Abstract
The latest addition to the CyberKnife product family, which was released in September 2009. This review updates the previous technical reviews of the original system version published in the late 1990s. There is a clear dose response for localized prostate cancer radiotherapy and there probablyis a radiobiological rationale for hypo-fractionation. Combining the two should maximize tumor control and increase the therapeutic ratio. Technical developments over the last decade have impacted virtually every aspect of the CyberKnife System. These developments have increased the geometric accuracy of the system and have enhanced the dosimetric accuracy and quality of treatment, with advanced inverse treatment planning algorithms, rapid Monte Carlo dose calculation, and post-processing tools that allow trade-offs between treatment efficiency and dosimetric quality to be explored. The CyberKnife can produce superior DVHs for sparing of rectum and bladder and excellent DVHs for target coverage compared with IMRT, and possesses dose heterogeneities to the same degree as IMRT plans.
 Keywords: CyberKnife System; Radiosurgery; Stereotactic Body Radiation Therapy; Hypofractionation; IMRT Hetrogeneities
Highlights
The CyberKnife® Robotic Radiosurgery System has undergone nearly twenty years of technical development from its conception [1] to its most current type, the CyberKnife VSITM System, the first of which was installed in April 2010
The CyberKnife combines two systems: a compact, unimportant linear accelerator mounted on a robotic arm that sends the radiation to the patient and an image guidance system that tracks the tumor's location within the body in real time to direct the radiation to the precise location where it is needed and adjusting the beam within millimeter tolerance up to 100 or more times during each treatment session
The robotic arm that delivers the radiation is so maneuverable that physicians may treat a lesion from up to 1600 non-coplanar aiming angles
Summary
The CyberKnife® Robotic Radiosurgery System has undergone nearly twenty years of technical development from its conception [1] to its most current type, the CyberKnife VSITM System, the first of which was installed in April 2010. The CyberKnife combines two systems: a compact, unimportant linear accelerator mounted on a robotic arm that sends the radiation to the patient and an image guidance system that tracks the tumor's location within the body in real time to direct the radiation to the precise location where it is needed and adjusting the beam within millimeter tolerance up to 100 or more times during each treatment session. The robotic arm that delivers the radiation is so maneuverable that physicians may treat a lesion from up to 1600 non-coplanar aiming angles. This means they may use it to treat tumors and other injuries anywhere in the body without open surgery.[8]. Skull skeletal tracking with 6d translational and method translation correction rotation corrections
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