Leksell-Gamma-Knife-Perfexion-product-brochure

Leksell Gamma Knife® Perfexion™ Preferred for a reason

Why do medical professionals and patients prefer Gamma Knife Surgery? More than 80,000 patients undergo No matter how complex or intricate the clinical Leksell Gamma Knife® radiosurgery every year. challenge, Gamma Knife surgery delivers the highest Pioneering knowledge, insight from physicians, levels of physician and patient satisfaction. This meticulous research and cutting-edge makes it the treatment of choice at leading hospitals technology—this is Leksell Gamma Knife surgery. and clinics around the world. —2—

Elekta perfects the art Setting the standard for radiosurgery and science of stereotactic This integrated system provides full cranial radiosurgery reach. The system is built to deliver outstanding patient and staff comfort and better dosimetry Pioneered by Elekta, stereotactic radiosurgery performance than any other radiosurgical system. involves delivering a single, high dose of radiation to a small and critically located target in the Leksell Gamma Knife Perfexion—the system that brain. This principle defines Gamma Knife surgery fuses the skills of the physician with the science and it has dramatically widened treatment of radiosurgery. possibilities for physicians and patients. Exceeding expectations Leksell Gamma Knife is specifically designed for non-invasive procedures. Gamma Knife surgery provides pinpoint accuracy, unmatched efficiency and outstanding results. Patients benefit from fast, painless treatment, often conducted in an outpatient surgical setting without the need for general anesthesia or even convalescence. Over 1 million patients have undergone Gamma Knife surgery. —3—

The ultimate cranial radiosurgical tool— Leksell Gamma Knife® Perfexion™ Leksell Gamma Knife is consistently One-button automation Robotic efficiency Composite Shots enable sculpting regarded as the best non-invasive The system offers physicians a fully With Leksell Gamma Knife Perfexion, the dose distribution, which is then treatment for brain disorders. So how automated, single push-button the multiple helmets of the previous delivered with the unmatched did we make the best even better? By approach to operations that translates Leksell Gamma Knife models have accuracy associated with listening to experts in radiosurgery and into dramatic time savings. The been replaced by a single robotic Gamma Knife surgery. then creating Leksell Gamma Knife cutting-edge design radically expands system with three collimator Perfexion. treatment reach to cover a wider sizes. Because the collimator size Unrivalled radiation protection range of anatomical structures. automatically changes according to Every feature of Leksell Gamma Knife Leksell Gamma Knife Perfexion the treatment plan, treatment times Perfexion reflects patient and staff is designed to irradiate targets Full reproducibility are radically reduced. safety and comfort. The system in the brain. Leksell Gamma Knife Perfexion offers provides radiation shielding that is protocol reproducibility with full Improved workflow speeds up to 100 times better than backward compatibility to existing radiosurgery alternative technologies. Gamma Knife surgery protocols. The system comes complete with That means building on the treatment Leksell GammaPlan®, the dedicated Room radiation levels are low enough experience of over 1.2 million treatment planning system designed to allow for a window into the patients and close to 3,000 peer- to take full advantage of the features treatment room and the system can reviewed papers. and intelligence incorporated in be accommodated within a normal- Leksell Gamma Knife Perfexion. sized room. —4—

Smooth and seamless treatment workflow The ideal treatment procedure for physicians and Diagnosis Frame Attachment Leksell® Stereotactic Frame is secured patients is a single session that is swift, precise to the patient’s head throughout the entire treatment and elegant. This is where Gamma Knife surgery, procedure to ensure maximum accuracy. together with the dedicated treatment planning system, excels. Each step in the process works to Improved workflow with the highest possible standard of convenience and Leksell Gamma Knife Perfexion enables superior clinical ­efficiency. ··100% uptime (98% uptime guaranteed) Complete integration ··Single run, one push-button for 99% of The system digitally integrates diagnostic images, treatment planning and dose delivery into a all cases seamless information flow. Finally, the procedure is ··Two hours saved per patient compared implemented via a single push-button operation. to previous systems Highest comfort and safety ··Treatment planning done twice as fast Patient comfort and well-being are priorities at every phase. The entire process is straightforward and the Data based on a study of 99 patients, conducted patient is usually ready to return to normal life the at Hospital La Timone, Marseille, France next day. (July-December 2006) and experience at Cromwell Hospital, London, UK. Workflow is so efficient that staff numbers are minimized while physicians’ valuable time is optimized. Imaging Images taken immediately before the treatment determine the precise shape, size and location of the target. —5—

Gamma Knife surgery— preferred for a reason With very few exceptions, Gamma Knife surgery Treatment planning Images are used to create a tailor- Treatment Targets are automatically irradiated according to is given on a single occasion and without general made treatment plan to enable an optimal radiation dose the plan. Throughout the treatment procedure the patient is anesthesia. After Gamma Knife surgery the patient to the target. The treatment plan is then transferred to the monitored via the intercom system. normally leaves the hospital on the same day or the Gamma Knife system. day after, making it a very cost-effective alternative to open surgery. Follow-up The effect of radiosurgery takes place over time. During the procedure, 192 radiation beams from cobalt-60 sources converge with high accuracy on the target. Each individual beam has low intensity and therefore does not affect the tissue it passes through on its way to the target. The beams converge in an isocenter where the cumulative radiation intensity becomes extremely high. By moving the patient’s head in relation to the beams’ isocenter, the radiation dose can be optimized in relation to the shape and size of the target. The extreme precision of Leksell Gamma Knife—better than 0.5 mm—makes it possible to administer a high radiation dose to the lesion with minimal risk of damaging healthy tissue. —6—

Professor Leksell with Leksell Stereotactic System®— a revolution in intracranial surgery Reaching new heights The number of patients to undergo Gamma Knife of excellence surgery has risen from about 7,000 patients in 1991 to 1.1 million by 2018. Correspondingly, the number of Over 70 years ago, Professor Lars Leksell discovered units installed ­globally over the last fifteen years has that by minimizing surgical intervention in gone from 20 units in 1991, to over 300 units by 2018. the skull, the mortality rate could be reduced along with the trauma to the patient. Solutions for tomorrow Elekta is continually evolving innovative solutions This concept led to the birth of minimally and that redefine the neurological landscape. non-invasive neurosurgery and the inception of Elekta. Leksell Gamma Knife Perfexion is built with the technology to advance frontiers and deliver on the Setting the gold standard vision that guided Lars Leksell—to deliver highly It was Professor Leksell who invented the stereotactic effective and efficient treatment, at reasonable cost, frame so fundamental to Gamma Knife surgery. with as little trauma to the patient as possible. The stereotactic concept of directing x-ray beams into the brain was used surgically for the first 1949 Introduction of Leksell Stereotactic System time in 1951. This marks the birth of stereotactic 1968 First Leksell Gamma Knife prototype for radiosurgery—and with it, Leksell Gamma Knife. clinical research In the 1980s, the first commercial deliveries 1986 First commercially dedicated Leksell of Leksell Gamma Knife systems were made. The unsurpassed clinical effectiveness of Gamma Knife the treatments conducted saw a dramatic 1989 Leksell Gamma Knife Society formed increase in the number of publications. Leksell 1999 Introduction of Leksell Gamma Knife C with Gamma Knife soon became the worldwide gold standard for stereotactic brain surgery. Automatic Positioning System™ (APS) 2006 Launch of the fifth generation—Leksell Gamma Knife Perfexion The collimator design of Leksell Gamma Knife Perfexion enables fully automated treatment delivery —7—

The power of planning­— Leksell GammaPlan The unique collimator Leksell GammaPlan® enables planning of design enables swift multiple lesions with treatment of complex The concept behind Leksell ­GammaPlan® is to enable speed and efficiency. structures through the physician to tailor a conformal treatment plan Composite Shots and for a specific medical condition. Optimal tool for planning multiple targets Dynamic Shaping. Based on a new algorithm, using automatic Leksell GammaPlan has been developed in balancing of the radiation dose, the treatment Leksell GammaPlan collaboration with the professionals who actually planning of multiple brain metastases is now as easy use the system. This explains why so much attention as planning for a single target. ··Client-server architecture simultaneously has been devoted to ensuring true user-friendliness, supports multiple users to the online speed and precision. Composite Shots and Dynamic Shaping patient database The unique collimator design fea­tured in Software modules for easier planning Leksell Gamma Knife Perfexion enables the ··Supports all imaging modalities (CT, MRI, Using the latest technology, Gamma Knife software most comp­ licated tumors to be treated with angio, PET and MEG), also including modules such as Inverse Planning, Re-Treatment absolute precision. non-stereotactic image studies and DICOM-RT bring more power to your planning. This opens the platform for future upgrades, while Composite Shots enable dose sculpting of complex ··Real-time dose calculation delivering on daily clinical needs for improved structures. And, Dynamic Shaping protects critical ··Optimized planning of multiple targets workflow, cost efficiency and treatment quality. anatomical structures in the vicinity of the target, ··Composite Shots enable dose scupting of thereby enabling a higher dose to the target. Rapid, precise planning complex structures The system makes it possible to plan treatment of Regardless of complexity ··Dynamic Shaping protects critical one or several lesions with as many isocenters as Leksell GammaPlan ensures the most precise and clinically deemed optimal. This is performed in a effective treatment is delivered, regardless of the anatomical ­structures matter of minutes. Irradiation of the lesions is then number and complexity of the targets—so physicians delivered with superior conformity and selectivity. can achieve new heights of patient success. —8—

ABC DE F The sophisticated sector The collimator system consists The unique collimator design The system is developed with The couch can easily be adjusted A series of interlocks are mechanism enables automatic of 192 cobalt 60 sources, divided offers full cranial reach, enabling reliable, state-of-the-art industrial for optimal patient comfort. incorporated for a well- collimator configuration within into 8 sectors that can be treatment of a wide range of components for absolute stability, integrated system with seconds and is designed to individually positioned to any of anatomical structures. safety and precision. enhanced safety features. deliver high serviceability. 4 states: 4 mm, 8 mm, 16 mm or off. During treatment, these The patient positioning system is sources are positioned via the built to be highly robust, accurate sector mechanism to generate and dependable. It moves the desired radiation beam, the patient into the correct and enable treatment of highly position according to the beams’ complex structures. isocenter, thereby optimizing the radiation dose to the target. A user-friendly, intuitive Graphical User Interface provides up-to-date information on your patient’s ID, treatment status and operational conditions. The single-button approach enables fast and Radiation shielding levels are the market’s best, up flexible surgical procedures, saving time and to 100 times better than alternative technologies. resources even as patients are effectively treated. Overall radiation levels are low enough to permit a window in the treatment room. —9—

The entire system comprises the least possible number of moveable components in order to deliver unsurpassed accuracy. From the very beginning, Elekta has been uncompromising in the levels of accuracy defined and delivered by Leksell Gamma Knife. For the future, unmatched accuracy is assured by Leksell Gamma Knife Perfexion. Proven accuracy in every step accuracy of 0.50 mm when having a valid service A common definition of accuracy is agreement. A study of 189 installed systems, “the measure of the difference between There is no other system capable of delivering based on 332 commissioning protocols, proved an the desired or planned outcome and a the standards of accuracy achieved by average level of radio­logical accuracy of 0.15 mm. measurable outcome.” Leksell Gamma Knife—a tested, proven fact. The only true stereotactic system Sub-millimeter accuracy Elekta guarantees 0.50 mm Only Leksell Gamma Knife offers a true results in clinical benefits In intracranial radiosurgery, clinical accuracy stereotactic system from the ground up, to is the sum of the accuracy contributions that facilitate precision with their sheer stability and Improved quality of life compared make up the entire treatment procedure— robustness. Leksell® Coordinate Frame immobilizes to surgery imaging, dose planning, patient positioning, the patient’s head throughout the procedure. radiological and mechanical accuracy. ··Less trauma ··Faster recovery Elekta guarantees that Leksell Gamma Knife ··Shorter hospital stays systems will perform with a total radiological ··Fewer surgery-related complications Improved clinical outcome ··Optimal dose to the target ··Minimum dose exposure to surrounding tissue — 10 —

Gamma Knife® surgery—based on clinical evidence Metastatic tumors, cumulative patients treated worldwide In today’s cost-driven healthcare Constantly evolving practice 600k environment, it’s crucial to evaluate Gamma Knife surgery is constant­ly expensive technology investments on expanding, with ongoing research for 250k 499 the basis of hard facts and proven new indications and the development 1.21k results. This is particularly true when of existing protocols. The design 2.35k choosing the best care for patients of Leksell Gamma Knife makes it 4.37k suffering from serious neurological especially suitable for treatment of 7.27k diseases and cancer. In these cases, multiple targets, which in most cases radiosurgery with Leksell Gamma means brain metastases. 11.58k Knife offers a range of benefits and 17.09k efficacies fully supported by years of Over 400,000 patients have been 23.8k evidence-based medicine. treated for metastatic tumors with Leksell Gamma Knife systems since 32.08k Proven and documented results the first treatment in 1968. With 41.98k Clinical results for Gamma Knife extremely good tumor control ­rate, treatment have been extensively few side effects and the ability to treat 53.25k published in peer-reviewed journals, multiple targets effectively, Gamma 66.1k which cite significant increases in Knife surgery occupies a unique 82.16k successful outcomes. Only Leksell position in this field. 100.46k Gamma Knife can show this long-term 120.3k performance and how it combines With all the clinical and managem­ ent 142.1k cost-effectiveness with improved advantages of Gamma Knife surgery, 163.14k quality of life for patients in both it has become a preferred method in 185.31k curative and palliative care. the care of metastatic disease. 205.03k 226.78k 251.94k 278.17k 305.6k 335k 365.81k 399.05k 434.01k 0 The percentage of centers submitting their numbers each year has varied between 68–100% from 1968 to 2017. 1991 reflects cumulative numbers since 1968. 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 The unique ability to treat multiple And with greater awareness among brain metastases provides new patients, Gamma Knife surgery is opportunities for the patient to prolong increasingly being requested when it life and gain better quality of life. comes to treatment of the brain. — 11 —

Playing a vital role in modern healthcare With the increasing number of cancer incidence rates and an aging population, Gamma Knife surgery plays an important role in modern healthcare. Hospital management and medical staff choose Leksell Gamma Knife for its extreme accuracy, streamlined workflow and outstanding therapeutic response. It frees resources in the clinic, provides evidence-based medicine, and gives the clinic confidence and reliability. Gamma Knife surgery helps reduce waiting lists for Several published studies demonstrate savings of Clinical need for more capacity radiation therapy and neurosurgery clinics. It offers more than 50% of direct costs associated with Taking the most common Gamma Knife surgery high quality care for disorders of the brain, and short microsurgery1. These gains are primarily due to the indications into a­ ccount, 325 to 830 people per million treatment times with rapid patient recoveries mean minimal need for hospitalization and intensive care, are candidates for this treatment.3 lower costs for the healthcare system and society. as well as the reduction of complications related to Patients get back to work and normal life faster open surgery. This number will most certainly grow in the future. compared to convalescence after open surgery. The number of cancer cases is predicted to increase by 50 percent—to 24.6 million new cases—by the Another study shows that one Gamma Knife system year 2020.4 As 20–40% of all cancer patients can free up to 700 ICU beds per year2. develop brain metastases,5 Leksell Gamma Knife will definitely play an important role in future health­care. — 12 —

Flexibility and freedom of choice—a complete product family Elekta is the world’s only radiosurgery solutions provider with a comprehensive range comprising systems, software and services. These are the components necessary to build and support a stereotactic center of excellence with dedicated solutions for head and body. The breadth of Elekta’s portfolio allows a neurosurgery or radiation oncology center to develop a strong reputation based on exceptional patient care and profitable collaborations. References [1] van Roijen L, et al. Costs and effects of open surgery versus SRS in treating vestibular schwannoma. Acta Neurochir, 1997. Rutigliano MJ, et al. The cost effectiveness of SRS versus surgical resection in the treatment of solitary metastatic brain tumours. Open Surgery, 1995. [2] Netten, et al, Unit at Health & Social Care 1999. University of Kent Canterbury, Hospital and Community Health Service. [3] Hamilton TM, Kano H and Lunsford LD. Gamma Knife radiosurgery: a review of epidemiology and practice. Leksell Gamma Knife Society; 2014. [4] World Cancer Report, World Health Organization. [5] American Cancer Society. — 13 —

Each Gamma Knife user receives Elekta works very closely with all users The successful evolution of Elekta’s automatic membership to the to understand their needs and learn solution developments over the years prestigious Leksell Gamma Knife from their findings. These insights are is a direct result of close collaboration Society. Today, this society is an invaluable for the development of with the members of the esteemed global network for sharing new products. Leksell Gamma Knife Society. clinical experience, scientific research and knowledge. — 14 —

Elekta Care™ Rest assured, you’ve got From prompt, personalized service and support We offer comprehensive learning opportunities to innovative learning programs and customized in a variety of formats, enabling your team to Elekta Care. consulting services, it’s all part of our forward- optimize your technology capabilities, expanding thinking commitment to provide you the best when and how your learning curve requires it. Elekta Care—our commitment to customer care—so you can make the most of providing the best customer care your Elekta technology investment throughout Elekta Care supports you from its lifecycle. start-up through your product’s lifecycle with comprehensive Elekta Care’s secure online customer portal, options from education, training Elekta Care Community, is accessible 24/7, and upgrades to solutions allowing bringing the power of Elekta Care’s dedicated you the highest uptime and support organization straight to you. improved operational efficiency. Clinical applications, technical or physics support is just a connection away and is backed by a global support network of 165 remote support specialists and more than 650 field service engineers. — 15 —

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