Precision and Progress: UPMC’s Gamma Knife® Legacy and the Future of Image-Guided Neurosurgery
January 16, 2024
In late 2022, UPMC and our Center for Image-Guided Neurosurgery reached a remarkable milestone in our quest for neurosurgical excellence – we treated our 18,500th patient with a Gamma Knife® procedure. This monumental achievement underscores UPMC’s long-standing commitment to exemplary patient care through the early adoption of innovative technologies with the power to change the practice of medicine and consequently change the lives of patients in need.
Revolutionizing Brain Surgery in North America: The Gamma Knife at UPMC – 36 Years and Counting
The Gamma Knife is a noninvasive neurosurgical tool used to treat various brain conditions through the use of highly focused gamma rays. It is a form of stereotactic radiosurgery, a method that allows for precise targeting of small volumes within the brain while sparing the surrounding healthy tissue.
The Gamma Knife was invented by Swedish neurosurgeon Lars Leksell in 1967. Dr. Leksell collaborated with biophysicist Börje Larsson to develop the technology.
UPMC has been a pioneer in image-guided neurosurgery and the use of the Gamma Knife since the early 1980s. In 1981, L. Dade Lunsford, MD, now the Lars Leksell and Distinguished Professor of Neurosurgery at the University of Pittsburgh, orchestrated the world’s first installation of an intraoperative CT scanner at UPMC Presbyterian, kickstarting a revolution in image-guided surgery.
“At that time, there were only two CT scanners in the entire Pittsburgh region. It was still very new technology. MRI did not yet exist,” says Dr. Lunsford. “We knew that integrating advanced imaging directly into the surgical suite would be of tremendous benefit, but it took forward-thinking with an eye toward innovation at the institutional level. That’s something that has always existed in Pittsburgh, to the benefit of our patients.”
Coming on the heels of that innovative first, Dr. Lunsford was the driving force behind UPMC in 1987 becoming the first site in North America and fifth in the world to install and begin using the Gamma Knife to perform minimally invasive neurological stereotactic radiosurgery.
Over the intervening decades, the Gamma Knife approach has proven itself highly effective for managing a variety of benign and malignant brain tumors, like vestibular schwannoma, meningioma, and metastatic brain lesions; arteriovenous malformations; trigeminal neuralgia, movement disorders, and forms of focal epilepsy, radically transforming the neurosurgical landscape for so many patients.
“It’s our role to not just use the technology, but to prove that it has value and put it into perspective of where that value lies in terms of patient care,” says Dr. Lunsford. “I think that shows up in our extensive experience, our ongoing study of outcomes – following the data where it leads us, training new generations of surgeons, and continually investing in technology.”
UPMC’s Center for Image-Guided Neurosurgery: A Hub of Excellence in Patient Care, Innovation, Research, and Education
Our Center for Image-Guided Neurosurgery (CIGNS) is a testament to UPMC’s leadership in the field, where multidisciplinary expertise converges to offer minimally invasive treatments. Currently under the leadership of Constantinos Hadjipanayis, MD, PhD, and with Dr. Lunsford as its esteemed director emeritus, the CIGNS is a nexus for innovation in imaged-guided surgical practice and research.
Today, our CIGNS boasts two state-of-the-art Gamma Knife units, making UPMC one of the few institutions worldwide to offer such advanced care. But the Center’s clinical work encompasses much more than just the Gamma Knife, and so too does its prodigious research output and educational offerings.
New innovative surgical procedures that are performed include fluorescence-guided surgery (FGS) and use of a robotic-assisted exoscope for better visualization of both benign and malignant brain tumors.
Minimally invasive neuroendoscopic procedures in the brain permit treatment of deep-seated colloid cysts and other tumors in the brain. Sophisticated imaging of brain tumors and how they impact important tracts in the brain that control motor and language function are routinely completed in the CIGNS with magnetoencephalography (MEG). Ajay Niranjan, MD, MBA, oversees the MEG unit in the CIGNS, which permits important surgical planning of complex brain tumors.
“We are an international destination for training in minimally invasive surgical techniques that includes Gamma Knife radiosurgery,” says Dr. Hadjipanayis. “Close to 3,000 individuals of varying disciplines have come to our center over the years to learn advanced techniques using the most current technologies available.”
The work as an external training center for surgeons goes hand-in-hand with the robust training and case load available to every neurosurgical resident and fellow who enters these programs in the Department of Neurological Surgery.
The Future is Here: Gamma Knife Esprit Comes in 2024
Continuing to embrace the future of Gamma Knife radiosurgery, UPMC and the Center for Image-Guided Surgery introduced the Gamma Knife Esprit unit in 2024. This addition signifies more than just technological advancement; it is a promise of improved patient access, safety, and treatment possibilities. Worldwide there are only a little more than 300 Gamma Knife units in operation. With two operational Gamma Knife clinical units to treat an array of complex conditions, we are one of only a handful of such centers that exist.
The Esprit device represents the current pinnacle of Gamma Knife technology with its integration of advanced robotics and dose planning using AI, expanded treatment scope, and refined patient comfort. Alongside our Gamma Knife Icon, the addition of the newest system at UPMC pushes us again into a new era in radiosurgical precision and patient-centric care, with systems designed for optimal dosage control and motion management.
A Legacy Cemented in Compassion and Advanced Care
At UPMC, the Gamma Knife and other radiosurgical and minimally invasive tools are more than medical devices and technical approaches; they are beacons of hope for those facing challenging neurological conditions. More than three decades of dedication and clinical excellence have positioned our center as a world leader in neurological radiosurgery.
The success of Gamma Knife radiosurgery and other techniques at UPMC is not just measured by numbers but by lives touched and transformed. Our journey began with the vision of pioneers like Dr. Lunsford and has been carried forward by a team deeply committed to life-changing care.
Our story continues, as does our commitment to innovation and patient-focused treatment. As we embrace the future, we stand proud of our past, ready to deliver the next level of neurosurgical care with the same compassion and excellence that have been our hallmark for decades, across generations.
Additional Information and Patient Referrals
Learn more about the remarkable journey of Gamma Knife surgery at UPMC and our Center for Image-Guided Neurosurgery at UPMC.com/GammaKnife. For direct patient consultations or referral discussions, please call 412-695-5975 or use our referral form.
Gamma Knife® is a trademark of Elekta AB.
