CyberKnife® Fact Sheet

The CyberKnife® System is the world’s first and only robotic radiosurgery system designed to treat tumors anywhere in the body with sub-millimeter accuracy.

How it Works

Scanning: Prior to treatment with the CyberKnife System, the patient undergoes imaging procedures to determine the size, shape and location of the tumor. The process begins with a standard high-resolution CT scan, or for certain tumors other imaging techniques, such as MRI, angiography or PET, may also be used. The CyberKnife treatment planning software helps integrate CT scans and other imaging data into the pre-treatment planning process.

Planning: Following the scanning, the image data is then digitally transferred to the CyberKnife System's treatment planning workstation, where the treating physician identifies the exact size, shape and location of the tumor to be targeted and the
surrounding vital structures to be avoided. A qualified physician and/or radiation oncologist or physicist then uses the CyberKnife software to generate a treatment plan to provide the desired radiation dose to the identified tumor location while avoiding damage to the surrounding healthy tissue. As part of the treatment plan, the CyberKnife System’s proprietary planning software automatically determines the number, duration and angles of delivery of the radiation beams.

Treatment: During a CyberKnife procedure, a patient lies comfortably on the treatment table, which automatically positions the patient. Anesthesia is not required, as the procedure is painless and non-invasive. The treatment, which generally lasts between 30 and 90 minutes, typically involves the administration of between 100 and 200 radiation beams delivered from different directions, each lasting from 10 to 15 seconds. Prior to the delivery of each beam of radiation, the CyberKnife System simultaneously takes a pair of X-ray images and compares them to the original CT scan. This image guided approach continually tracks, detects and corrects for any movement of the patient and tumor throughout the treatment to ensure precise targeting. The patient typically leaves the facility immediately upon completion of the procedure.

Follow-up: Follow-up imaging, generally with either CT or MRI, is usually performed in the weeks and months following the treatment to confirm the destruction and eventual elimination of the treated tumor.

Key Advantages

  • Treats tumors anywhere in the body
  • Continually tracks, detects and corrects for tumor and patient movement throughout the treatment
  • Delivers high-dose radiation with sub-millimeter accuracy, minimizing damage to surrounding healthy tissue
  • Treats tumors from virtually unlimited directions with flexible robotic mobility
  • Provides an option for patients diagnosed with previously inoperable or surgically complex tumors
  • Treats patients in as few as one to five visits
  • Improves patients quality of life during and after treatment
    • Non-invasive alternative to surgery
    • Pain free and requires no anesthesia
    • Minimal side effects
    • Outpatient procedure with little or no recovery time
    • Allows for an immediate return to normal activities

Clinical Validation

To date, more than 40,000 patients worldwide have been treated by the CyberKnife Robotic Radiosurgery System. Since July 2006, more than 50 percent of all CyberKnife procedures in the United States were extracranial. More than 250 peer-reviewed papers support the CyberKnife System in clinical practice.

Key Components

Compact X-band linear accelerator: The proprietary compact X-band linear accelerator, the component that generates the radiation that destroys the tumor, is smaller and weighs significantly less than standard medical linear accelerators ypically used in radiation therapy. This compact lightweight design allows it to be mounted directly to a robotic manipulator.

Robotic manipulator: The manipulator arm, with six-degrees-of-freedom range of motion, is designed to move and direct the linear accelerator with an extremely high level of precision and repeatability, allowing doses of radiation to be delivered from nearly any direction. This flexibility enhances the ability to diversify beam paths and beam entrance and exit points, helping to minimize risks of radiation damage to healthy cells near the tumor. Furthermore, the rapid response time of the manipulator arm allows tracking of tumors that move with respiration in real-time.

Real-time image: guidance system with continuous target tracking and feedback – Real-time image-guided robotics enables the CyberKnife System to continually track, detect and correct for tumor and patient movement throughout the entire treatment without the need for clinician intervention.

Image detectors: The image detectors capture high-resolution anatomical images throughout the treatment. These live images are continually compared to previously captured digitally reconstructed radiographs to determine real-time patient ositioning. Based on this information, the robotic manipulator instantly corrects for any detected movement.

X-ray sources: The low-energy X-ray sources generate X-ray images to determine the location of bony landmarks throughout the entire treatment. Both the X-ray sources and image detectors are rigidly mounted to the room to ensure the highest degree of accuracy.

Additional Technologies

Synchrony® Respiratory Tracking System: Continually synchronizes beam delivery to the motion of tumors affected by respiration, such as those in the lung, liver and pancreas, without breath-holding or gating techniques. Unlike traditional radiation therapy, the Synchrony System enables patients to breathe normally throughout their treatment while maintaining extreme accuracy and minimizing damage to surrounding healthy tissue.

RoboCouch® Patient Positioning System: Robotically aligns patients precisely with six degrees of freedom, reducing patient setup times and enabling faster treatments.

Xsight® Spine Tracking System: Eliminates the need for surgical implantation of fiducials by using the bony anatomy of the spine to automatically locate and track tumors, making radiosurgery less invasive along the spinal column.

Xsight® Lung Tracking System: Tracks the movement of lung tumors directly, without fiducials, with precision and reliability.

Xchange™ Robotic Collimator Changer: Automatically exchanges collimators robotically,
maintaining highly conformal treatments delivered more efficiently.

4D Treatment Optimization and Planning System: Takes into account not only the movement of the target but also the movement and deformation of the surrounding tissue, optimizing the treatment of tumors that move with respiration.

MultiPlan® Treatment Planning System: This intuitive workflow-based workstation designed specifically for CyberKnife radiosurgery, enables the creation of plans that have excellent conformality and coverage with steep dose gradients.

InView® Image Fusion and Contouring Station: The InView Image Fusion and Contouring Station offers physicians the flexibility of working in remote locations providing efficiency and ease of use by combining ultra-fast image fusion technology and contouring tools.