Depending on your specific case and treatment site, the following
appointments may be necessary. It is very important that you keep them all
and arrive as scheduled. For all of these appointments, please wear
comfortable clothing.
Fiducial Placement
For treatment sites below the neck, it may be necessary to place gold markers (also called fiducials) into the tumor. Through these markers, the Cyberknife System will track the tumor's position during treatment. The markers will be placed in an outpatient area at the medical center or by a surgeon in the operating room. Your CK nurse will let you know when and where your markers will be placed. For many of these procedures, you may need sedative medication when the markers are placed, and therefore you will need someone to drive you home after this appointment.
Once these markers are implanted, they need to "sit" for a minimum of one week before the next phases of your appointments may begin.
Magnetic Resonance Imaging (MRI)
For patients with conditions involving the head, neck, or spine, magnetic
resonance imaging (MRI) may need to be done as part of the treatment
planning process. MRI provides the physician with a detailed look at the
target as well as surrounding structures. MRI uses a strong magnetic field
and radio waves to make images of areas of interest inside of the body. MRI
does not use X-rays (radiation).
Your MRI will be done at one of our
radiology department sites. During your MRI, a special dye will be injected into a vein, usually
through an intravenous (IV) line in your arm. A new IV may be needed even
if you have a long-term intravenous device, such as a port-a-cath or PICC
line. Be sure to tell your CyberKnife nurse and others treating you if you
have ever had an allergic reaction to X-ray dye or to shellfish in the
past, or if you have any other drug or medication allergies. Tell someone
even if you think this information is already in your record. This is for
your safety.
Treatment Simulation
A
Computer Tomography (CT)
simulation session is required and is done on the fifth floor of the
Shapiro Clinical Center at BIDMC. For CyberKnife treatments involving the
head or neck areas, the CT simulation therapist will position you on the CT
table with a custom-fit flexible plastic mask. For other regions of the
body, the CT simulation therapist may position you within a custom-fit body
mold. The custom fit mask and body mold are used to maintain you
comfortable and still throughout your CyberKnife treatment.
Upon completion of your positioning on the CT table, a CT scan is done.
This CT data is downloaded into the CyberKnife planning computer, where
your physician and a member of the physics staff will develop your
CyberKnife treatment plan.
You may be given special instructions if you have to avoid eating or drinking before your CT scan. During your CT scan, a contrast dye may be used. Again, please be sure to let members of your treatment team know if you have an allergy to dye or to any other substance, even if you think this information is in your chart.
The entire CT simulation session should take about two hours. You will be given a folder with important information about your CyberKnife treatments. Please make sure you take this folder home with you and keep it handy.
