Monday, November 15, 2010


Robotic Radiosurgery. How robots are becoming a part of the cure for one of the most horrid of human ailments. Video Inside!

Posted by Alexandru Nicolae

Image Credit: Howie Blog.

Because it's Mustache November (for those that don't know, it involves growing a mustache in support of finding a cure for prostate cancer), I thought I would do a short piece on cancer treatment. But me being the tech-junkie that I am, I've decided to discuss a cool new piece of cancer-fighting technology that few people know about. It's called CyberKnife, and it's robotic, missle-guided, radiosurgery. Let that sink in before you read the rest, I'll wait here...

CyberKnife is to radiation therapy what heat-seeking missiles are to bombs; it is a form of radiation treatment that's super precise and offers a huge advantage over conventional radiotherapy. Currently, it offers treatments for cancers that are inoperable because of their location (like the brain), or simply too small to excise, and it's been shown to be super effective against tumors at a multitude of body locations. It's fast (treatment times are measured in minutes, not hours), fewer side-effects, and there's no anesthesia or cutting involved. So how does this thing work?

It's called frameless image-guided therapy. Conventional radiotherapy relies on a linear accelerator (a particle accelerator, like at CERN), to beam high-energy electrons into a tumor, thereby killing it. The only problem with it is that it's fixed to an immobile gantry; the accelerator can only rotate around fixed axes and therefore has a tough time hitting small tumors or metastases. This is where the CyberKnife comes in. Usually indicated for use in treating brain metastases (an area where you don't want to play around in), it puts the linear accelerator concept onto a 6 dimensional robotic arm. Six dimensional means that it has 6 degrees of freedom in its motion. The robotic arm rotates around the patient tracking the tumor and beaming it when prescribed, it does this with an image guided tracking system.

Video Credit: SJM Health System.

The image guided tracking system works like this: they take x-rays from different angles and localize the tumor, then they beam it once, take another set of images, repeat. All of it is integrated with extremely complex targeting and tracking software that I won`t try to explain, simply because I don't understand it myself. Regardless, it keeps track of the patient even if they move. So far this makes this form of treatment one of the least invasive methods of surgery I have seen thus far.

There are some issues, however. Because it is so new, few studies have been done on it's clinical effectiveness when compared to conventional radiotherapy methods. Individual studies have been done on specific sites on patients with progressed cancer with some promise, but more work definitely needs to be done to figure out its full potential and to cover all loose ends. The main benefit of greater target selectivity with reduced clinical treatment time and side effects makes this technology worth pursuing though.

On a small aside, I also discovered that recently deceased hollywood actor Patrick Swayze was being treated with the CyberKnife in 2008, and according to media reports was doing much better after his treatment. Unfortunately, like with most cancers, it came back and he passed away. Hopefully these new treatments continue to develop so we will one day be rid of this horrible disease. I for one will do my part by posting more information on the fight against cancer for the rest of Movember. If all you can do is grow a mustache (or a fake mustache, ladies), you've already done more than you think by raising awareness for the cure.


Muacevic A, Kufeld BW, Kreth FW, Tonn JC. (2010). Feasibility, safety, and outcome of frameless image-guided robotic radiosurgery for brain metastases. J Neurooncol;97:267-274.

Gerszten PC, Ozhasoglu C, Burton SA, et al. (2003). CyberKnife frameless single-fraction stereotactic radiosurgery for benign tumors of the spine. J Neurosurg; 14(5): -

Shiomi H.(2006). CyberKnife. Japanese J Clin Radiol;51(5):573-582.

Adler JR, Chang SD, Murphy MJ, et al. (1997). The CyberKnife: a frameless robotic system for radiosurgery. Sterotact Funct Nuerosurg; 69(1-4): 124-8.

CyberKnife Robotic Radiosurgery System

CADTH: CyberKnife

Patrick Swayze smiling again after "miracle" response to cancer treatment. Daily


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