Image-guided spine radiosurgery success at the University of Pittsburgh Medical Center

Sunnyvale 10 January 2003The University of Pittsburgh Medical Center (UPMC) in Pennsylvania has now treated 100 spinal tumour patients with Accuray's CyberKnife Stereotactic Radiosurgery System. Treatments took place over the last 14 months and were delivered in single and staged fractions. Stereotactic radiosurgery involves the use of precise targeting and multiple beams of high doses of radiation to ablate tumours and other defined lesions non-invasively.


The CyberKnife is the only system capable of performing single session or staged radiosurgery on lesions located anywhere in the body. This is made possible through the use of image-guidance and robotics. UPMC installed the software necessary to begin spinal treatments in 2002 and is now established as the most active CyberKnife spinal radiosurgery centre in the United States.

"Spinal stereotactic radiosurgery using the CyberKnife can now be performed safely, accurately, and effectively. This technique offers a successful alternative therapeutic modality for the treatment of a variety of spinal lesions not amenable to open surgical techniques, in medically inoperable patients, lesions located in previously irradiated sites, or as an adjunct to surgery. The major potential benefits of radiosurgical ablation of spinal lesions are short treatment time in an outpatient setting with no recovery time and good treatment effect", stated Peter Gerstzen, M.D., M.P.H., Assistant Professor of Neurosurgery at University of Pittsburgh.

Dr. Gerstzen has pioneered spinal treatments with the CyberKnife at UPMC. Earlier this year, he was awarded a research grant by the American Association of Neurological Surgeons and Congress of Neurological Surgeons Section on Disorders of the Spine and Peripheral Nerves to evaluate the outcomes of patients undergoing CyberKnife treatment for neurosurgical lesions.

Shalom Kalnicki, M.D., Vice Chairman of Clinical Affairs in Radiation Oncology at UPMC, commented: "With the tremendous success of CyberKnife therapy in the treatment of tumours involving the brain and spine, we are now developing collaborative relationships with other disciplines to expand the use of this technology to new areas such as carcinomas of the biliary tree and pancreas, as well as isolated lung and mediastinal tumours. We believe the CyberKnife's versatility can potentially be used to effectively treat many new indications."

The University of Pittsburgh Medical Center (UPMC), affiliated with the University of Pittsburgh Schools of the Health Sciences, is an integrated health care delivery system in western Pennsylvania, and one of the largest not-for-profit integrated health care systems in the United States. UPMC meets comprehensive health care needs through the region's largest and finest network of tertiary, speciality and community hospitals.

"UPMC exemplifies how we envision the CyberKnife revolutionising how tumours are treated. In the past, radiosurgery has primarily been a tool neurosurgeons used to treat brain lesions because it required the use of a metal frame to achieve sufficient radiation targeting accuracy. The CyberKnife replaces the frame with an advanced image-guidance system that uses bony landmarks or small, embedded markers to target the radiation. The unique frameless nature of the CyberKnife now makes it possible for both radiation oncologists and new surgical specialities to utilise radiosurgery as a potential treatment alternative", stated Euan Thomson, Chief Executive Officer of Accuray.

The CyberKnife Stereotactic Radiosurgery System is a non-invasive robotic radiosurgery device that can ablate tumours and other lesions without open surgery. It delivers multiple beams of precisely directed radiation that converge upon the tumour while minimising injury to surrounding healthy tissue. The CyberKnife is the only system that integrates image-guidance and robotic delivery of radiation. Existing conventional systems rely on an external metal frame attached to the skull for target localisation, which limits their application to lesions in the head. The CyberKnife instead uses internal reference points in the anatomy such as skeletal landmarks or small implanted markers, to enable frameless treatment of lesions anywhere in the body.

The unique CyberKnife technology was developed in co-operation with Stanford University and was cleared by the FDA in August 2001 to provide radiosurgery for lesions anywhere in the body when radiation treatment is indicated. To date, the CyberKnife has been used to treat more than 3000 patients worldwide.

CyberKnife incorporates logic that precisely corrects for patient movement during actual treatment delivery. The level of accuracy achievable by the system allows higher doses of radiation to be used, which provides the potential for greater tumour-killing efficacy and greater likelihood of cure.

Through the development and promotion of the CyberKnife system and participation in ongoing clinical research at prominent academic hospitals, Accuray will help make stereotactic radiosurgery a viable and accessible option for patients all over the world. More CyberKnife news is available in the VMW January 2003 article USC/Norris Comprehensive Cancer Center and Hospital launches CyberKnife non-invasive robotic tumour treatment.

Leslie Versweyveld

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