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Cancer / Oncology Treatments

CyberKnife Robotic Radiosurgery

CyberKnife is a painless, non-invasive radiation treatment that can be an alternative to Radiotherapy or open surgery. 

During the Cyberknife radiosurgery procedure, the tumour receives a cumulative dose of radiation to control or destroy the tumour cells while radiation exposure to surrounding tissue is minimized. 

The Cyberknife can be able to compensate for patient movement and ensure accurate delivery of radiation during treatment. 

When during the treatment, the patient movement occurs, the cameras detect the position change, and the robot can compensate for the action by repositioning the LINAC before administering the radiation beam. This constant correction of beam replacement ensures accurate tumour targeting. 

Understanding the Mechanism 

The unique mechanism of the Cyberknife treatment provides a non-invasive, surgical-like outcome for lesions of the spine and brain. Cyberknife is the first commercial application of Robotic Stereotactic Radiosurgery for the brain and the spinal cord. 

Additionally, this technology has the benefit of using the Cyberknife system for radiological applications outside the brain and for staged radio-surgical procedures. 

Cyberknife radiosurgery is working effectively to treat selected lung malignancies. The combination of investigational hardware and software with Cyberknife technology can deliver conformal radiation to moving metastatic and primary lung tumours if surgery is not an option. The Cyberknife accommodates lung and tumour motion, enabling modifications to be made so as to deliver a maximal therapeutic dose while minimizing surrounding tissue toxicity. 


Diseases that can be treated with Cyberknife 

The Cyberknife method of treatment is a great help to patients who are dealing with deadly tumours. Cyberknife is used to treat: 

  • Non-Cancerous Tumours
  • Prostate Cancer
  • Brain Cancer
  • Liver Cancer
  • Lung Cancer
  • Breast Cancer
  • Cancerous Spine Tumours
  • Head and Neck Cancer 

 Test and Diagnosis 

Following Imaging techniques are used to confirm the location and extent of tumour: 

  • MRI Scan (magnetic resonance imaging ): This includes the use of magnetic and sound waves to study the tumour.
  • CT Scan (computerized tomography): This includes a series of X rays at different angles to take images.
  • Biopsy: Biopsy is performed by extracting a part of tumour tissue for detailed diagnosis to study whether the tumour is benign or malignant. 

Cyberknife treatment Procedure 

Once patients are evaluated by a team of doctors, the treatment process begins. The process involves the following three steps: 

  • Treatment Setup
  • Treatment Planning
  • Treatment Delivery 

Each of the mentioned procedures can occur either on the same day or on separate visits. Unlike the conventional stereotactic Radiosurgery, the Cyberknife treatment procedure does not require that the patient be admitted in an acute care setting while the plan is formulated. The patient is able to return home in between treatment planning appointments. 

Treatment Setup 

During the treatment setup, the team plans the overall details of radiation delivery. If a tumour is being treated, a custom-fit plastic mask is made for the patient. The patient undergoes a CT scan with iodinated dye contrast with the mask in place. Then, the CT Scan data is integrated into the treatment planning software and digitally reconstructed demonstrations in which various patient positions are correlated with images of the target. This helps the computer in three-dimensional space to identify exactly where the lesion is located. 

Treatment Planning 

Cyberknife treatment planning process utilizes the clinical experience of both the physicist and the radiation oncologists as well as the power of high-speed supercomputers to determine the dose, volume, and pattern of the radiation beam target. During the planning phases of the Cyberknife, the millions of calculations are performed to determine the most effective radiation delivery plan. 

Treatment Delivery 

After the treatment planning phase is completed, the patient returns for treatment delivery. During treatment, the patient lies by keeping the face upwards on the treatment table fitted with the appropriate immobilization device. At the beginning of the treatment, the imaging system acquires digital x-rays of tumour localization and patient position. This obtained information is then transmitted to the robotic arm, which is then used to move the LINAC to the appropriate position.

As the treatment continues, the robot moves and retargets the LINAC at multiple positions around the patient and deliver a small radiation beam at each position. To complete the treatment, this process is repeated at 50 to 300 different positions around the patient. 

Cyberknife Treatment Benefits 

  • Treatment of tumour lesions are far more accurate with targeting tumours
  • Minimal exposure to healthy tissues
  • Non-invasive involves no blood loss
  • Painless treatment procedure requires no anaesthesia



Dr. Anthony Vijay Pais
Dr. Anusheel Munshi
Dr. Subodh Chandra Pande

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