{"entity":{"id":"cyberknife","kind":"technology","name":"CyberKnife robotic radiosurgery","aka":[],"tldr":"A small accelerator on an industrial robot arm that aims hundreds of pencil-thin beams from any direction and follows the tumour as the patient breathes, so brain, spine, prostate, lung and pancreatic tumours can be treated in one to five sessions without a head frame.","summary":"CyberKnife, invented by Stanford neurosurgeon John Adler and first used in 1994, mounts a compact 6 MV linac on a six-axis robot. Instead of a gantry rotating about one isocentre, the robot visits many nodes around the patient and delivers non-isocentric, non-coplanar beams shaped by fixed cones or a variable-aperture or multileaf collimator. Two ceiling-mounted kilovoltage X-ray cameras image the skull, spine or implanted fiducials throughout treatment and the robot corrects its aim, and the Synchrony system models the breathing cycle from chest markers so the beam moves with a lung, liver or pancreatic tumour rather than treating a widened margin. That made frameless brain radiosurgery, spinal radiosurgery and five-fraction prostate SBRT practical and it treats trigeminal neuralgia and benign tumours as well.\n\nCompared with a modern C-arm linac fitted for stereotactic work, CyberKnife tracks motion natively and reaches unusual beam angles, but sessions are long (often thirty to sixty minutes or more), fields are small so it does not treat large or conventional volumes, and throughput is low, which keeps it in dedicated stereotactic programmes. Gamma Knife remains the comparator for intracranial targets and linac-based SRS is the mass-market alternative.","status":"established","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/CyberKnife","links":[{"label":"Accuray: CyberKnife","url":"https://www.accuray.com/cyberknife/"},{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/CyberKnife"}],"tags":["machines-wave"],"related":["gamma-knife","zap-x","c-arm-linac","tomotherapy","sabr-oligometastases"],"cancers":["brain-tumours","metastatic-cancer","prostate","pancreatic","nsclc","hcc"],"sections":["radiation","devices"],"technologies":["radiosurgery-srs","sbrt","respiratory-motion-management"],"targets":[],"drugs":[],"companies":["accuray"],"institutions":["stanford","georgetown-lombardi","charite","apollo-hospitals","upmc-hillman"],"pathways":[],"terms":["stereotactic-radiosurgery","fiducial-markers"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A robot-mounted 6 MV linac delivers many non-isocentric beams while stereo kilovoltage imaging tracks bone or fiducials and a respiratory model steers the beam, giving frameless sub-millimetre targeting with motion tracking.","strengths":["Frameless with real-time tracking of skull, spine and fiducials","Follows breathing motion without gating","Non-coplanar beams from almost any angle"],"limitations":["Long sessions and low throughput","Small fields only, not for large volumes","Fiducial placement is invasive for soft-tissue targets"],"since":1994},"route":"/technologies/cyberknife/","neighbours":{"technology":[{"id":"c-arm-linac","kind":"technology","name":"C-arm medical linear accelerators (TrueBeam, Versa HD and others)","route":"/technologies/c-arm-linac/"},{"id":"gamma-knife","kind":"technology","name":"Gamma Knife","route":"/technologies/gamma-knife/"},{"id":"respiratory-gating-tumour-tracking-systems","kind":"technology","name":"Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony)","route":"/technologies/respiratory-gating-tumour-tracking-systems/"},{"id":"respiratory-motion-management","kind":"technology","name":"Respiratory motion management (4D-CT, gating, breath-hold, tracking)","route":"/technologies/respiratory-motion-management/"},{"id":"sbrt","kind":"technology","name":"SBRT / SABR (stereotactic radiotherapy)","route":"/technologies/sbrt/"},{"id":"sabr-oligometastases","kind":"technology","name":"Stereotactic ablative radiotherapy for oligometastatic disease","route":"/technologies/sabr-oligometastases/"},{"id":"radiosurgery-srs","kind":"technology","name":"Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)","route":"/technologies/radiosurgery-srs/"},{"id":"tomotherapy","kind":"technology","name":"TomoTherapy and Radixact (helical radiotherapy)","route":"/technologies/tomotherapy/"},{"id":"zap-x","kind":"technology","name":"ZAP-X gyroscopic radiosurgery","route":"/technologies/zap-x/"}],"cancer":[{"id":"brain-tumours","kind":"cancer","name":"Brain and spinal cord tumours (all types)","route":"/cancers/brain-tumours/"},{"id":"hcc","kind":"cancer","name":"Hepatocellular carcinoma","route":"/cancers/hcc/"},{"id":"metastatic-cancer","kind":"cancer","name":"Metastatic cancer (cancer that has spread)","route":"/cancers/metastatic-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"company":[{"id":"accuray","kind":"company","name":"Accuray","route":"/companies/accuray/"}],"institution":[{"id":"apollo-hospitals","kind":"institution","name":"Apollo Hospitals (Apollo Cancer Centres)","route":"/institutions/apollo-hospitals/"},{"id":"charite","kind":"institution","name":"Charité Universitätsmedizin Berlin","route":"/institutions/charite/"},{"id":"georgetown-lombardi","kind":"institution","name":"Georgetown Lombardi Comprehensive Cancer Center","route":"/institutions/georgetown-lombardi/"},{"id":"stanford","kind":"institution","name":"Stanford Health Care / Stanford Cancer Institute","route":"/institutions/stanford/"},{"id":"upmc-hillman","kind":"institution","name":"UPMC Hillman Cancer Center","route":"/institutions/upmc-hillman/"}],"term":[{"id":"fiducial-markers","kind":"term","name":"Fiducial markers","route":"/terms/fiducial-markers/"},{"id":"stereotactic-radiosurgery","kind":"term","name":"Stereotactic radiosurgery (SRS)","route":"/terms/stereotactic-radiosurgery/"}]}}