CyberKnife radiosurgery robot

One of the most successful robotic applications is the CyberKnife from Accuray Inc. (Sunnyvale, CA, USA). This stereotactic radiosurgery system integrates IGS with robotic positioning. The 6 MeV LINAC relatively light-weight photon device is mounted on a KUKA 6 DOF industrial manipulator. Its primary deployment is the irradiation of brain and spine tumors. X-ray cameras are used to track the spatial displacement of the patient and compensate for motion caused by e.g. breathing. The overall accuracy of the system is 0.42 ± 0.4 mm, while patient skin motions are detected with a 0.35 mm precision. The CyberKnife moves the radiation beam by physically repositioning the radiation source. It uses intra-corpuscular markers and Polaris (NDI Inc.) infrared cameras to track the patients’ moving body surface.
To improve accuracy, radioopaque fiducial markers are implanted in or near the tumor region several days before CT scanning for treatment planning. The fiducials, which are detectable in X-ray images, are used as reference markers to locate and track tumor location during patient alignment and treatment delivery. The Synchrony Respiratory Tracking System builds a correlation model between the positions of periodically detected fiducials and the real-time locations of optically tracked markers placed on the chest to track tumor location. It uses 4D CT (imaging through time) to measure respiratory tissue motion and deformation and to account for the effect of displacement and deformation through the irradiation.
Accuray has sold more than 150 units, 2/3 of them are installed in the US. The initial price of the robot is around 4 M USD. The closest system to Hungary is in Munich and Istanbul, where a treatment costs 12,000-17,000 USD.


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