installed in the 1980s all with 201 cobalt-60 sources. In parallel to these developments, a similar approach was designed for a linear particle accelerator or Linac. Installation of the first 4 MeV clinical linear accelerator began in June 1952 in the Medical Research Council (MRC) Radiotherapeutic Research Unit at the Hammersmith Hospital, London. The system was handed over for physics and other testing in February 1953 and began to treat patients on 7 September that year. Meanwhile, work at the Stanford Microwave Laboratory led to the development of a 6 MeV accelerator, which was installed at Stanford University Hospital, California, in 1956. Linac units quickly became favored devices for conventional fractionated radiotherapy but it lasted until the 1980s before dedicated Linac radiosurgery became a reality. In 1982, the Spanish neurosurgeon J. Barcia-Salorio began to evaluate the role of cobalt-generated and then Linac-based photon radiosurgery for the treatment of AVMs and epilepsy. In 1984, Betti and Derechinsky described a Linac-based radiosurgical system. Winston and Lutz further advanced Linac-based radiosurgical prototype technologies by incorporating an improved stereotactic positioning device and a method to measure the accuracy of various components. Using a modified Linac, the first patient in the United States was treated in Boston Brigham and Women's Hospital in February 1986. 21st century Technological improvements in medical imaging and computing have led to increased clinical adoption of stereotactic radiosurgery and have broadened its scope in the 21st century. The localization accuracy and precision that are implicit in the word "stereotactic" remain of utmost importance for radiosurgical interventions and are significantly improved via image-guidance technologies such as the N-localizer and Sturm-Pastyr localizer that were originally developed for stereotactic surgery. In the 21st century the original concept of radiosurgery expanded to include treatments comprising up to five fractions, and stereotactic radiosurgery has been redefined as a distinct neurosurgical discipline that utilizes externally generated ionizing radiation to inactivate or eradicate defined targets, typically in the head or spine, without the need for a surgical incision. Irrespective of the similarities between the concepts of stereotactic radiosurgery and fractionated radiotherapy the mechanism to achieve treatment is subtly different, although both treatment modalities are reported to have identical outcomes for certain indications. Stereotactic radiosurgery has a greater emphasis on delivering precise, high doses to small areas, to destroy target tissue while preserving adjacent normal tissue. The same principle is followed in conventional radiotherapy although lower dose rates spread