Factors affecting the accuracy of respiratory tracking of the image-guided robotic radiosurgery system

2019 ◽  
Vol 37 (10) ◽  
pp. 727-734
Author(s):  
Mitsuhiro Inoue ◽  
Kohei Okawa ◽  
Junichi Taguchi ◽  
Yoshifumi Hirota ◽  
Yohei Yanagiya ◽  
...  
Keyword(s):  
Factors Affecting ◽  
Image Guided ◽  
Robotic Radiosurgery ◽  
Respiratory Tracking

scholarly journals Technical Description, Phantom Accuracy, and Clinical Feasibility for Single-Session Lung Radiosurgery Using Robotic Image-Guided Real-time Respiratory Tumor Tracking

2007 ◽  
Vol 6 (4) ◽  
pp. 321-328 ◽  
Author(s):  
A. Muacevic ◽  
C. Drexler ◽  
B. Wowra ◽  
A. Schweikard ◽  
A. Schlaefer ◽  
...  
Keyword(s):  
Real Time ◽  
Lung Tumor ◽  
Tracking Error ◽  
Single Session ◽  
Primary Tumors ◽  
Image Guided ◽  
Tumor Tracking ◽  
Robotic Radiosurgery ◽  
Respiratory Tracking

To describe the technological background, the accuracy, and clinical feasibility for single session lung radiosurgery using a real-time robotic system with respiratory tracking. The latest version of image-guided real-time respiratory tracking software (Synchrony®, Accuray Incorporated, Sunnyvale, CA) was applied and is described. Accuracy measurements were performed using a newly designed moving phantom model. We treated 15 patients with 19 lung tumors with robotic radiosurgery (CyberKnife®, Accuray) using the same treatment parameters for all patients. Ten patients had primary tumors and five had metastatic tumors. All patients underwent computed tomography-guided percutaneous placement of one fiducial directly into the tumor, and were all treated with single session radiosurgery to a dose of 24 Gy. Follow up CT scanning was performed every two months. All patients could be treated with the automated robotic technique. The respiratory tracking error was less than 1 mm and the overall shape of the dose profile was not affected by target motion and/or phase shift between fiducial and optical marker motion. Two patients required a chest tube insertion after fiducial implantation because of pneumothorax. One patient experienced nausea after treatment. No other short-term adverse reactions were found. One patient showed imaging signs of pneumonitis without a clinical correlation. Single-session radiosurgery for lung tumor tracking using the described technology is a stable, safe, and feasible concept for respiratory tracking of tumors during robotic lung radiosurgery in selected patients. Longer follow-up is needed for definitive clinical results.

Future Directions in Robotic Neurosurgery

2021 ◽  
Author(s):  
Christopher R Wagner ◽  
Timothy Phillips ◽  
Serge Roux ◽  
Joseph P Corrigan
Keyword(s):  
Machine Learning ◽  
Operating Room ◽  
Key Factors ◽  
Future Directions ◽  
Factors Affecting ◽  
Implementation Challenges ◽  
Image Guided ◽  
Robotic Neurosurgery ◽  
Specific Technology ◽  
Technology Trends

Abstract In this paper, we highlight promising technologies in each phase of a robotic neurosurgery operation, and identify key factors affecting how quickly these technologies will mature into products in the operating room. We focus on specific technology trends in image-guided cranial and spinal procedures, including advances in imaging, machine learning, robotics, and novel interfaces. For each technology, we discuss the required effort to overcome safety or implementation challenges, as well as identifying example regulatory approved products in related fields for comparison. The goal is to provide a roadmap for clinicians as to which robotic and automation technologies are in the developmental pipeline, and which ones are likely to impact their practice sooner, rather than later.

Treatment planning for image-guided robotic radiosurgery

2005 ◽  
pp. 131-137
Author(s):  
Rhea Tombropoulos ◽  
Achim Schweikard ◽  
Jean-Claude Latombe ◽  
John R. Adler
Keyword(s):  
Treatment Planning ◽  
Image Guided ◽  
Robotic Radiosurgery

scholarly journals Image-Guided Robotic Radiosurgery for Trigeminal Neuralgia

Neurosurgery ◽  
2017 ◽  
Vol 83 (5) ◽  
pp. 1023-1030 ◽  
Author(s):  
Pantaleo Romanelli ◽  
Alfredo Conti ◽  
Livia Bianchi ◽  
Achille Bergantin ◽  
Anna Martinotti ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Trigeminal Nerve ◽  
Pain Control ◽  
Target Volume ◽  
Image Guided ◽  
Single Center Experience ◽  
Robotic Radiosurgery ◽  
Sensory Disturbances ◽  
Prescription Dose

Abstract BACKGROUND Frameless, non-isocentric irradiation of an extended segment of the trigeminal nerve introduces new concepts in stereotactic radiosurgery for medically resistant trigeminal neuralgia (TN). OBJECTIVE To report the results of the largest single-center experience about image-guided robotic radiosurgery for TN. METHODS A cohort of 138 patients treated with CyberKnife® (Accuray Incorporated, Sunnyvale, California) radiosurgery with a minimum follow-up of 36 mo were recruited. Pain relief, medications, sensory disturbances, rate and time of pain recurrence were prospectively analyzed. RESULTS Median follow-up was 52.4 mo; median dose 75 Gy; median target length 5.7-mm; median target volume 40 mm³; median prescription dose 60 Gy (80% isodose line). Actuarial pain control rate (Barrow Neurological Institute [BNI] class I-IIIa) at 6, 12, 24, and 36 mo were 93.5%, 85.8%, 79.7%, and 76%, respectively. Overall, 33 patients (24%) required a second treatment. Overall, 18.1% developed sensory disturbances after 16.4 ± 8.7 mo. One patient (0.7%) developed BNI grade IV dysfunction; 6 (4.3%) developed BNI grade III (somewhat bothersome) hypoesthesia after retreatment; BNI grade II (not bothersome) hypoesthesia was reported by 18 patients (11 after retreatment). Shorter nerve length (<6 mm vs 6 mm), smaller nerve volume (<30 mm3 vs >30 mm3), and lower prescription dose (<58 vs >58 Gy) were associated with treatment failure (P = .01, P = .02, P = .03, respectively). Re-irradiation independently predicted sensory disturbance (P < .001). CONCLUSION Targeting a 6-mm segment of the trigeminal nerve with a prescribed dose of 60 Gy appears safe and effective. Persistent pain control was achieved in most patients with acceptable risk of sensory complications, which were typically found after re-irradiation.

Development of a Streamlined, Non-invasive Robotic Radiosurgery Method for Treatment of Uveal Melanoma

2008 ◽  
Vol 7 (5) ◽  
pp. 369-373 ◽  
Author(s):  
Alexander Muacevic ◽  
Martin Nentwich ◽  
Berndt Wowra ◽  
Sibylle Staerk ◽  
Anselm Kampik ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Treatment Plan ◽  
Three Dimensional ◽  
Ct Scanning ◽  
Single Session ◽  
Image Guided ◽  
Robotic Radiosurgery ◽  
Retrobulbar Anaesthesia ◽  
Treat All

To analyze the feasibility and safety of frameless, image-guided robotic radiosurgery against uveal melanoma, we developed a streamlined procedure that is completed within 3 hours under retrobulbar anesthesia without immobilization. Twenty patients (10 men and 10 women) with medium (3–5-mm prominence) and large (>5-mm prominence) unilateral uveal melanomas were treated with a frameless robotic radiosurgery system. Median age was 61 years (range 32–78 years). All patients underwent a single-session procedure beginning with retrobulbar anaesthesia, followed by computerized tomography (CT) scanning that was used in the generation of a treatment plan, and then the delivery of a radiosurgical tumor dose between 18 and 22 Gy to the 70% isodose line. Three-dimensional treatment planning was aimed at securing the optical lens and the optic disc as much as possible. Follow-up occurred at 3, 6, 12, and 18 months after the radiosurgery with clinical, ultrasound, and CT studies. We were able to treat all patients in the frameless setup within 3 hours. In five patients with lateral and dorsal tumors, the dose to the optic lens could be kept below 2 Gy. The clinical response was evaluated for the first seven patients treated with a follow-up of at least 6 months. No local recurrences occurred with any of the clinically evaluated patients for a mean 13-month follow-up (range 6–22 months). Maximum median apical tumor height according to standardized A-scan ultrasound evaluations decreased from 7.7 to 5.6 mm (p < 0.1). The median reflectivity increased from 41% to 70% (p < 0.01). None of the patients developed a secondary glaucoma during the short-term follow-up period. Frameless, single-session, image-guided robotic radiosurgery is a feasible, safe and comfortable treatment option for patients with uveal melanoma. Longer follow-up and analysis of a larger patient series is required for definitive clinical recommendations.

Split-Volume Treatment Planning of Multiple Consecutive Vertebral Body Metastases for Cyberknife Image-Guided Robotic Radiosurgery

2008 ◽  
Vol 33 (3) ◽  
pp. 175-179 ◽  
Author(s):  
Arjun Sahgal ◽  
Cynthia Chuang ◽  
David Larson ◽  
Kim Huang ◽  
Paula Petti ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Vertebral Body ◽  
Image Guided ◽  
Robotic Radiosurgery

Robotics and its applications in stereotactic radiosurgery

2007 ◽  
Vol 23 (6) ◽  
pp. E5 ◽  
Author(s):  
Mayur Jayarao ◽  
Lawrence S. Chin
Keyword(s):  
Stereotactic Radiosurgery ◽  
Computer Technology ◽  
Planning Techniques ◽  
Robotic Assisted ◽  
Technological Basis ◽  
Image Guided ◽  
Robotic Radiosurgery ◽  
Beam Delivery ◽  
Subsequent Introduction ◽  
Review Current

✓ Stereotactic radiosurgery has undergone a remarkable evolution since its conception and the subsequent introduction of image-guided radiosurgery, primarily because of the concurrent advances in imaging and computer technology. However, recent improvements in real-time imaging, inverse planning techniques, and frameless alternatives have greatly enhanced the conformity and accuracy of the radiosurgical procedure. As a consequence, the possibility of hypofractionation is offered, and both intra- and extracranial targets can now be ablated with sustained submillimetric precision. Although all indispensable features, none is as impressive or useful as the incorporation of robotics, robotic beam delivery, or robotic-assisted planning, which has only served to improve the accuracy and homogeneity of therapy. The aim of this article was to describe the general technological basis of robots in radiosurgery and to review current clinical usage of robotic radiosurgery devices. Emphasis has been placed on robotic principles and the various popular applications currently available.

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