The CyberKnife treatment procedure is quite similar to what is being done for
radiotherapy patients. It involves five steps:
1) Consultation with the Patient:
Consultation with the patient can be made by phone at which time an appointment
After it has been determined that the patient is eligible for CyberKnife
treatment, the patient proceeds to patient setup.
The Initial Consultation:
Radiation oncologist and other physicians determine if the size and types of
tumors or lesions could greatly benefit from treatment with CyberKnife. Varying
physicians address issues that differentiate between cranial and spine
treatments and those of other extracranial treatments. A treatment can be
scheduled at this time and may begin with a one-hour treatment only a few days
2) Patient Setup:
No head frame or body frame
is required for CyberKnife patient setups. The patient is fitted with custom-fit
foam body cradle or custom-fit plastic mask. Placement of small metal
may be required. This can often take place on the same day as a treatment.
For an intracranial lesion:
The radiation therapist will outfit the patient with a thermoplastic mask that
molds to the patient's face and keeps the patient's head immobile during
For a spinal lesion:
Either the neurosurgeon or the interventional radiologist will implant 3-5 small
stainless steel screws in or near the lesion. If the patient has a soft-tissue
lesion, the surgeon or interventional radiologist will implant 3-5 gold seed
markers in or near the lesion. The gold seed markers and stainless steel screws
are used by the CyberKnife Tracking System to track and locate the lesion.
For lung, liver, pancreatic lesions, or any lesion that moves with respiration,
the patient will be outfitted with the
Synchrony tracking vest.
Image acquisition (Diagnostic images of the lesion are
taken.) CT images are required but can be fused very quickly with
PET, and 3D Angio images. Once the
images are acquired, physicians easily and quickly outline the treatment volume
with the CyRIS InView Image Fusion and Contouring Station. Once the treatment
volumes are defined, the physicists generate the treatment plan to deliver on
the clinical objectives.
- It is fully optimized for full-body radiosurgery.
- The CyberKnife treatment planning system is very flexible and allows
images and contours between the CyberKnife System and other systems to be
sent and received.
- The CyberKnife treatment planning system generates a customized
treatment plan to meet the patient's clinical objectives. It generates a
customized plan to deliver hundreds of beams from many different angles to
cover the lesion with the dose but spare the surrounding healthy tissue.
4) Administering a Treatment:
CyberKnife assimilates and coordinates information as it moves in 50 to 100
positions, administering the dose of radiation.
View Animation of treatment
The CyberKnife system continually tracks patient and lesion movement and
delivers hundreds of different beams from different angles to ablate the lesion
but spare healthy tissue.
5) Follow-up Visit:
After the treatment or series of treatments are administered, the patient
returns three to six months later for a visit to determine progress. Evaluation
is often accessed with an MRI,
which can be done at this time.