cyberknife medanta

CYBERKNIFE Introduction &System

Overview

-Vikraman Subramani Email ID : emailvikraman@gmail.com

Questions ???

1. What is Cyberknife ?

2. For what it is ?

3. How it differs from Linac?

4. What it contains ?

5. What is the mould room procedure?

6. How to take the CT for this ?

7. Do we need 4D CT ?

8. Is it real time tracking machine?

9. What is the tracking tool ?

10. Is there 3D imaging ?

11. Is there iso centre /Refernce point ?

12.How to setup the patient without reference ?

13.Can we use the fiducial ?

14.What is field sizes?

15.Fixed field sizes ?

16. Is there MLC ?

17. Irregular tumor and maximum /Minimum tumor size ?

18.What kind of cases we can treat ?

19.What is the dose rate ?

20.How much MU /fraction ?

21. Is there any record and verify as MOSAIQ ?

22.6D couch ?

23.Treatment time ?

24.What is the planning system

25 . How to contour ?

26. Fusion ?

27 .Invasive ?

28 . Frame/Frameless ?

29.DRR ?

30.How many DRR?

31.Every beam will have DRR ?

32.How many degrees of freedom ?

33.What is the reference field sizes ?

34.What is the daily QA ?

35.How to do the warm up ?

36.

……………………………………etc

1. What is Cyberknife ? (Robotic radiosurgery )

2. For what it is ? (Full body stereotactic radio surgery /therapy)

3. How it differs from Linac?

4. What it contains ? (Robot/linac/x Ray/Imager/laser/couch/modulator/chiller)

5. What is the mould room procedure? (Different)

6. How to take the CT for this ? (Standard technique for all cases)

7. Do we need 4D CT ? (No)

8. Is it real time tracking machine? (Yes)

9. What is the tracking tool ? ( 6 Types)

10. Is there 3D imaging ? (No)

11. Is there iso centre /Refernce point ? ( Yes for dosimetry purpose)

12.How to setup the patient without reference ? (DRR)

13.Can we use the fiducial ? (Yes but not necesary)

14.What is field sizes? (60 mm)

15.Fixed field sizes ? (Yes)

16. Is there MLC ? (IRIS)

17. Irregular tumor and maximum /Minimum tumor size ? (Yes)

18.What kind of cases we can treat ?

19.What is the dose rate ? ( 1000MU)

20.How much MU /fraction ? ( 10000-15000 MU)

21. Is there any record and verify as MOSAIQ ? ( No )

22.6D couch ? ( Yes)

23.Treatment time ? ( 40 minutes)

24.What is the planning system ( Multiplan)

25 . How to contour ?

26. Fusion ? ( fiducial/auto)

27 .Invasive ? ( No)

28 . Frame/Frameless ? ( frameless)

29.DRR ? (Yes)

30.How many DRR? (Depends on site)

31.Every beam will have DRR ? ( No)

32.How many degrees of freedom ? ( 6)

33.What is the reference field sizes ? (60 mm)

34.What is the daily QA ? (Yes)

35.How to do the warm up ? ( 2000MU)

36.

……………………………………etc

Accuray/Cyberknife/VSI

Versatile/Simple/Intelligent

Cyberknife robotic radiosurgery

• Revolutionary piece of technology which delivers the radiation with sub millimeter accuracy

• Worlds first & only robotic radiosurgery to treat tumors anywhere in the body

• Single /Multiple fractions

• Fullbody radiosurgery /Radiotherapy

state

Cases

Acoustic neuroma

Anaplastic astrocytoma

Arteriovenous malformation (AVM)

Craniopharyngioma

DNET

Ependymoma

Epidural hematoma

Gangliocytoma

Germinoma

Glioblastoma multiforme

Glioma

Glomus jugulare tumor

Hemangioblastoma

Meningioma

Neurocytoma

Neurofibroma

Neurofibromatosis

Oligodendroglioma

PNET

Pituitary adenoma

Schwannoma

Trigeminal neuralgia

Vestibular schwannoma

Osteosarcoma

Nasopharyngeal carcinoma

Squamous cell carcinoma

Non-small cell lung cancer

Small-cell lung cancer

Pancreatic cancer

Hepatocellular carcinoma

Prostate cancer

Renal cell carcinoma

Colon cancer

Ovarian cancer

Uterine cancer

Arteriovenous malformation (AVM)

http://www.accuray.com/sites/default/files/demos/vsi/index.html

http://www.accuray.com/sites/default/files/demos/vsi/index.html

Synchrony™

camera

Treatment couch

Linear

accelerator

Manipulator

Image

detectors

X-ray sources

Targeting System

Robotic Delivery System

History

Computer controlled robot

Kuka robot KR240

The name derived from the initial letters of “Keller und

Knappich Augsburg”.

Founded in 1898

Millimeter ==========Sub millimeter

MECHANICAL PRECISION <+/- 0.06 millimeter

Sub millimeter accuracy

GM, Chrysler, Ford, Porsche, BMW, Audi, Mercedes-

Benz, Volkswagen, Ferrari, Harley-Davidson, Boeing,

Siemens, IKEA, Swarovski, Wal-Mart, Budweiser, BSN

Medical as well as Coca-Cola and others,

Computer controlled robot

Kuka robot KR240

derived from the initial letters of the company name

“Keller und Knappich Augsburg”.

Founded in 1898 &

John Adler – American Neurosurgeon who

Invented cyberknife – fellowship at karolinska

Institute sweden with Larslekshell in radiosurgery

2001 FDA approved for cyberknife

MECHANICAL PRECISION <+/- 0.06 millimeter

Sub millimeter accuracy

Computer controlled robot

Head & Neck

Collimator Assembly

12 directions in each nodes

Proximity prediction program & Proximity detection Program

Proximity prediction program & Proximity detection Program

Workflow

Tracking •6D Skull Tracking

•Synchrony Tracking

•Fiducial tracking

•Xsight lung tracking

•Xsight spine tracking

•In tempo adaptive tracking

http://www.accuray.com/sites/default/files/demos/vsi/index.html

http://accuray.learn.com/files/scorm/Fiducial%20Placement%20Guidel

ines/index_lms.html

1. What is Cyberknife ?

2. For what it is ?

3. How it differs from Linac?

4. What it contains ?

5. What is the mould room procedure?

6. How to take the CT for this ?

7. Do we need 4D CT ?

8. Is it real time tracking machine?

9. What is the tracking tool ?

10. Is there 3D imaging ?

11. Is there iso centre /Refernce point ?

12.How to setup the patient without reference ?

13.Can we use the fiducial ?

14.What is field sizes?

15.Fixed field sizes ?

16. Is there MLC ?

17. Irregular tumor and maximum /Minimum tumor size ?

18.What kind of cases we can treat ?

19.What is the dose rate ?

20.How much MU /fraction ?

21. Is there any record and verify as MOSAIQ ?

22.6D couch ?

23.Treatment time ?

24. QA

25.What is the planning system

26 . How to contour ?

27. Fusion ?

28 .Invasive ?

29 . Frame/Frameless ?

30.DRR ?

31.How many DRR?

32.Every beam will have DRR ?

33.How many degrees of freedom ?

……………………………………etc

Thanks