Michael T. Munley, Ph.D., Edward G. Shaw, M.D., M.A., James J. Urbanic, M.D., Michael D. Chan, M.D. International Journal of Radiation Oncology • Biology • Physics Volume 81, Issue 4, Pages e519-e524 (November 2011) DOI: 10.1016/j.ijrobp.2011.02.056 Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 1 (A) Axial T1-weighted spoiled gradient echo MRI used for treatment planning for Gamma Knife radiosurgery for an acoustic neuroma. Prescription dose of 11.5 Gy was delivered to the 45% isodose line and tumor margin. (B) Axial T1-weighted spoiled gradient echo MRI acquired at time of the same patient developing symptomatic noncommunicating hydrocephalus. This image reveals a treatment response with development of central hypoattenuation within the tumor. International Journal of Radiation Oncology • Biology • Physics 2011 81, e519-e524DOI: (10.1016/j.ijrobp.2011.02.056) Copyright © 2011 Elsevier Inc. Terms and Conditions

Fig. 2 (A) Axial T1-weighted spoiled gradient echo MRI used for treatment planning for Gamma Knife radiosurgery (GKRS) for a facial nerve schwannoma. Prescription dose of 12 Gy was delivered to the 50% isodose line and tumor margin. The patient developed a facial nerve palsy 1 week after GKRS. (B) Axial T1-weighted spoiled gradient echo MRI acquired 16 months after GKRS, showing a central hypoattenuation within the tumor. International Journal of Radiation Oncology • Biology • Physics 2011 81, e519-e524DOI: (10.1016/j.ijrobp.2011.02.056) Copyright © 2011 Elsevier Inc. Terms and Conditions