Читать книгу Leksell Radiosurgery - Группа авторов - Страница 13

Thanks to a donation from a Swedish foundation, the first prototype GK was constructed in 1967. It was loaded with cobalt-60 at the nuclear facility of Studsvik, 2 h south of Stockholm, and on October 25, 1967 the world’s first GK surgery (GKS) was carried out in this entirely non-clinical setting. The patient had a craniopharyngioma.

In January 1968, the GK was transported to Stockholm where it was installed in the private Sophiahemmet Hospital (Fig. 7). Now followed many years of meticulous and cautious investigation into the use of GKS. We needed to understand what indications would be suited for this non-invasive approach, what dose would be right for any given indication, and we needed to learn more about the physics and radiobiology of SRS.

Fig. 7. 1968 – the prototype GK installed at the private Sophiahemmet Hospital in Stockholm.

Stereotaxy at this time was used almost exclusively for functional disorders and initially this was also true for the GK [9, 10]. However, with the installation of the first CT scanner in 1974, it became attractive to also address benign tumors and AVMs. This exploration began with vestibular schwannomas in 1971 and was followed by AVMs in 1972 [11, 12]. Indications that were strictly off limits were gliomas and metastases. The reason for this was the need to prove the value of the methodology through long-term follow-up.

In 1974 a second improved GK was installed in Stockholm, this time at the Karolinska Hospital. Sweden was to remain the only country were SRS was performed until 1979. Robert Rand at UCLA then persuaded his friend Leksell to donate the 1967 prototype GK to UCLA (Fig. 8). Rand’s intention was to use the prototype for animal experiments. After a few years the UCLA prototype was finally disassembled and shipped back to Sweden. Initially there were plans to exhibit it at the Stockholm Museum of Technology. We subsequently decided that we did not want the budding field of GKS to be seen as antiquated, and the prototype was therefore scrapped.

Fig. 8. 1979 – the prototype donated to UCLA – open house invitation.