Who Is A Suitable Candidate For Gamma Knife Radiosurgery?

Who Is A Suitable Candidate For Gamma Knife Radiosurgery?

When faced with a diagnosis of a neurological condition such as a brain tumour, arteriovenous malformation (AVM), or trigeminal neuralgia, working out the best treatment pathway can be complex. Your multidisciplinary team will make every effort to involve you in the decision-making process and help you to understand your options.

In some cases, traditional open brain surgery may be the first line of defence. It can be effective for removing large masses, but it is also an invasive and higher risk procedure with a long recovery time. For some patients, Gamma Knife surgery may be a safer, quicker and more effective alternative.

Understanding who may benefit from it (and who might not) is an important step to making informed decisions about your care.

How Gamma Knife radiosurgery works

Despite its name, Gamma Knife is not “surgery” in the traditional sense. It is a form of stereotactic radiosurgery (SRS), a non-invasive procedure that uses highly focused beams of radiation to target abnormal tissue in the brain with remarkable accuracy.

The treatment relies on advanced imaging and planning to deliver hundreds of tiny radiation beams that converge at a single point inside the brain. The cumulative dose is strong enough to treat the abnormality while sparing surrounding healthy tissue. Unlike open surgery, there are no incisions, and patients typically go home the same day.

This combination of precision, safety, and convenience makes Gamma Knife an attractive option, but careful patient selection remains key to a successful outcome.

Conditions commonly treated with Gamma Knife

Gamma Knife is often considered for patients with:

• Benign and malignant brain tumours – such as meningiomas, pituitary adenomas, and brain metastases.
• Vascular malformations – including AVMs and cavernous malformations.
• Functional disorders –most notably trigeminal neuralgia, a chronic pain condition.
• Acoustic neuromas (vestibular schwannomas) –tumours affecting balance and hearing.
• Recurrent or residual tumours –where previous surgery or radiation has not fully resolved the issue.

Who makes a good candidate?

Whether a patient is suitable for Gamma Knife radiosurgery depends on several factors:

Size and location of the target

Gamma Knife is most effective for small to medium-sized lesions, usually less than three to four cm in diameter. Lesions located deep within the brain or close to vital structures may actually be better suited to Gamma Knife than open surgery, since precision targeting reduces the risk of collateral damage.

Type of condition

Certain conditions, such as trigeminal neuralgia or small brain metastases, respond particularly well to radiosurgery. On the other hand, very large tumours or those requiring immediate decompression may not be appropriate.

Overall health and surgical risk

For patients who are elderly, have multiple medical conditions, or are not fit for traditional surgery, Gamma Knife offers a safer, non-invasive alternative. The procedure does not require general anaesthesia, making it suitable for patients who might otherwise be high-risk surgical candidates.

Previous treatments

Gamma Knife is often considered when surgery, chemotherapy, or conventional radiotherapy have not been fully successful, or when additional intervention is needed for tumour regrowth.

Patient goals and lifestyle

Some patients prioritise shorter recovery times and the ability to return quickly to daily life. For those who want to avoid the downtime associated with open surgery, Gamma Knife is often appealing.

Who might not be suitable?

Not all patients are suitable candidates. Gamma Knife may not be recommended if:

• The tumour or lesion is too large.
• Widespread disease requires whole-brain radiation.
• The abnormality is located in an area unsuitable for safe targeting.
• The patient has a condition requiring urgent surgical removal.

In such cases, neurosurgeons may recommend other forms of treatment, or a combination of therapies.

The role of the multidisciplinary team

Decisions about radiosurgery are rarely made by a single specialist. Instead, care is guided by a multidisciplinary team of neurosurgeons, radiation oncologists, neurologists, and radiologists. Together, they review the patient’s medical history, imaging scans, and overall health to determine the safest and most effective approach.

This team-based evaluation ensures that patients receive treatment tailored to their individual needs.

The patient experience

For those who are good candidates, Gamma Knife offers several advantages:

• Outpatient treatment –no hospital stay is typically required.
• Minimal discomfort – most patients experience little to no pain.
• Rapid recovery –many return to normal activities within days.
• Precision and safety –sparing healthy brain tissue reduces the risk of side effects.

While results may take weeks or months to appear, many patients benefit significantly from this focused, non-invasive treatment. If you would like to find out more information, please contact our team today.

Centres of Excellence for Stereotactic Radiosurgery treatment of complex Brain Tumours