Lunsford LD, Sheehan JP, eds. Intracranial Stereotactic Radiosurgery. Thieme; 2009; 200 pp; 119 ill; $169.95
This volume offers the expertise of a multinational group of authors in the practice of stereotactic radiosurgery (STR) for a variety of intracranial lesions. It does not favor any single device but discusses approaches by Gamma Knife, CyberKnife, and proton beam applications. The book is logically organized, starting with a history of stereotactic radiosurgery followed by the radiobiologic considerations necessary to understand the relationship between single fraction dosing and multiple fraction dosing in STR. There is an excellent discussion of the histopathologic changes that occur in brain and tumors in the acute, subacute, and chronic time frames after STR. A short discussion of image-guided STR (CyberKnife) is given, and this is followed by a string of chapters, each devoted to a different tumor type or functional treatment area. This organization makes this volume a very useful reference for those seeking guides to STR of these types of tumors or problems. The majority of clinical chapters deal with the STR of benign tumors and the last four with malignant tumors, including pediatric brain tumors, both benign and malignant. This probably reflects the initial intention of Lars Leksell (who pioneered the development of the Gamma Knife) that emphasized that STR was to be used for benign disease. In fact, the use of STR for metastatic intracranial disease was not described until 1987, fully 20 years after Leksell treated his initial case, which was a solid craniopharyngioma. This first use for brain metastases was by STR using a modified linear accelerator and not the Gamma Knife.
The text, in general, is well written, informative, and accurate. It is printed on glossy paper to enhance the text images, which are usually clear and easy to read (especially the images that show dose distributions). The printing is clear and crisp; however, the glossy paper can render the text difficult to read in certain lighting situations and this reviewer’s old eyes had some problems with the size of the type, especially in the figure legends.
The images are reasonably good, although a few appear slightly off-focus. The major drawback is that some of the Gamma Knife plan reproductions are very dim and, although the isodose lines are well seen, the anatomy may be difficult, especially for those who are not radiologists or neurosurgeons. Many of the plates are in color, which enhances the text and makes viewing the dosing easier than in black-and-white images. The chapters are easy to read, current, and contain good references from excellent sources. Most, but not all, are very well written and easy to follow.
Overall, this is a book that compares favorably with those that preceded it. The present text has the advantage of including other means of STR besides the Gamma Knife and does a very credible job of impartiality and presentation of useful information to those who seek to learn more about this type of treatment. I do not believe that this volume will have much direct appeal to neuroradiologists, unless they wish to learn more about the principles and practice of STR. On the other hand, the volume will appeal to radiation oncologists and neurosurgeons, as well as others who wish to incorporate STR into their armamentarium for the treatment of the benign and malignant diseases.
