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The CyberKnife System Benefits of CyberKnife Treatement Process Case Studies

The CyberKnife® System

System Overview

A Revolutionary New Treatment Option
The CyberKnife system uses precisely targeted radiation to destroy lesions anywhere in the body in as few as 1-5 fractions and is an excellent alternative to traditional surgery. Because it is not surgery, CyberKnife does not present the same problems as traditional surgery. There is no anesthesia and the risk of infection and hemorrhaging is minimized.

The CyberKnife offers sub-millimeter targeting precision and effectively spares healthy tissue surrounding the targeted area, due to the extremely sharp radiation fall off outside the high-dose region. Following treatment, the patient goes home with no need for recovery time.

Precision, Image-Guided Radiation
The CyberKnife combines two systems: a compact, lightweight linear accelerator mounted on a robotic arm that sends the radiation to the patient; and an image guidance system that tracks the tumor's location within the body - in real time - to direct the radiation to the precise location where it is needed.

The guidance system uses the patient's skeletal structure or implanted radio-opaque markers as a point of reference, continuously re-imaged throughout the entire treatment, re-aquiring the target volume and adjusting the beam within millimeter tolerance up to 100 or more times during each treatment session. In fact, it is the only system that monitors and tracks tumor position continually during treatment.

The robotic arm that delivers the radiation is so maneuverable that physicians may treat a lesion from up to 1600 non-coplanar targeting angles. This means they may use it to treat tumors and other lesions anywhere in the body without open surgery, including some that were previously untreatable.

A Full-Body Radiosurgery System
CyberKnife was developed by Accuray Incorporated and received FDA clearance in 1992. Their on-going mission is “To provide treatment planning and image-guided radiosurgery and precision radiotherapy for lesions, tumors, and conditions anywhere in the body when radiation treatment is indicated.” Over 140 medical centers worldwide have chosen CyberKnife and 20,000 patients have been treated as of January 1, 2006.

CyberKnife Defines Radiosurgery
Using image-guidance, robotics and dynamic respiratory motion tracking, the CyberKnife System delivers superior accuracy and conformality to lesions throughout the body. Developed by Accuray and FDA approved for full body use in 2001, it is the first device to enable full-body dynamic radiosurgery. CyberKnife is making possible effective new treatments in clinical areas such as spine, lung, liver, pancreas and prostate lesions.

Full-Time Robotics Technology
The CyberKnife System utilizes a robotic manipulator to move the compact linear accelerator with six degrees of freedom. With this range of motion, the robotic manipulator is capable of positioning the linear accelerator to an infinite number of beam positions and orientations. This creates the ability to accurately adjust the beam to react to three-dimensional translational and rotational target volume displacements, providing treatment flexibility and accuracy that is unsurpassed in radiosurgery. Such versatility allows both non-isocentric and isocentric treatment of lesions and enables superior conformality.

Dynamic Motion Tracking™
The CyberKnife System tracks position in tumors that move with respiration in real time, by synchronizing radiation delivery to the motion of the respiratory cycle, using a sophisticated combined optical and radiographic tracking system. This 4D tracking capability is unique to the CyberKnife and not only makes treatment with the CyberKnife significantly more comfortable for patients, but safer, faster and more accurate as well.

Real-Time Image Guidance Throughout the Treatment
Image-guided CyberKnife radiosurgery is non-invasive and 100% frameless. Since treatments can be delivered in single or fractionated sessions, CyberKnife offers optimum protection for adjacent critical structures. Unlike traditional radiosurgery devices, the CyberKnife systems tracks internal reference points. In this way the CyberKnife automatically detects and compensates for patient and tumor movement in real time, with updated image guidance at every beam position

Technical Information

Compact Linear Accelerator with Express™
The compact X-band linear accelerator emits circular beams with secondary collimation ranging from 5 mm to 60 mm. This compact lightweight system allows for precisely delivered pencil-shaped beams of radiation in almost any direction, providing superior conformality when treating patients.

Robotic Manipulator
The robotic manipulator used by the CyberKnife System is made by Kuka™, one of the leading robot manufactures in the world. This high-precision robot is capable of delivering a repeatability accuracy of less than 0.2 mm.

X-Ray Sources
The low-energy x-ray sources generate two perpendicular, oblique diagnostic x-rays that determine the location of bony landmarks or implanted radiopaque markers throughout the entire treatment.

Image Detectors
The high-resolution image detectors capture x-ray images and generate digital images of the anatomy. These images are taken throughout the treatment and are simuntaneously compared to the digitally reconstructed radiographs (DRRs) generated from the CT scans used for treatment planning. The imaging system then determines the patient’s position and sends a command to the robotic manipulator to correct for movement.

AXUM™Treatment Couch
The AXUM™ Automatic Patient Positioning System automatically and accurately aligns patients in one simple step, significantly reducing patient setup times and increasing patient throughput.

Synchrony™ Respiratory Tracking System
The Synchrony Respiratory Tracking System is the first technology in the world capable of delivering radiosurgery to targets that move with respiration. The CyberKnife System synchronizes the Robotic Delivery System to the motion of the tumor so margins of less than a millimeter are needed in order to compensate for respiratory motions.

CyRIS™ MultiPlan™ Treatment Planning
CyRIS™ Treatment Planning includes fast, multi-modality image fusion with simplified contouring. Supports forward and inverse planning methods and achieves desired plan results quickly andefficiently. Streamlines overall planning process to maximize the capabilities of CyberKnife System.

CyRIS™ InView™ Image Fusion and Contouring
With CyRIS InView, physicians are able to perform fusion, contouring and dose review in the comfort of their own office or other remote location.