Basic Comparison between Gamma Knife & Cyberknife System

History of Invention:

Gamma Knife:?Invented by Swedish neurosurgeon Lars Leksell, who developed the concept and the first prototype in the early 1950s. The Gamma Knife was later developed and refined in collaboration with the Swedish company Elekta AB.

Cyberknife:?The CyberKnife is a robotic radiosurgery system that was invented by Dr John R. Adler, a neurosurgeon in the early 1990s. The system was developed at Stanford University in California.

Structure & Design:

Gamma Knife:?A large number (192-201) of cobalt-60 sources are housed in a hemispherical orientation and the beams are collimated to focus on a single point.

Cyberknife:?A Compact X-Band Linear accelerator mounted in a Robotic arm and utilizes a 6MV- pencil beam to deliver the Non- non-isocentric treatment. KuKa Robot has 6 axis of movement.

Treatment Approaches:

Gamma Knife:?Limited to treating only Intracranial Targets inside the skull and a few cervical spine cases. It excels in treating brain tumours, AVMs, and other brain conditions.

Cyberknife:?Can treat both Intracranial and extracranial body targets. CyberKnife is more versatile and can be used to treat tumours and lesions in various parts of the body, including the brain, spine, lungs, liver, and prostate.

Requirement of Immobilization:

Gamma Knife:?Uses a head frame secured by screws into the skull bone by an Invasive Procedure to deliver the treatment.

Cyberknife: Delivers a Non-invasive treatment by using a Soft U-frame mask to ensure patient comfort and positioning stability during treatment.

Treatment Sessions:

Gamma Knife:?Gamma Knife uses the large head frame treatment delivered in a single fraction with a high dose from a fixed no of beam angles Treatment, typically involves a single session or a few sessions depending on the case. It's often preferred for situations where a single, highly precise dose of radiation is required.

Cyberknife: Delivering a high dose of Photon energy by multiple non-coplanar pencil beams in 1-5 treatment sessions, or may be delivered over multiple sessions (fractions) spread out over several days or weeks. This fractionation approach allows for high doses of radiation while minimizing damage to surrounding healthy tissues.

Prescription? Isodose Line:

Gamma Knife:?This work explores how the choice of prescription isodose line (IDL) affects the dose gradient, target coverage, and treatment time for Gamma Knife radiosurgery when a smaller shot is encompassed within a larger shot at the same stereotactic coordinates.

For GK-based delivery, the 50% IDL is by far the most common selection – largely based on historical precedent and the assumption that prescribing the 50% IDL provides the steepest dose fall-off outside the target.

Cyberknife:?Prescription isodose line is a critical aspect of treatment planning in radiation therapy. It is used to determine how the radiation dose will be distributed within the target volume and surrounding tissues. The cyberknife dose is prescribed usually at 75-85% IDL

Radiation Source:

Gamma Knife:?It uses cobalt-60 radioisotope sources (192-201) that emit highly focused gamma radiation from fixed positions. The radiation beams intersect at the target, delivering a precise dose of radiation.

Cyberknife:Instead of fixed radiation sources, CyberKnife employs a robotic arm with a linear accelerator that can move around the patient's body and deliver highly energetic 6MV X-rays in targeting tumours from multiple angles.

Real-Time Tumor Tracking:

Gamma Knife:?It does not track the target in real-time, although the recent model is equipped with a CBCT facility prior to the treatment delivery.

Cyberknife:?Real-Time Tumor Tracking with a live orthogonal X-ray imaging system enhances confidence in delivering the radiosurgical dose with submillimeter accuracy.

Treatment Duration:

Gamma Knife:?Treatments are typically shorter in duration, often completed in a single session lasting several hours.

Cyberknife:?Cyberknife treatments can be delivered in a single session or over multiple sessions, depending on the treatment plan and the patient's specific needs.

Treatment Planning:

In both systems, detailed imaging, such as CT scans or MRI scans, is used for treatment planning to precisely define the target volume and optimize radiation delivery.

Ultimately, the choice between Gamma Knife and CyberKnife depends on the specific clinical scenario, the location of the tumor, and the patient's individual needs. Both technologies offer advanced and effective options for delivering targeted radiation therapy.

Gamma Knife radiosurgery?is a specialized and highly precise medical technology that offers several advantages for the treatment of certain brain conditions and disorders. Here are some of its key advantages:

Precision: Gamma Knife is renowned for its exceptional precision in delivering radiation therapy. It uses multiple converging beams of gamma radiation to precisely target a specific area within the brain while sparing surrounding healthy tissue.

Frame-Based Immobilization: Although frameless options are available in some cases, Gamma Knife can use a rigid frame to immobilize the patient's head with submillimeter accuracy. This ensures that the patient's head remains perfectly still during treatment.

Single Session: Many Gamma Knife treatments are completed in a single session, often lasting a few hours. This quick and efficient treatment timeline reduces the need for multiple treatment sessions.

Minimal Radiation Exposure: The precise targeting of Gamma Knife minimizes radiation exposure to healthy brain tissue, reducing the risk of damage to critical structures and potential side effects.

Effective for Various Conditions: Gamma Knife is particularly well-suited for treating a range of brain conditions, including benign and malignant tumors, arteriovenous malformations (AVMs), trigeminal neuralgia, and certain functional disorders.

Low Risk of Infection: Since it does not involve surgical incisions, Gamma Knife treatment carries a lower risk of infection compared to traditional brain surgery.

Minimal Recovery Time: Patients typically experience a shorter recovery time compared to surgical procedures, allowing them to return to their normal activities more quickly.

Outpatient Procedure: Gamma Knife treatment is often performed on an outpatient basis, which means that patients can typically go home the same day as the procedure.

High Success Rates: Gamma Knife has demonstrated high success rates for treating many brain conditions, achieving excellent tumor control and relief from symptoms in many cases.

Customized Treatment Plans: Each Gamma Knife treatment plan is customized to the patient's specific condition, taking into account the size, shape, and location of the target within the brain.

Lower Risk of Complications: Gamma Knife carries a lower risk of complications compared to traditional open surgery.

CyberKnife Radiosurgery?is a cutting-edge radiation therapy technology that offers several advantages for the treatment of various medical conditions. Some of its key advantages include:

Extreme Precision: One of the primary advantages is its Sub-millimetre precision in delivering radiation therapy. The robotic arm can adjust in real-time to track the patient's movements and tumor motion, ensuring that the radiation is precisely targeted at the tumor while sparing healthy surrounding tissues.

Non-Invasive: CyberKnife treatment is non-invasive, meaning there is no need for surgical incisions. Patients do not require anaesthesia, and there is no risk of infection associated with surgical procedures.

Frameless Treatment: Unlike some other radiosurgery systems, CyberKnife typically does not require a rigid frame to immobilize the patient's head or body. This frameless approach improves patient comfort and allows for more flexibility in treatment.

Versatility: CyberKnife can be used to treat a wide range of tumors and conditions throughout the body, including those in the brain, spine, lung, prostate, liver, pancreas, and more. Its adaptability makes it suitable for both intracranial and extracranial treatments.

Fewer Treatment Sessions: Depending on the patient's condition and treatment plan, CyberKnife can often deliver the required radiation dose in fewer treatment sessions compared to conventional radiation therapy. Some treatments can be completed in just one session.

Reduced Side Effects: The precision of CyberKnife treatment allows for maximal tumor control while minimizing radiation exposure to healthy tissues. This can lead to reduced side effects and a quicker recovery for many patients.

No Need for Anesthesia: Because CyberKnife is non-invasive and painless, patients typically do not require anaesthesia during treatment. They can remain awake and comfortable throughout the procedure.

Shorter Treatment Times: CyberKnife treatments are generally quicker compared to conventional radiation therapy. This reduces the time commitment for patients and allows them to resume their daily activities sooner.

Real-Time Imaging: CyberKnife incorporates real-time imaging during treatment, ensuring that the tumor is in the correct position for radiation delivery. This dynamic tracking helps maintain treatment accuracy.

Individualized Treatment: CyberKnife treatment plans are highly individualized, and tailored to each patient's specific tumor size, shape, and location. This personalized approach maximizes treatment effectiveness.

Low Risk of Complications: Due to its precision and non-invasive nature, CyberKnife carries a relatively low risk of complications compared to traditional surgery or radiation therapy.

For more visit:?Cyberknife, WORLDS NO. ONE ROBOTIC RADIOSURGERY SYSTEM

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