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TU‐E‐213A‐03: Everything You Need to Know About the Cyberknife, But Were Afraid to Ask
Author(s) -
MastersonMcGary M
Publication year - 2009
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.3182438
Subject(s) - cyberknife , computer science , radiosurgery , payload (computing) , quality assurance , medical physics , robot , radiation treatment planning , nuclear medicine , artificial intelligence , radiation therapy , medicine , radiology , computer network , external quality assessment , pathology , network packet
The CyberKnife (Accuray, Inc. Sunnyvale, CA) is a stereotactic radiotherapy unit, designed to treat both intracranial and extracranial targets with sub‐millimeter spatial accuracy. An industrial robot has a compact 6 MV x‐band linac as its payload. The robot is able to orient the linac with six degrees of freedom, and to aim its x‐ray beam at the target volume in a non‐isocentric and non‐coplanar fashion. Typically, hundreds of beams (selected from thousands of possible beam angles) are delivered during each treatment fraction. A bi‐plane digital radiography system determines and feeds‐back target position coordinates to the robot throughout treatment, allowing the robot to continuously correct its aim to account for intra‐fraction patient and target movement. The CyberKnife uses several different tracking methodologies depending upon the type of target being treated. Both rigid body and deformable body geometries are employed. Special correlative tracking techniques have been developed to track targets that move with respiration. With nearly real‐time correction for target motion and highly precise dose delivery, the CyberKnife allows the practitioner to employ tighter margins and to deliver high doses per fraction accurately. This talk is intended to review the unique features of the CyberKnife system, and to discuss how those features require special considerations in site planning, acceptance testing, commissioning, quality assurance, treatment planning, and clinical implementation. Examples of common clinical applications and dose regimens will also be presented. Learning Objectives: 1. Understand the fundamental design and functionality of the CyberKnife system. 2. Understand the impact of machine design on site planning, acceptance testing, commissioning, treatment planning, as well as system and sub‐system quality assurance. 3. Understand the different clinical considerations associated with robotic SRS and SBRT. 4. Enable the attendee to introduce a CyberKnife system into his/her clinical practice efficiently, effectively, and safely.