Radiosurgery (precise, high dose radiation) is used to devitalise tissue with small diameters (few mm to 3 cm). This study compares clinical efficacy (indications: brain tumours, brain metastases and 6 other indications) and cost aspects of the two application forms.

The search revealed 3 HTAs with appropriate study questions resulting in indices on equality (low evidence quality), but no primary studies with high levels of evidence. Apart from those, indices of equality come from studies with low evidence level. Some indications (according to technical studies and expert questionnaires) seem to be treated more efficient by GK, some by aLIN indicating to use the devices according to their strength.

Cost components differ (GK: higher acquisition cost but longer lifetime; radiation sources must be renewed every 7 years, but lower maintenance cost; aLIN: usable also for extracranial indications) but in combination both application forms perform with similar yearly cost. Differences are vastly influenced by local variables (configuration, case numbers, etc.) and should therefore be evaluated for decisions on the equipment. Indications should be evaluated by means of currently available options.