CyberKnife
Revolutionary Image Guided Robotic Radiosurgery

What is Radiosurgery?

Radiosurgery is a non-invasive procedure that uses precisely directed high-energy radiation beams to destroy abnormal (often cancerous) lesions within the body and brain. Using stereotactic techniques, or 3D targeting, an ablative dose of radiation can be delivered to the lesion while simultaneously sparing the normal surrounding tissues. Due to unparalleled treatment accuracy overwhelming doses of radiation can be delivered to the target in a short overall treatment coarse. By definition, the entire radiosurgery is administered in one to five daily sessions. This is in stark distinction to standard radiation (even with image guidance) that is generally delivered daily over a 4-8 week time period. Standard external beam radiation counts on normal tissues also receiving meaningful amounts of radiation. This necessitates the standard treatments to be spread out over time to allow for normal tissue repair .

   


History of Radiosurgery

Stereotactic radiosurgery has been used for more than 35 years to treat benign and malignant tumors, vascular malformations, and other disorders of the brain with minimal invasiveness. To date, more than 200,000 patients have been treated worldwide with radiosurgery. The original radiosurgery systems required a rigid metal frame to be fixed to the patient's skull during the procedure and could only treat lesion in the brain. Modern systems, pioneered by CyberKnife, have eliminated the need for frames attached to the skull and opened the door to tumors within the body which were previously untreatable. We are now entering a new era on the war on cancer.

What Makes the CyberKnife System Revolutionary?

The CyberKnife® System is the world's most accurate robotic radiosurgery device. It is an intelligent robotic radiosurgery system designed to treat tumors anywhere in the body with sub-millimeter accuracy. The CyberKnife's flexible robotic arm provides unparalleled access to previously unreachable tumors. And, because CyberKnife is noninvasive, doctors can treat tumors anywhere in the body without making a single incision. The CyberKnife provides a viable option for those patients previously diagnosed with inoperable tumors.

The CyberKnife System uses image guidance technology and computer controlled robotics to continuously track, detect and correct for tumor and patient movement throughout the treatment. Because of its extreme precision, the CyberKnife System does not require invasive head or body frames to stabilize patient movement, vastly increasing the system's flexibility and patient comfort.

Unlike traditional radiosurgery systems that can only treat tumors in the head, the CyberKnife System can treat areas throughout the body. In fact, body treatments currently represent more than 50 percent of CyberKnife procedures in the United States, including those of the spine, lung, prostate, liver and pancreas.

 

Precision Robotic Technology

A compact linear accelerator is mounted in an extremely precise robotic positioning system allowing six degrees of freedom. With this range of motion infinite number of beam positions and orientations are possible providing unsurpassed flexibility and conformality. The ability to deliver the most precise treatments without the need for an invasive head or body frame vastly increases the system's flexibility and patient comfort.

 

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Real-Time Image Guidance

The Cyberknife continuously tracks, detects, and corrects for tumor and patient movement throughout treatment. The tracking is accomplished through sophisticated computer technology and an image guidance system which monitors the patient during the entire procedure. Any corrections for movement are not only performed through the robotic linear accelerator but with the assistance of a robotic patient table (Axum).

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Dynamic Motion Tracking

Through Synchrony Respiratory Tracking System, a component of the CyberKnife, natural respiratory patterns can be account for on an individual basis and in real time. This makes the procedure more comfortable, safer, faster, and more accurate.

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Patient Benefits

As a CyberKnife patient, you benefit from:

No Incisions
No Pain • Bloodless Procedure
No Stereotactic Frame (as used with the Gamma Knife™)
No Anesthesia
No Recovery Time
Immediate Return to Normal Activity


Simple Outpatient Treatment Process

Step 1: Consultation

You will meet with your Radiosurgeon to discuss whether CyberKnife is right for you. You will go over the benefits and potential risks unique to your case. The procedure is not performed during the initial consultation. If CyberKnife Radiosurgery is decided to be the best treatment for you then several steps are required to ensure the to most effective and safe results.

Step 2: Pre-Treatment Prep

Fiducial Placement- For cases outside of the brain, small gold markers called fiducials are often implanted into the tumor. This is performed much the same way a biopsy is done. This allows the robotic unit to track your tumor at all times during treatment.

Mask or Body Mold - A mask (brain tumor) or body mold might be made. The mold is used to help minimize movement during the treatment. The process is simple and painless.

Imaging - A CT scan is taken. The radiosurgeons will use the scan to identify the exact size, shape and location of the tumor along with the surrounding vital structures to be avoided. This CT scan speaks directly with the planning and treatment computer system. It can be combined with other images such as an MRI or PET scan to ensure the greatest ability to target the lesion.

Step 3: Treatment Planning

Once prep is completed and the anatomy has been defined, physicians and the team will use the CyberKnife System's state of-the-art software to determine the number, intensity and direction of the radiation beams the robot will send to the target. This planning procedure, which is completed after you have left the CyberKnife Center, will help ensure that a sufficient dose is administered to the tumor in order to destroy it while avoiding the adjacent healthy tissue.

Step 4: The Treatment

Arriving - Wear comfortable clothing and no jewelry. Bring a CD to listen to during your treatment.

Positioning - During the CyberKnife procedure, you will need to lie still. Generally, no sedation or anesthesia is used because the treatment is painless.

Painless Treatment, Verification & Targeting - The treatment itself involves the administration of radiation beams delivered from different directions. Prior to the delivery of each radiation beam, the image guidance system takes x-ray images and compares them to the original CT scan. This information is used to ensure the radiation is targeted directly at the tumor while avoiding critical structures. The whole treatment generally takes 30 minutes to 2 hours.

Completion - Patients usually leave the center and resume normal activity immediately following the treatment.

Follow-Up - Follow-up imaging is generally performed to monitor the tumor's progress. While waiting for your results, stay busy and keep a positive mental state of mind.


Conditions Treated By CyberKnife®

Skull
Base 		Head and
Neck 		Lung/
Thoraic		 Liver Pancreas Melanoma Intracranial Spine Kidney Prostate Recurrent Disease
Acoustic Neuroma Nasopharynx Tumors Primary, Metastatic
& Recurrent Cancers		 Primary &
Metastatic Cancer 		Primary or
Recurrent Cancer 		Primary, Metastatic or
Recurrent Cancer		 Trigeminal
Neuralgia 		Primary, Metastatic
& Recurrent Cancer 		Primary or
Recurrent Cancer		 Primary or
Recurrent Cancer		 Brain, Skeleton,
&
Soft Tissue
Cavernous Sinus Misc. Skull Base Tumors a a a a Astrocytomas a a a a
Parasellar Meningioma Recurrent Cancers a a a a Hemangioblastomas a a a a
Pituitary Adenoma a a a a a Craniopharyngiomas a a a a
Schwannoma a a a a a Meningioma a a a a
a a a a a a AVM a a a a
a a a a a a Metastasis a a a a


 
 
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