Motion Management

Continuously adapting treatment to target motion is a challenge, but the CyberKnife® System offers a expanding set of options that help track tumor types anywhere in the body — including head, prostate, lung, spine, liver, pancreas and other extracranial tumors. Our treatment delivery software provides an automatic, intuitive user interface to efficiently control all interactions between the robotic manipulator, treatment couch and imaging system. The software quickly and automatically processes live images acquired throughout treatment at user-defined intervals, calculates offsets based on Digitally Reconstructed Radiographs (DRRs) and sends offset data to the robotic manipulator for immediate and automatic motion compensation.

Depending on the type of tumor being treated, the CyberKnife System will use different targeting and tracking methods:

  • 6D Skull Tracking System: renders invasive stereotactic head frames obsolete, by using the bony anatomy of the skull to continuously track intracranial targets and automatically correct for even the slightest translational or rotational target shift during treatment delivery.
  • Synchrony Respiratory Motion Tracking System: This solution continuously synchronizes beam delivery with the motion of the target resulting from respiration, without the need to interrupt the treatment or move the patient. It allows clinicians to significantly reduce margins, while eliminating the need for gating or breath-holding techniques.
  • Xsight® Spine Tracking System and Xsight Spine Prone Tracking System: use the bony anatomy of the spine to automatically locate and track tumors, eliminating the need for surgical implantation of fiducials and making radiosurgery in and near the spine more precise and less invasive. With the Xsight Spine Prone feature, the benefits of non-invasive spine treatments can be extended to patients in prone, as well as the supine, position.
  • Xsight Lung Tracking System and 1-View Tracking System: work together with the Synchrony® Respiratory Motion Tracking System to eliminate the need to implant fiducials. These solutions directly and non-invasively track the lung tumors independently of their position.
  • InTempoTM Adaptive Imaging System: uses the CyberKnife System’s time-based image guidance to assist with tracking and correcting non-predictable intrafraction target motion.
  • Lung Optimized Treatment is an integrated suite of tools that provides a complete fiducial-free clinical solution for lung cancer patients and optimizes non-invasive lung SBRT treatments. Lung Optimized Treatment consists of the following features:
    • Simulation Application is a workflow-based application that automatically recommends the optimal choice for fiducial-free treatment of lung tumors based on specifics of clinical conditions.
    • 1-View is a tracking method that works in conjunction with Synchrony Respiratory Tracking System. 1-View tracks lung tumor motion in one of two X-ray projections allowing accurate dose delivery with radiosurgical margins in the tracked direction. Under this scenario ITV expansion is applied in the non-tracked X-ray projection.
    • 0-View is a treatment method that applies in situations when a lung tumor is not clearly visible in either X-ray projection. 0-View uses ITV expansion in two X-ray projections and Xsight Spine Tracking System to track patient position.