The CyberKnife is a frameless robotic radiosurgery system invented by John R. Adler, a Stanford University Professor of Neurosurgery and Radiation Oncology. The two main elements of the CyberKnife are (1) the radiation produced from a small linear particle accelerator and (2) a robotic arm which allows the energy to be directed at any part of the body from any direction.
The CyberKnife system is a method of delivering radiotherapy, with the intention of targeting treatment more accurately than standard radiotherapy.[1] It is not widely available, although the number of centres offering the treatment around the world has grown in recent years to over 150, particularly centered in the USA, Japan, the Far East, India and Europe - the first UK CyberKnife was opened at The Harley Street Clinic [1] in February 2009.
The CyberKnife system is sold by the company Accuray, located in Sunnyvale, California. The CyberKnife system is used for treating benign tumors, malignant tumors and other medical conditions.[2][3]
Robotic Mounting
The first is the fact that the radiation source is mounted on a precisely controlled industrial robot. The original CyberKnife used a Japanese Fanuc robot[4], however the more modern systems use a German KUKA KR 240.[5] Mounted on the Robot is a compact X-band linac that produces 6MV X-ray radiation. The linac is capable of delivering approximately 600 cGy of radiation each minute - a new 800 cGy / minute model was announced at ASTRO[6][7] 2007.
The radiation is collimated using fixed tungsten collimators (also referred to as “cones”) which produce circular radiation fields. At present the radiation field sizes are: 5, 7.5, 10, 12.5, 15, 20, 25, 30, 35, 40, 50 and 60 mm. ASTRO 2007 also saw the launch of the IRIS[7] variable-aperture collimator which uses two offset banks of six prismatic tungsten segments to form a blurred dodecagon field that is almost circular.
The IRIS replicates the fixed collimator sizes without the need for exchanging the fixed collimators. Mounting the radiation source on the robot allows complete freedom to position the radiation within a space about the patient. The robotic mounting allows very fast repositioning of the source, which enables the system to deliver radiation from many different directions in a feasibly short treatment time.
(Arip Nurahman)
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