Treatment Day
Frame Fit and Imaging
On the day of your treatment, you will need to go straight to
the main x-ray department in the Bristol Royal Infirmary (A217) and
wait in the waiting room. As this is early in the morning there
might not be a receptionist at the desk but this does not matter as
you do not need to check in. You will be asked to wait and will be
collected by a radiographer.
You may wish to bring one friend or relative with you.
Facilities in the Gamma Knife waiting room include TV, free drinks
machine, toilets and free WiFi. You may wish to bring snacks and
food for yourself and for the person accompanying you.
To enable treatment to be delivered with pin-point accuracy, it
is necessary for you to be completely still and in exactly the same
position for the MRI scan and treatment. To ensure this, we either
use a special frame which is attached to your head or a mask. The
most suitable method will be chosen by the doctor.
The Gamma Knife frame can be applied before or after the MRI
scan and will remain on throughout the day until your treatment is
complete. The stereotactic frame is made of light weight metal. It
is placed on your head by the consultant or neurosurgeon.
Anaesthetic is injected into your scalp to numb the skin at four
anchor points, two in your forehead and two in the scalp at the
back of your head. You may feel some discomfort during these
injections. There will be no need for your head to be shaved. The
frame will then be attached to your head by four small pins. Once
the frame has been fitted helmets will be placed over the frame to
check the positioning. It is common to feel some pressure after the
head frame is attached. Occasionally, pain killers such as
Paracetamol are required to alleviate this. If you feel you require
any then please ask a member of staff.
The Gamma Knife mask is made after the MRI scan on the treatment
couch in the Gamma Knife centre. It is made from a thermoplastic
material which is heated and shaped to your face. Once the mask has
been made you will have a cone-beam computer tomography (CBCT)
scan. These images are fused with the MRI images and used to plan
your treatment. The mask will only be worn during treatment. A CBCT
is repeated prior to treatment to enable adjustments to your plan
for any slight variation in position. A reflective marker is placed
on your nose to continuously monitor your position. If movement is
detected, treatment is paused and another CBCT is done before
treatment is resumed.
