The cyberknife in clinical use: Current roles, future expectations

Sonja Dieterich, Iris C. Gibbs

Research output: Chapter in Book/Report/Conference proceedingChapter

51 Citations (Scopus)

Abstract

The CyberKnife system deploys a linac mounted on an agile robot and directed under image guidance for stereotactic radiotherapy using nonisocentric beam delivery. A design advantage of the CyberKnife system is its method of active image guidance during treatment delivery. Recent developments in the hardware and software of the system have significantly enhanced its functionality: (a) an optimized path traversal process significantly reduces the robot motion time, resulting in reductions of overall treatment times of at least 5-10 min; (b) to optimize the accuracy of dose calculation in CyberKnife planning/delivery, Monte Carlo algorithms have been introduced; (c) the new IRIS collimator reduces the monitor units required, increases treatment speed and improves conformality and homogeneity of treatment plans; (d) XSight lung tracking, an algorithm for fiducial- less lung tracking, has been developed for peripheral, radio-dense lung tumors with diameters 1 15 mm; and (e) a sequential optimization planning process incorporates a more flexible approach to optimize the multiple, complex treatment planning criteria used today. The clinical efficacy of CyberKnife radiosurgery for brain/head lesions such as metastases, arteriovenous malformations, acoustic neuromas and meningiomas is well established. Since there is no need for skeletal fixation with the CyberKnife, radiosurgery can be applied to targets beyond the brain, and the technology has been extensively used for stereotactic body radiotherapy, treating targets in many anatomic sites. Currently, clinical studies have been completed or are ongoing for common malignancies including tumors involving the spine, lung, pancreas, liver and prostate.

Original languageEnglish (US)
Title of host publicationIMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition
PublisherS. Karger AG
Pages181-194
Number of pages14
ISBN (Electronic)9783805596817
ISBN (Print)9783805596800
DOIs
StatePublished - May 27 2011
Externally publishedYes

Fingerprint

lungs
Radiosurgery
planning
delivery
Lung
brain
radiation therapy
tumors
robot dynamics
Therapeutics
pancreas
Neoplasms
Fracture Fixation
spine
Acoustic Neuroma
Arteriovenous Malformations
Brain
Meningioma
metastasis
collimators

ASJC Scopus subject areas

  • Medicine(all)
  • Physics and Astronomy(all)

Cite this

Dieterich, S., & Gibbs, I. C. (2011). The cyberknife in clinical use: Current roles, future expectations. In IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition (pp. 181-194). S. Karger AG. https://doi.org/10.1159/000322423

The cyberknife in clinical use : Current roles, future expectations. / Dieterich, Sonja; Gibbs, Iris C.

IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition. S. Karger AG, 2011. p. 181-194.

Research output: Chapter in Book/Report/Conference proceedingChapter

Dieterich, S & Gibbs, IC 2011, The cyberknife in clinical use: Current roles, future expectations. in IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition. S. Karger AG, pp. 181-194. https://doi.org/10.1159/000322423
Dieterich S, Gibbs IC. The cyberknife in clinical use: Current roles, future expectations. In IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition. S. Karger AG. 2011. p. 181-194 https://doi.org/10.1159/000322423
Dieterich, Sonja ; Gibbs, Iris C. / The cyberknife in clinical use : Current roles, future expectations. IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition. S. Karger AG, 2011. pp. 181-194
@inbook{529a6c5b835c4d148b18cd28746cef22,
title = "The cyberknife in clinical use: Current roles, future expectations",
abstract = "The CyberKnife system deploys a linac mounted on an agile robot and directed under image guidance for stereotactic radiotherapy using nonisocentric beam delivery. A design advantage of the CyberKnife system is its method of active image guidance during treatment delivery. Recent developments in the hardware and software of the system have significantly enhanced its functionality: (a) an optimized path traversal process significantly reduces the robot motion time, resulting in reductions of overall treatment times of at least 5-10 min; (b) to optimize the accuracy of dose calculation in CyberKnife planning/delivery, Monte Carlo algorithms have been introduced; (c) the new IRIS collimator reduces the monitor units required, increases treatment speed and improves conformality and homogeneity of treatment plans; (d) XSight lung tracking, an algorithm for fiducial- less lung tracking, has been developed for peripheral, radio-dense lung tumors with diameters 1 15 mm; and (e) a sequential optimization planning process incorporates a more flexible approach to optimize the multiple, complex treatment planning criteria used today. The clinical efficacy of CyberKnife radiosurgery for brain/head lesions such as metastases, arteriovenous malformations, acoustic neuromas and meningiomas is well established. Since there is no need for skeletal fixation with the CyberKnife, radiosurgery can be applied to targets beyond the brain, and the technology has been extensively used for stereotactic body radiotherapy, treating targets in many anatomic sites. Currently, clinical studies have been completed or are ongoing for common malignancies including tumors involving the spine, lung, pancreas, liver and prostate.",
author = "Sonja Dieterich and Gibbs, {Iris C.}",
year = "2011",
month = "5",
day = "27",
doi = "10.1159/000322423",
language = "English (US)",
isbn = "9783805596800",
pages = "181--194",
booktitle = "IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition",
publisher = "S. Karger AG",

}

TY - CHAP

T1 - The cyberknife in clinical use

T2 - Current roles, future expectations

AU - Dieterich, Sonja

AU - Gibbs, Iris C.

PY - 2011/5/27

Y1 - 2011/5/27

N2 - The CyberKnife system deploys a linac mounted on an agile robot and directed under image guidance for stereotactic radiotherapy using nonisocentric beam delivery. A design advantage of the CyberKnife system is its method of active image guidance during treatment delivery. Recent developments in the hardware and software of the system have significantly enhanced its functionality: (a) an optimized path traversal process significantly reduces the robot motion time, resulting in reductions of overall treatment times of at least 5-10 min; (b) to optimize the accuracy of dose calculation in CyberKnife planning/delivery, Monte Carlo algorithms have been introduced; (c) the new IRIS collimator reduces the monitor units required, increases treatment speed and improves conformality and homogeneity of treatment plans; (d) XSight lung tracking, an algorithm for fiducial- less lung tracking, has been developed for peripheral, radio-dense lung tumors with diameters 1 15 mm; and (e) a sequential optimization planning process incorporates a more flexible approach to optimize the multiple, complex treatment planning criteria used today. The clinical efficacy of CyberKnife radiosurgery for brain/head lesions such as metastases, arteriovenous malformations, acoustic neuromas and meningiomas is well established. Since there is no need for skeletal fixation with the CyberKnife, radiosurgery can be applied to targets beyond the brain, and the technology has been extensively used for stereotactic body radiotherapy, treating targets in many anatomic sites. Currently, clinical studies have been completed or are ongoing for common malignancies including tumors involving the spine, lung, pancreas, liver and prostate.

AB - The CyberKnife system deploys a linac mounted on an agile robot and directed under image guidance for stereotactic radiotherapy using nonisocentric beam delivery. A design advantage of the CyberKnife system is its method of active image guidance during treatment delivery. Recent developments in the hardware and software of the system have significantly enhanced its functionality: (a) an optimized path traversal process significantly reduces the robot motion time, resulting in reductions of overall treatment times of at least 5-10 min; (b) to optimize the accuracy of dose calculation in CyberKnife planning/delivery, Monte Carlo algorithms have been introduced; (c) the new IRIS collimator reduces the monitor units required, increases treatment speed and improves conformality and homogeneity of treatment plans; (d) XSight lung tracking, an algorithm for fiducial- less lung tracking, has been developed for peripheral, radio-dense lung tumors with diameters 1 15 mm; and (e) a sequential optimization planning process incorporates a more flexible approach to optimize the multiple, complex treatment planning criteria used today. The clinical efficacy of CyberKnife radiosurgery for brain/head lesions such as metastases, arteriovenous malformations, acoustic neuromas and meningiomas is well established. Since there is no need for skeletal fixation with the CyberKnife, radiosurgery can be applied to targets beyond the brain, and the technology has been extensively used for stereotactic body radiotherapy, treating targets in many anatomic sites. Currently, clinical studies have been completed or are ongoing for common malignancies including tumors involving the spine, lung, pancreas, liver and prostate.

UR - http://www.scopus.com/inward/record.url?scp=84960321141&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960321141&partnerID=8YFLogxK

U2 - 10.1159/000322423

DO - 10.1159/000322423

M3 - Chapter

C2 - 21625154

AN - SCOPUS:79958192161

SN - 9783805596800

SP - 181

EP - 194

BT - IMRT, IGRT, SBRT: Advances in the Treatment Planning and Delivery of Radiotherapy: Second Edition

PB - S. Karger AG

ER -