Stereotactic Radiosurgery to the Nucleus Accumbens: A Dosimetric Feasibility Study

We demonstrated the technical feasibility of targeting the NAc with SRS for the management of treatment-refractory addiction using a single sample patient. Two- and four-shot models appear to be most feasible to achieve the highest point-dose while respecting critical structure constraints. The attempt to add a six-shot drove the optical chiasm dose over our institutional constraint of 10 Gy in a single fraction due to the proximity to the chiasm. Demonstrating the efficacy and safety of radiosurgery to the NAc for addiction will require further carefully defined pre-clinical and clinical studies.