Gamma knife procedure
THERE ARE SIXTEEN IMAGES TO LOAD.
MAKE A COFFEE, WE'LL BE READY SOON!
On 2 September Chen Zhongping escorted us to the Guangdong Minimally Invasive Neurosurgery Medical Centre
where we saw Professor Hua Shenling, who, with Prof Chen, reviewed
Margaret' MRI and PET scans
and recommended in favour of Gamma knife treatment..
After the decision was made to proceed with treatment, the first step, after injection of a mild sedative, was to fit the frame to Margaret's head. This required local anaesthetic. Here a whole team assists: clockwise from left rear, with spectacles, the gamma knife planner (name not known) who had planned three and a half thousand procedures; Fu Xuan, resident neurosurgeon, who operates on days he is not assisting with gamma knife; Prof Hua, injecting the local anaesthetic alongside a frame point in the forehead (the points must touch the bone to provide precise location for the procedure); Prof Chen, observing; Prof Hu, Director of this Medical Centre.
After this, measurements were taken to plot the position of
the frame and skull relative to a plastic dome
providing orientation to the Gamma Knife. Black object in the planner's hand
measures distance in millimetres.
Then we had to get into a hospital van, Margaret accompanied
by a nurse,
to drive five minutes to another Adjunct Hospital, for the planning MRI,
where the scan would be based on the precise positioning of the frame.
and we had a little wait in a rather nice waiting room, before the planning MRI
. 
after which we took the van back to the Gamma Knife centre,
where Margaret had a rest during planning
- the MRI results had been sent directly to the planner's computer.
The planner marked the target on every picture of the tumour on the MRI.
Photo shows the planner's computer monitor, with some of these images, planning
markings in green
- the objective being to deal with a suspect area around the periphery of the
tumour.
This then was the entry of the planned work on Margaret's outpatient card
These three following photos show Margaret being prepared for
the procedure.
(There is a splash of floral colour on her white dress by the way, it's not
a wound!)
We were very impressed by the courtesy and care of hospital
staff.
After initial adjustment, Margaret required seven further adjustments, between
eight 5.5 minute treatments, over an hour.
The hemispherical object over Margaret's head contains 210 radial
tubes. When staff leave the room, the patient is moved back into the machine,
and these tubes match up with extensions in the body of the machine. At the
end of each tube is a cobalt 60 source of gamma rays.
This system provides very precise and small targetting.
For a small lesion, one treatment may suffice.
To deal with Margaret's more diffuse target, the eight treatments were needed.
After the treatment and again on 3 and 4 September,
we returned for Margaret to have IV dosage of 250ml mannitol and 10mg dexamethosone,
to cope with post-operative oedema.
It would have been possible for Margaret to stay in the hospital, it was quite
comfortable and very clean,
but we had not prepared for that, and as I did not know my way around town very
well, it was easier for us to make daily visits.
Driving home from the hospital...
. 