Intracranial Stereotactic Radiosurgery. L.D. Lunsford and J.P. Sheehan, eds. Thieme; 2009, 200 pages, 119 illustrations, $169.95.
Intracranial Stereotactic Radiosurgery 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 (Accuray, Sunnyvale, California), or proton-beam applications. The book is logically organized, starting with a history of STR, followed by the radiobiologic considerations necessary to understand the relationship between single-fraction and multiple-fraction dosing in STR. There is an excellent discussion of the histopathologic changes that occur in the brain and tumors in the acute, subacute, and chronic timeframes 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 book a very useful reference for those seeking guides to STR of these types of tumors or problems.
Most clinical chapters deal with the STR of benign tumors, and the last 4 with malignant tumors, including pediatric brain tumors both benign and malignant. This arrangement probably reflects the initial intention of Lars Leksell (who pioneered the development of the gamma knife), which 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 of STR for brain metastases was with 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, 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, though a few appear slightly out of focus. The major drawback is that some of the gamma knife plan reproductions are very dim, and though 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, and this enhances the text and makes viewing the dosing easier than viewing it in black and white. The chapters are easy to read and current and have 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 beside 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 and others who wish to incorporate STR into their armamentarium for the treatment of the benign and malignant diseases.
