scholarly journals The CyberKnife® Robotic Radiosurgery System in 2010

2010 ◽  
Vol 9 (5) ◽  
pp. 433-452 ◽  
Author(s):  
W. Kilby ◽  
J. R. Dooley ◽  
G. Kuduvalli ◽  
S. Sayeh ◽  
C. R. Maurer
Keyword(s):  
Robotic Radiosurgery

scholarly journals Robotic Radiosurgery for Persistent Postoperative Acromegaly in Patients with Cavernous Sinus-Invading Pituitary Adenomas—A Multicenter Experience

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 537
Author(s):  
Felix Ehret ◽  
Markus Kufeld ◽  
Christoph Fürweger ◽  
Alfred Haidenberger ◽  
Paul Windisch ◽  
...  
Keyword(s):  
Disease Control ◽  
Effective Treatment ◽  
Cavernous Sinus ◽  
Treatment Options ◽  
Cavernous Sinus Invasion ◽  
Robotic Radiosurgery ◽  
Patient Morbidity ◽  
Biochemical Remission ◽  
Patients Experience

Background: The rates of incomplete surgical resection for pituitary macroadenomas with cavernous sinus invasion are high. In growth hormone-producing adenomas, there is a considerable risk for persistent acromegaly. Thus, effective treatment options are needed to limit patient morbidity and mortality. This multicenter study assesses the efficacy and safety of robotic radiosurgery (RRS) for patients with cavernous sinus-invading adenomas with persistent acromegaly. Methods: Patients who underwent RRS with CyberKnife for postoperative acromegaly were eligible. Results: Fifty patients were included. At a median follow-up of 57 months, the local control was 100%. The pretreatment insulin-like growth factor 1 (IGF-1) levels and indexes were 381 ng/mL and 1.49, respectively. The median dose and prescription isodose were 18 Gy and 70%, respectively. Six months after RRS, and at the last follow-up, the IGF-1 levels and indexes were 277 ng/mL and 1.14, as well as 196 ng/mL and 0.83, respectively (p = 0.0001 and p = 0.0002). The IGF-1 index was a predictor for biochemical remission (p = 0.04). Nine patients achieved biochemical remission and 24 patients showed biochemical disease control. Three patients developed a new hypopituitarism. Conclusions: RRS is an effective treatment for this challenging patient population. IGF-1 levels are decreasing after treatment and most patients experience biochemical disease control or remission.

Operational analysis: A method for observing and analyzing digital media operations

2021 ◽  
pp. 146144482199864
Author(s):  
Kathrin Friedrich ◽  
A S Aurora Hoel
Keyword(s):  
Digital Media ◽  
Task Orientation ◽  
Operational Analysis ◽  
Media Technologies ◽  
Robotic Radiosurgery ◽  
Middle Range ◽  
Operational Models ◽  
Media Research ◽  
Media Applications ◽  
Tracking Devices

Interventional digital media applications such as robotic surgery, remote-controlled vehicles or wearable tracking devices pose a challenge to media research methodologically as well as conceptually. How do we go about analyzing operational media, where human and non-human agencies intertwine in seemingly inscrutable ways? This article introduces the method of o perational analysis to systematically observe and critically analyze such situated, interventional and multilayered entanglements. Against the background of ongoing efforts to develop operational models for understanding digital media, the method of operational analysis conceptually ascribes to media technologies a real efficacy by approaching them as adaptive mediators. As an operational middle-range approach, it allows to integrate theoretical discussions with considerations of the situatedness, directedness, and task-orientation of operational media. The article presents an analytical toolbox for observing and analyzing digital media operations while simultaneously testing it on a particular application in robotic radiosurgery.

scholarly journals Multicriterial CNN based beam generation for robotic radiosurgery of the prostate

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Stefan Gerlach ◽  
Christoph Fürweger ◽  
Theresa Hofmann ◽  
Alexander Schlaefer
Keyword(s):  
Deep Learning ◽  
Treatment Planning ◽  
Treatment Plan ◽  
Plan Quality ◽  
New Approach ◽  
Beam Generation ◽  
Radiological Features ◽  
Improve Treatment ◽  
Robotic Radiosurgery ◽  
Treatment Plans

AbstractAlthough robotic radiosurgery offers a flexible arrangement of treatment beams, generating treatment plans is computationally challenging and a time consuming process for the planner. Furthermore, different clinical goals have to be considered during planning and generally different sets of beams correspond to different clinical goals. Typically, candidate beams sampled from a randomized heuristic form the basis for treatment planning. We propose a new approach to generate candidate beams based on deep learning using radiological features as well as the desired constraints. We demonstrate that candidate beams generated for specific clinical goals can improve treatment plan quality. Furthermore, we compare two approaches to include information about constraints in the prediction. Our results show that CNN generated beams can improve treatment plan quality for different clinical goals, increasing coverage from 91.2 to 96.8% for 3,000 candidate beams on average. When including the clinical goal in the training, coverage is improved by 1.1% points.

RADT-30. MULTISESSION RADIOSURGERY ALONE FOR TREATMENT OF PRESUMED MENINGIOMAS: AN INTERIM REPORT FROM A SINGLE INSTITUTION PROTOCOL

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi47-vi48
Author(s):  
Michael Carrasquilla ◽  
Alexander Tai ◽  
Matthew Forsthoefel ◽  
Edina Wang ◽  
Siyuan Lei ◽  
...  
Keyword(s):  
Local Control ◽  
Tumor Resection ◽  
Symptom Improvement ◽  
Tumor Control ◽  
Single Institution ◽  
Robotic Radiosurgery ◽  
Early Results ◽  
Alternative Treatment Option

Abstract PURPOSE Meningiomas are the most commonly diagnosed primary intracranial tumor. Resection and single-fraction radiosurgery are treatment options with well-established long-term outcomes data. Multisession radiosurgery is an alternative treatment option with promising early results. However, mature outcomes literature does not yet exist. In this study, we report our institution’s interim results on the efficacy and safety of 5-fraction radiosurgery alone for radiographically diagnosed meningiomas. MATERIALS AND METHODS Between 2005-2015 all patients who completed treatment on a single institution protocol utilizing 5-fraction robotic radiosurgery alone for the treatment of progressing radiographically diagnosed meningiomas were eligible for inclusion. Local control was calculated using the Kaplan-Meier Method. RESULTS Forty-four consecutive predominately female patients (84%) ranging in age from 33-85 (median: 59) were included in the present study. Median tumor volume was 4.05mm3 (range: 0.94-15.4mm3) and the majority of tumors were located at the base of skull (66%). A median dose of 25Gy (range: 25Gy-35Gy), was delivered to a median isodose line of 82%, (range: 70%-90%) over a median of 7 days (range: 5-11 days). Acute toxicity was minimal with 7 patients (15%) requiring a short course of steroids for symptomatic edema during treatment. Of 16 patients who presented with a cranial nerve deficit, symptom improvement was noted in 11 patients (69%). No permanent treatment related toxicity was noted in our cohort. The median radiographic follow-up was 6.9 years (range: 0.5-14.8 years). The 5 and 8-year local control rates were 100% and 95%. The median time to local failure (n=2) in our cohort was 8.2 years. CONCLUSIONS The treatment of radiographically diagnosed meningiomas with 5-fraction robotic radiosurgery provides excellent local control to date, with low rates of acute and late toxicity. However, with late failures noted in our series, continued follow-up is needed to determine the optimal dose required for long-term tumor control.

scholarly journals Treatment planning for MLC based robotic radiosurgery for brain metastases: plan comparison with circular fields and suggestions for planning strategies

2017 ◽  
Vol 3 (2) ◽  
pp. 151-154
Author(s):  
Daniela Schmitt ◽  
Rami El Shafie ◽  
Sebastian Klüter ◽  
Nathalie Arians ◽  
Kai Schubert ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Low Dose ◽  
Treatment Time ◽  
Conformity Index ◽  
High Dose ◽  
Gradient Index ◽  
Plan Comparison ◽  
Robotic Radiosurgery ◽  
Target Volumes ◽  
Beam Transmission

AbstractTo evaluate the possible range of application of the new InCise2 MLC for the CyberKnife M6 system in brain radiosurgery, a plan comparison was made for 10 brain metastases sized between 1.5 and 9cm3 in 10 patients treated in a single fraction each. The target volumes consist of a PTV derived by expanding the GTV by 1mm and were chosen to have diversity in the cohort regarding regularity of shape, location and the structures needed to be blocked for beam transmission in the vicinity. For each case, two treatment plans were optimized: one using the MLC and one using the IRIS-collimator providing variable circular fields. Plan re-quirements were: dose prescription to the 70% isodose line (18 or 20Gy), 100% GTV coverage, ≥98% PTV coverage, undisturbed central high dose region (95% of maximum dose) and a conformity index as low as possible. Plan com-parison parameters were: conformity index (CI), high-dose gradient index (GIH), low-dose gradient index (GIL), total number of monitor units (MU) and expected treatment time (TT). For all cases, clinically acceptable plans could be gen-erated with the following results (mean±SD) for CI, GIH, GIL, MU and TT, respectively for the MLC plans: 1.09±0.03, 2.77±0.26, 2.61±0.08, 4514±830MU and 27±5min and for the IRIS plans: 1.05±0.01, 3.00±0.35, 2.46±0.08, 8557±1335MU and 42±7min. In summary, the MLC plans were on average less conformal and had a shallower dose gradient in the low dose region, but a steeper dose gradient in the high dose region. This is accompanied by a smaller vol-ume receiving 10Gy. A plan by plan comparison shows that usage of the MLC can spare about one half of the MUs and one third of treatment time. From these experiences and results suggestions for MLC planning strategy can be de-duced.

scholarly journals Treatment of Symptomatic Cervical Metastasis with Emergency Surgery and CyberKnife Robotic Radiosurgery

2017 ◽  
Vol 31 (1) ◽  
pp. 74-79
Author(s):  
Ataru Fukuda ◽  
Isao Kitahara ◽  
Tomohiro Morito ◽  
Ryo Tanaka ◽  
Hiroaki Shirotori ◽  
...  
Keyword(s):  
Emergency Surgery ◽  
Cervical Metastasis ◽  
Robotic Radiosurgery ◽  
Cyberknife Robotic Radiosurgery

scholarly journals Magnetic Resonance Imaging-Based Robotic Radiosurgery of Arteriovenous Malformations

2021 ◽  
Vol 10 ◽  
Author(s):  
Tobias Greve ◽  
Felix Ehret ◽  
Theresa Hofmann ◽  
Jun Thorsteinsdottir ◽  
Franziska Dorn ◽  
...  
Keyword(s):  
Treatment Planning ◽  
Cox Regression ◽  
Target Volume ◽  
Neurological Deficits ◽  
Patient Comfort ◽  
Invasive Treatment ◽  
Cox Regression Analysis ◽  
Robotic Radiosurgery ◽  
Martin Grade ◽  
Cerebral Avms

ObjectiveCyberKnife offers CT- and MRI-based treatment planning without the need for stereotactically acquired DSA. The literature on CyberKnife treatment of cerebral AVMs is sparse. Here, a large series focusing on cerebral AVMs treated by the frameless CyberKnife stereotactic radiosurgery (SRS) system was analyzed.MethodsIn this retrospective study, patients with cerebral AVMs treated by CyberKnife SRS between 2005 and 2019 were included. Planning was MRI- and CT-based. Conventional DSA was not coregistered to the MRI and CT scans used for treatment planning and was only used as an adjunct. Obliteration dynamics and clinical outcome were analyzed.Results215 patients were included. 53.0% received SRS as first treatment; the rest underwent previous surgery, embolization, SRS, or a combination. Most AVMs were classified as Spetzler-Martin grade I to III (54.9%). Hemorrhage before treatment occurred in 46.0%. Patients suffered from headache (28.8%), and seizures (14.0%) in the majority of cases. The median SRS dose was 18 Gy and the median target volume was 2.4 cm³. New neurological deficits occurred in 5.1% after SRS, with all but one patient recovering. The yearly post-SRS hemorrhage incidence was 1.3%. In 152 patients who were followed-up for at least three years, 47.4% showed complete AVM obliteration within this period. Cox regression analysis revealed Spetzler-Martin grade (P = 0.006) to be the only independent predictor of complete obliteration.ConclusionsAlthough data on radiotherapy of AVMs is available, this is one of the largest series, focusing exclusively on CyberKnife treatment. Safety and efficacy compared favorably to frame-based systems. Non-invasive treatment planning, with a frameless SRS robotic system might provide higher patient comfort, a less invasive treatment option, and lower radiation exposure.

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