CyberKnife: Clinical information
How it works |
What to expect |
Information for physicians |
Our team
Information for physicians
CyberKnife system features
The CyberKnife is the world's first and only full-body radiosurgery
system. It combines real-time image guidance throughout treatment, unique
Dynamic Motion Tracking™ and full-time robotics technology to treat tumors
and lesions that were formerly inoperable. CyberKnife system features
include:
Compact linear accelerator with express™
The compact X-band linear accelerator emits circular beams with secondary
collimation ranging from 5mm to 60mm. This compact, lightweight system
produces pencil-shaped beams of radiation that can be precisely delivered in
almost any direction. This allows for superior conformality when treating
patients.
Robotic manipulator
The CybeKnife's high-precision robotic manipulator is made by Kuka®, one of
the world's leading manufacturers of robots. The robot is capable of
delivering a repeatability accuracy of less than 0.2mm.
X-Ray sources
Low-energy x-ray sources generate two perpendicular, oblique, diagnostic
x-rays that locate bony landmarks or implanted radiopaque markers throughout
the treatment process.
Image detectors
High-resolution image detectors capture x-ray images and generate digital
images of the patient's anatomy. New images are captured throughout
treatment and are compared to the digitally reconstructed radiographs (DRRs)
generated from the CT scans used in treatment planning. The imaging system
then corrects for changes in the patient's position by sending a command to
the robotic manipulator.
AXUM™ treatment couch
The AXUM Automatic Patient Positioning System automatically and accurately
aligns patients in one simple step, significantly reducing patient set-up
times and increasing patient throughput.
Synchrony™ respiratory tracking system
The Synchrony Respiratory Tracking System is the first technology in the
world capable of delivering dynamic radiosurgery to targets that move with
respiration. The CyberKnife system synchronizes the Robotic Delivery System
with motion of the tumor, so margins of less than one millimeter are needed
to compensate for respiration.
CyberKnife treatment planning system
The CyberKnife Treatment Planning System uses inverse and conformal planning
techniques, which capitalize on the strengths of the system's unique
delivery model.
Treatment planning
The CyberKnife's unique maneuverability offers the clinician a wider
range of treatment options than conventional stereotactic radiosurgery
devices. The treatment planning system is designed to support the clinician
in determining the optimal treatment plan of individual patients, including
beam weight, targeting positions, dose distributions and more.
Only the CyberKnife system offers all these planning and delivery
options:
- Inverse planning
- Non-isocentric delivery
- Hypofractionation
The system is based on CT scanning. MR images can be fused with the CT to
provide optimal information on soft tissue as well as skeletal anatomy. CT
angiography — injection of a contrast medium to demonstrate flow of fluid or
blockage — is specifically useful in the treatment of arteriovenous
malformations.
Patient immobilization
The CyberKnife system is the only stereotactic radiosurgery system that
uses the body's skeletal structure as a reference frame. Depending on the
area being treated by the CyberKnife system, the cranium or small implanted
fiducials serve as the reference frame in current clinical applications.
With conventional stereotactic radiosurgery devices, the patient is
fitted with a rigid, stereotactic frame prior to scanning. This instrument
provides fiducial reference points for localization, as well as a means of
immobilization during treatment. Immobilization is necessary to maintain a
constant spatial relationship between the lesion and the radiation source to
ensure accurate dose delivery. The patient wears the frame throughout the
treatment process.
Elimination of the frame was a key factor in the development of the
CyberKnife system. The use of a rigid stereotactic frame presents several
drawbacks in treatment:
- It can cause pain for the patient
- It limits the use of fractionation
- Fixation of the frame requires the use of some form of anesthesia
and additional medical resources
To limit large movements, the patient may be fitted with a non-invasive
flexible mesh mask. The CyberKnife system can also be adapted for use with a
frame if the clinician prefers.
Localization
With the CyberKnife system, advanced image guidance technology tracks the
target throughout treatment. The system repeatedly confirms target location
in relationship to skeletal structure by processing radiographic images and
correlating them to previously obtained CT scans. The imaging cameras detect
any patient movement, and the CyberKnife system's linac is repositioned very
accurately with respect to the target.
The CyberKnife system's use of stereotaxy for tumor localization differs
from conventional stereotactic radiosurgery devices in several ways:
- The CyberKnife uses true image guidance technology
- The CyberKnife utilizes the skeletal structure of the body as its
reference frame, eliminating the need for an invasive frame
- The CyberKnife continually monitors and adjusts for patient movement
during treatment
Treatment delivery
The CyberKnife system has several technological features that provide
unmatched maneuverability in targeting tumors and lesions, including:
- Compact 6-MV linear accelerator
- Computer-controlled robotic arm with six degrees of freedom
- Image guidance technology that eliminates the need for a rigid
stereotactic frame and enables treatment of extra-cranial sites
When compared to conventional radiosurgery devices, the CyberKnife offers
the advantage of:
- Increased access to and coverage of target volume
- Broader range of clinical applications, including:
- Lesions in and around the cranium that are unreachable with other
systems
- Enhanced ability to avoid critical structures
- Lesions in the neck and spine
- Larger tumors
- Otherwise inoperable tumors
- Lesions throughout the body
- Highly conformal dose distributions
- Option of fractionated treatments
- Option of targeting multiple tumors, in different locations, during
a single treatment imaging and physician consultation are required to
monitor your progress
CyberKnife treatment team at Aurora St. Luke's Medical Center is led by
Kenneth Bastin, MD.
|
