FIRST AMENDMENT TO EQUIPMENT LEASE AGREEMENT

Exhibit 10.45a

FIRST AMENDMENT TO EQUIPMENT LEASE AGREEMENT

     This FIRST AMENDMENT TO EQUIPMENT LEASE AGREEMENT (this “Amendment”) is dated November, 2006, and is entered into by and between GK FINANCING, LLC, a California limited liability company (“GKF”), and LEHIGH VALLEY HOSPITAL, a not-for- profit Pennsylvania hospital corporation (“LVH”), with reference to the following facts:

Recitals :

     WHEREAS, GKF and LVH entered into an Equipment Lease Agreement dated May 28, 2003 (the “Lease”), pursuant to which LVH leases from GKF, a Leksell Stereotactic Gamma Unit, Model C with Automatic Positioning System.

     WHEREAS, GKF and LVH desire to amend the Lease as set forth herein.

     NOW THEREFORE, in consideration of the mutual covenants, conditions and agreements set forth herein, and for such other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows:

Agreement :

     1.  Defined Terms . Unless otherwise defined herein, the capitalized terms used herein shall have the same meanings set forth in the Lease.

     2.  Lease Payment . In recognition of lower than anticipated reimbursement levels for Procedures, the Lease Payment shall be reduced from the sum of * to the sum of * for each Procedure that is performed on or after the “Effective Date” by LVH or its representatives or affiliated health care entities, irrespec