CyberKnife: A new paradigm in radiotherapy

Gopalakrishna, Kurup

doi:10.4103/0971-6203.62194

Cited by 46 publications

(43 citation statements)

References 7 publications

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“…Stereotactic radiosurgery (SRS) is a radiation therapy treatment frequently used to treat benign and malignant intracranial lesions in a single or few high dose fractions with highly precise dose placement, and its clinical use has been growing in recent years (Harrison et al, 2014; Kamath et al, 2005; Kurup, 2010; Loeffler and Alexander, 1990). In order to prevent complications to nearby critical structures such as nerves or other vascular regions, well-planned SRS employs a steep dose fall-off around the target volume.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, immobilization from thermoplastic masks can still be uncomfortable and highly restrictive. To address these issues, some solutions consider tracking the patient and altering the radiation source position to respond to their motion (Bichay and Mayville, 2016; Kurup, 2010). Another widespread approach uses external camera tracking systems, often with occasional internal snapshots for position verification, and beam gating to ensure proper dose coverage (Dhabaan et al, 2012; Goyal and Kataria, 2014; Jia et al, 2015; Li et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Towards frameless maskless SRS through real-time 6DoF robotic motion compensation

Belcher¹,

Liu²,

Chmura³

et al. 2017

Phys. Med. Biol.

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Purpose Stereotactic radiosurgery (SRS) uses precise dose placement to treat conditions of the CNS. Frame-based SRS uses a metal head ring fixed to the patient’s skull to provide high treatment accuracy, but patient comfort and clinical workflow may suffer. Frameless SRS, while potentially more convenient, may increase uncertainty of treatment accuracy and be physiologically confining to some patients. By incorporating highly precise robotics and advanced software algorithms into frameless treatments, we present a novel frameless and maskless SRS system where a robot provides real-time 6DOF head motion stabilization allowing positional accuracies to match or exceed those of traditional frame-based SRS. Methods A 6DOF parallel kinematics robot was developed and integrated with a real-time infrared camera in a closed loop configuration. A novel compensation algorithm was developed based on an iterative closest-path correction approach. The robotic SRS system was tested on six volunteers, whose motion was monitored and compensated for in real-time over 15-minute simulated treatments. The system’s effectiveness in maintaining the target’s 6DOF position within preset thresholds was determined by comparing volunteer head motion with and without compensation. Results Comparing corrected and uncorrected motion, the 6DOF robotic system showed an overall improvement factor of 21 in terms of maintaining target position within 0.5 mm and 0.5 degree thresholds. Although the system’s effectiveness varied among the volunteers examined, for all volunteers tested the target position remained within the preset tolerances 99.0% of the time when robotic stabilization was used, compared to 4.7% without robotic stabilization. Conclusion The pre-clinical robotic SRS compensation system was found to be effective at responding to sub-millimeter and sub-degree cranial motions for all volunteers examined. The system’s success with volunteers has demonstrated its capability for implementation with frameless and maskless SRS treatments, potentially able to achieve the same or better treatment accuracies compared to traditional frame-based approaches.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Towards frameless maskless SRS through real-time 6DoF robotic motion compensation

Belcher¹,

Liu²,

Chmura³

et al. 2017

Phys. Med. Biol.

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“…PTV depth does not affect collimator design, as the patient will be positioned such that the center of the PTV is at isocenter. Since the diameter of the collimator apertures is dependent on PTV size, several collimators will be needed and collimators will be exchanged depending on the needs of the treatment, similar to early CyberKnife TM systems …”

Section: Methodsmentioning

confidence: 99%

Inverse optimization of low‐cost kilovoltage x‐ray arc therapy plans

Breitkreutz¹,

Renaud

Seuntjens

et al. 2018

Medical Physics

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“…CyberKnife ® (Accuray Incorporated, Sunnyvale, CA, USA), in contrast, enables the delivery of a focused dose concentration to tumours while allowing a steep decrease in dose to nearby OARs (Bondiau et al . ; Kurup ; Scalchi et al . ; Thariat et al .…”

Section: Introductionmentioning

confidence: 99%

Clinical observation on the efficacy of CyberKnife for primary or metastatic retroperitoneal tumours

Zhuang

Song

Wang

et al. 2013

Eur J Cancer Care (Engl)

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The aim of the paper is to evaluate the efficacy of CyberKnife® for the treatment of primary or metastatic retroperitoneal tumours. Twenty-eight patients were treated. The prescription isodose line (median, 78%; range, 70-84%) covered the planning target volume at a total dose of 2000-6000 cGy (median, 4500 cGy) and a biologically effective dose of 3750-10,080 cGy (median, 7680 cGy) in 2-10 fractions (median, five fractions). The results showed that the complete response, partial response, stable disease, and progressive disease rates were 43% (12/28), 36% (10/28), 18% (5/28), and 4% (1/28) respectively. The overall response rate was 96%. The 1-, 2- and 3-year local control rates were 92%, 86%, and 86% respectively. The 1-, 2- and 3-year overall survival rates were 60%, 49%, and 49% respectively. No significant difference was found between local progression-free survival and overall survival. Moreover, if a patient only had metastases in the retroperitoneum and local control was effective, there was no significant difference between local progression-free survival and overall progression-free survival. In conclusion, CyberKnife treatment for retroperitoneal tumours resulted in high response rates with minimal side effects. All radiation-induced side effects were well tolerated.

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CyberKnife: A new paradigm in radiotherapy

Cited by 46 publications

References 7 publications

Towards frameless maskless SRS through real-time 6DoF robotic motion compensation

Towards frameless maskless SRS through real-time 6DoF robotic motion compensation

Inverse optimization of low‐cost kilovoltage x‐ray arc therapy plans

Clinical observation on the efficacy of CyberKnife for primary or metastatic retroperitoneal tumours

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