{"entity":{"id":"zap-x","kind":"technology","name":"ZAP-X gyroscopic radiosurgery","aka":[],"tldr":"A self-shielded brain radiosurgery machine: a compact accelerator swings around the head on two nested gantries inside its own steel shell, so it needs no concrete bunker and no radioactive cobalt, and can be installed in an ordinary outpatient building.","summary":"ZAP-X was designed by John Adler, the inventor of CyberKnife, to make dedicated brain radiosurgery cheaper to site. A low-energy linac is carried on two independent gantries that rotate like a gyroscope, giving beams from thousands of non-coplanar directions that converge on the target, and the whole machine is enclosed in shielding so that the room needs no vault. Kilovoltage imaging inside the shell checks the skull position throughout treatment and the patient lies on a couch that slides into the enclosure. Cleared in the United States in 2017 and since in Europe and Japan, it treats brain metastases, meningiomas, schwannomas, pituitary adenomas and trigeminal neuralgia in one to five sessions.\n\nAgainst Gamma Knife it avoids cobalt-60 sourcing, decay and licensing; against a general-purpose linac it is dedicated and self-shielded but treats nothing below the neck. The installed base is small and long-term outcome data are early, so it is a machine to watch rather than an established standard.","status":"emerging","asOf":"2026-09-17","links":[{"label":"ZAP Surgical Systems","url":"https://zapsurgical.com/"}],"tags":["machines-wave"],"related":["gamma-knife","cyberknife","c-arm-linac"],"cancers":["brain-tumours","metastatic-cancer","pituitary-tumours"],"sections":["radiation","devices"],"technologies":["radiosurgery-srs","sbrt"],"targets":[],"drugs":[],"companies":["zap-surgical-systems"],"institutions":["gustave-roussy"],"pathways":[],"terms":["stereotactic-radiosurgery"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A self-shielded linac on two nested rotating gantries delivers converging non-coplanar beams to intracranial targets with integrated kilovoltage image guidance, removing the need for a radiation vault or a cobalt source.","strengths":["No bunker and no radioactive source","Thousands of beam directions","Lower siting cost for dedicated brain radiosurgery"],"limitations":["Head and upper neck only","Small installed base and early outcome data","Single vendor"],"since":2017},"route":"/technologies/zap-x/","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":"cyberknife","kind":"technology","name":"CyberKnife robotic radiosurgery","route":"/technologies/cyberknife/"},{"id":"gamma-knife","kind":"technology","name":"Gamma Knife","route":"/technologies/gamma-knife/"},{"id":"sbrt","kind":"technology","name":"SBRT / SABR (stereotactic radiotherapy)","route":"/technologies/sbrt/"},{"id":"radiosurgery-srs","kind":"technology","name":"Stereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)","route":"/technologies/radiosurgery-srs/"}],"cancer":[{"id":"brain-tumours","kind":"cancer","name":"Brain and spinal cord tumours (all types)","route":"/cancers/brain-tumours/"},{"id":"metastatic-cancer","kind":"cancer","name":"Metastatic cancer (cancer that has spread)","route":"/cancers/metastatic-cancer/"},{"id":"pituitary-tumours","kind":"cancer","name":"Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma","route":"/cancers/pituitary-tumours/"}],"section":[{"id":"devices","kind":"section","name":"Devices & Physical Therapies","route":"/fronts/devices/"},{"id":"radiation","kind":"section","name":"Radiation Therapy","route":"/fronts/radiation/"}],"company":[{"id":"zap-surgical-systems","kind":"company","name":"ZAP Surgical Systems","route":"/companies/zap-surgical-systems/"}],"institution":[{"id":"gustave-roussy","kind":"institution","name":"Gustave Roussy","route":"/institutions/gustave-roussy/"}],"term":[{"id":"stereotactic-radiosurgery","kind":"term","name":"Stereotactic radiosurgery (SRS)","route":"/terms/stereotactic-radiosurgery/"}]}}