Frameless image-guided intracranial and extracranial radiosurgery using the Cyberknife™ robotic system

The Cyberknife™ is an image-guided robotic radiosurgery system. The image guidance system includes a kilovoltage X-ray imaging source and amorphous silica detectors. The radiation delivery device is a mobile X-band linear accelerator mounted onto a robotic arm. Through a highly complex interplay between the image guidance system, an automated couch, and the high-speed linear accelerator, near real-time tracking of the target is achieved. The Cyberknife™ gained Federal Drug Administration clearance in the United States in 2001 for treatment of tumors “anywhere in the body where radiation treatment is indicated.” Because the Cyberknife™ system does not rely on rigid fixation of a stereotactic frame, tumors outside of the intracranial compartment, even those tumors that move with respiration can be treated with a similar degree of ease as intracranial targets. A description of the Cyberknife™ technology and a review of some of the current intracranial and extracranial applications are detailed herein.