Pioneering Brain Malformation Treatment in India Using Radiosurgery Technology

A 17-year-old female with a complex arteriovenous malformation (AVM) of the brain has become the first person in India to be treated using an advanced and fast radiosurgery platform.

The technology involved in the therapy was the Novalis Tx radiosurgery platform system, developed by Varian Medical Systems, Inc. (Palo Alto, CA, USA) and BrainLAB (Munich, German). Doctors at Kokilaben Dhirubhai Ambani Hospital (Mumbai, India) performed the pioneering stereotactic radiosurgery treatment in a single session that took just a few minutes to complete. "The patient's malformation, which was near the motor cortex on the right side of the brain, had been partially embolized and it was considered that no further treatment was possible,” said Dr. Ram K. Narain, the hospital's chief operating officer. "Following Novalis Tx radiosurgery treatment the patient's symptoms had alleviated considerably. She will now have an MRI [magnetic resonance imaging] scan every six months to monitor her progress. The medical team was very happy with her treatment.”

Arteriovenous malformations are abnormal connections between veins and arteries and are normally congenital and frequently inoperable. Bleeding from an AVM can be devastating, especially in the brain, where it can cause severe and often fatal strokes.

Dr. Narain reported that Kokilaben Hospital was proud to be the first in India to introduce the Novalis Tx radiosurgery platform clinically. "Image-guided, frameless, and noninvasive radiosurgery is very much today's innovation and tomorrow's radiosurgery technique of choice,” he said. "It offers a more patient-friendly alternative to conventional radiosurgery systems that require immobilization with a head ring that attaches to the skull. With this system, we can deliver a highly conformal and homogenous dose to irregularly shaped lesions in a single session, which was not achievable with conventional radiosurgery techniques. These faster treatments can be completed in minutes rather than the hours taken by conventional techniques and they can be carried out on lesions anywhere in the body, not just in the brain.”

According to Dr. Narain, the team at Kokilaben Hospital will use the Novalis Tx radiosurgery platform to perform radiosurgery and stereotactic radiotherapy for a number of indications, including lung, brain, liver, and prostate metastases, recurrent brain tumors, pituitary adenomas, acoustic neuromas, and meningiomas. "In particular it will help us to manage complex skull-base tumors and arteriovenous malformations with multimodality treatments, including stereotactic radiosurgery.”

The Novalis Tx radiosurgery platform features very high dose delivery rates, which contribute to shorter treatment times. It also provides dynamic fine beam-shaping and noninvasive, precise patient positioning for rapid and more comfortable treatments. Integrated imaging capabilities pinpoint the target before and during treatment and enable positioning of the patient with millimeter precision.

Kokilaben Hospital is a private center that treats approximately 3,000 new cancer patients each year from across India. Waiting lists are a major problem for cancer patients in India, and the speed and flexibility of the Novalis Tx radiosurgery platform will enable Kokilaben Hospital to treat more patients.

Ten Novalis Tx platforms have been ordered by Indian cancer centers in the two years since its introduction, making them among the most enthusiastic adopters of Novalis Tx technology to date.

Varian Medical Systems is a world-leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, proton therapy, and brachytherapy. The company supplies informatics software for managing comprehensive cancer clinics, radiotherapy centers, and medical oncology practices.

BrainLAB develops, manufactures, and markets software-driven medical technology that enables procedures that are more precise, less invasive, and less expensive than traditional treatments. Among the core products are image-guided systems that provide highly accurate real-time information used for navigation during surgical procedures.

Related Links:
Varian Medical Systems
BrainLAB