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How Does it Work?

Introduction

Of the many radiation therapy treatment options available, the Cyberknife system distinguishes itself by offering new treatment possibilities. Its main feature is its ability to bring frameless radiosurgery to not only lesions within the skull, but also to the rest of the body. Among its advantages with other systems, is its capability to treat a spine lesion by tracking its vertebral body, treating moving targets by tracking and modeling the movement of the fiducial(s) implanted within the target. Furthermore, it delivers collimated beams of radiation with sterotactic accuracy based on the complex plans designed by the physicist and attending. In comparison to frame based systems, these capabilities increase patient comfort and treatment options.

The company that manufactors the Cyberknife system is located on the internet at: http://www.accuray.com

Common treatment sites, but not limited to:

  1. Skull: Acoustic neuroma, trigeminal neuralgia, metastasis, arteriovenous malformations (AVM), brain metastasis.
  2. Chest: Lung
  3. Abdomen: Liver, Kidney, Pancreas
  4. Pelvis: Prostate
  5. Spine

Cyberknife System Tracking Modalities:

Skull Tracking

This treatment modality allows the frameless (non invasive) treatment of brain lesions based on the planar x-ray images of the patient's skull.

XSight Spine

This treatment modality allows the treatment of vertebral bodies or para-spinal lesions based on planar x-ray images of their bony anatomy.

XSight Lung

This treatment modality allows the treatment of lung lesions based on their outline within the x-ray images. This modality is advantageous for the treatment of lung lesions because it does not require the implant procedure of the fiducial gold markers. Although it is capable to track the lesion with respiration it is limited to lung lesions.

Fiducial tracking

Fiducials are gold markers used as reference points for treatment delivery during treatment. This type of treatment is used for lesions that do not move with respiration and are outside the skull or spine.

Synchrony

The advantage of the Synchrony modality is that it allows the system to accurately track implanted gold markers throughout their movement with respiration.

Cyberknife Treatment Devices

Kuka Robot

Fixed Collimator

Iris Variable Aperture

The Iris Variable Aperture collimator further decreases treatment delivery time, while improving the treatment planning process. These major advantages results from its capacity to automatically change its collimator sizes to those dictated by the treatment plan from every single treatment position. Prior to Iris, if more than one collimator was required for a set of treatment positions, the system would treat through all the set's treatment positions with the 1st collimator; the radiation therapist replaced the collimator, and then the machine would repeat from the start through the set of treatment positions with the 2nd fixed collimator. Also, prior to the Iris Variable Aperture system, the physicist would be limited to 3 collimator sizes per set of treatment positions. With the Iris, all 12 collimator sizes are available to be used from any treatment position. This reduces patient time on the treatment table while improving the fulfillment of the radiation oncologist's treatment objectives. Imaging System

Diagnostic x-ray tubes

Amorphous Silicon Detectors

X-Change Table

Camera Array

Led Light Emitters for Synchrony Vest

Contact Information

Keith C. Field CyberKnife Center
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-2345