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The role of medical physicists in developing stereotactic
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This article is a tribute to the pioneering medical physicists over the last
who have participated in the research, development, and
commercialization of stereotactic
radiotherapy utilizing a wide range of technology. The authors have
described the evolution of SRS through the eyes of physicists from its beginnings with the Gamma Knife™ in
1951 to proton and
charged particle therapy; modification of commercial linacs to accommodate high
setups; the multitude of accessories that have enabled fine tuning patients for
relocalization, immobilization, and repositioning with submillimeter accuracy; and finally
the emerging technology of SBRT. A major theme of the article is the expanding role of the
physicist from that of advisor to the neurosurgeon to the current role
as a primary driver of new technology that has already led to an adaptation of cranial
SRS to other
sites in the body, including, spine, liver, and lung. SRS continues to be at the
forefront of the impetus to provide technological precision for radiation therapy and has
demonstrated a host of downstream benefits in improving delivery strategies for
conventional therapy as well. While this is not intended to be a comprehensive history,
and the authors could not delineate every contribution by all of those working in the
pursuit of SRS
development, including physicians, engineers, radiobiologists, and the rest of the therapy
staff in this important and dynamic radiation therapy modality, it is clear that physicists have had a
substantial role in the development of SRS and theyincreasingly play a leading role in furthering
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