Stereotactic radiosurgery (SRS) is a way to accurately treat brain tumors. SRS involves the use of a special head frame to keep the head from moving during treatment. The head frame makes very accurate treatment possible. The frame must be attached to the skull with special pins. It feels very tight and can hurt. A special immobilization device can be used to keep the head from moving.

This device does not need any pins and does not hurt. We would like to see if the new way of holding the head still can be used for SRS. This is the purpose of the study. New X-Ray machines can be used to find if the head has moved in the mask. We hope that we can use these new tools to treat brain tumors just as accurately without using a head frame. It will make treatment more comfortable for the patient. This is why we are asking patients to join the study.

Inclusion Criteria:

• Histologically confirmed malignancy with the presence of intraparenchymal brain metastases.
• A diagnostic contrast enhanced MRI demonstrating the presence of brain metastases performed within two weeks prior to registration.
• Age ≥ 18 years.
• Must be scheduled or planning to be scheduled for SRS treatment.
• Karnofsky performance status ≥60.
• Patient must sign a study-specific informed consent form. If the patient's mental status precludes his/her giving informed consent, written informed consent may be given by the patient's legal representative.

Exclusion Criteria:

• Unable to provide informed consent
• Major medical illness including poor cardiac or pulmonary status which would result in inability of the patient to lie down for the procedure.
• Inability to obtain histologic proof of malignancy.
• Younger than 18 years of age.
• Serum creatinine > 1.3 mg/dl.
• Karnofsky performance status of ≤50.
• Allergy to either CT or MR contrast dyes.

MSKCC Clinic