Demystifying CyberKnife Stereotactic Body Radiation Therapy for Interventional Radiologists

Abstract

Stereotactic body radiation therapy (SBRT) using CyberKnife system is a relatively new radiation therapy that has demonstrated feasibility, safety, and efficacy with a high local control of various extracranial unresectable primary cancer and oligometastasis. It involves accurate delivery of very high dose of radiation to the target or tumor volume with high precision and conformity, while minimizing the radiation exposure of nontargeted tissue. Radiopaque fiducial markers (FMs) implantation in and around the tumors is required to track the selected tumor during CyberKnife SBRT, especially in those organs moving with respiration. They act as internal radiographic landmarks that maintain a fixed relationship within the tumor and with each other. Although their implantation can be technically demanding, it can be performed using various techniques with varying success; however, percutaneous implantation under image guidance by interventional radiologists is the most common method. Close collaboration between interventional radiologists and radiation oncologists with understanding of the technical aspects of CyberKnife SBRT and FMs implantation has important implications for optimal delivery of therapy and direct impact on the interventional radiology practice in selected patients proposed for CyberKnife SBRT.

Prediction of the motion of chest internal points using a recurrent neural network trained with real-time recurrent learning for latency compensation in lung cancer radiotherapy

“…Such signals may be the position of internal or external markers. Internal fiducial markers are small metallic objects implanted in the lung, close to the tumor, prior to the radiotherapy treatment, and whose position can be measured by fluoroscopic imaging systems, such as CyberKnife's orthogonal X-ray imaging sources and flatpanel detectors [7]. In contrast, external fiducial markers are objects attached to the patient's chest whose position can be recorded using an infrared tracking system.…”

Prediction of the Position of External Markers Using a Recurrent Neural Network Trained With Unbiased Online Recurrent Optimization for Safe Lung Cancer Radiotherapy

“…To overcome this problem, the position of external markers placed on the chest and abdomen can be recorded by infrared cameras (e.g. Cyberknife system [14] in Fig. 1).…”

Urine microbiome changes during and after radiotherapy for prostate cancer

“…Modern radiotherapy technologies allow for precise irradiation in the lower abdomen and pelvis such as prostate cancer, bladder cancer, cervical cancer, anal cancer, limiting the impact on surrounding tissues (1) . But still, radiotherapy not only treats the cancer but also irradiates nearby other anatomical structures such as the urinary tract or intestines, where some early and late side effects are often observed (2,3) .…”