A survey of the Gamma Knife Centers in the United States to determine if there are specific criteria, including number and size of metastasis, used in deciding acceptibility for GKS.

Keywords: brain metastasis, radiosurgery, gamma knife, survey, practice

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     There is both literature and daily practice controversy concerning the appropriate number and size of brain metastasis in deciding the acceptability of a patient for GKS. Some physicians and insurance companies will defer to the literature and offer criticism or even limit payments if these criteria are exceeded, and they seem to be constantly changing. Some centers will offer numerous re-treatments to surviving patients whereas others will not.
     We sought to determine practice patterns.
 We undertook a survey of all of the Gamma Knife Centers in the United States to see what the actual practices are. The results will illustrate the variability with regard to ''academic center'' vs ''private practice center'', and to determine how many centers are tracking their outcomes, and will offer multiple treatment sessions.
     This was a survey of only American centers.
     The results may encourage more liberal use of Gamma Knife treatment if the physicians can be assured that others are doing the same.
     A study of practice patterns can identify growing trends in management.


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