Accuray integrates in-room 4D imaging with the CyberKnife robotic radiosurgery system and launches three new products for lung cancer treatment

Paris 21 November 2006Accuray Incorporated, a global expert in the field of robotic radiosurgery, has introduced the industry's first solution that combines the power of robotic radiosurgery with either 3D or 4D diagnostic quality computer tomography (CT) scanning in the treatment room. With advanced imaging technology, clinicians can visualize the exact location of the tumour and its surrounding critical structures, immediately prior to treatment, to ensure the radiosurgery procedure delivers the treatment as planned.


Unlike other in-room imaging solutions, the 4D imaging system is designed to ensure clinicians have access to diagnostic quality images and 4D image data in unmatched acquisition time. Radiation therapy solutions have generally relied on slower, lower quality imaging techniques such as cone beam imaging. In contrast, the Accuray radiosurgery solution offers the option of incorporating a Siemens state-of-the-art SOMATOM CT system, enabling faster, dynamic, higher resolution, diagnostic quality imaging in the treatment room.

"We have designed the CyberKnife System to be the most accurate robotic radiosurgery system in the world", stated Euan S. Thomson, Ph.D., president and chief executive officer of Accuray. It is a dynamic treatment system that can track tumours throughout the treatment, even as they move with respiration. In evaluating our options for in-room imaging, we selected a high resolution 4D system, the most advanced option available. This collaboration with Siemens has enabled Accuray to bring state-of-the-art 3D and 4D diagnostic quality imaging into the CyberKnife radiosurgery treatment process."

The combination of the CT scanner with the CyberKnife System is made possible by the recent release of the RoboCouch Patient Positioning System. Once positioned on the robotic couch, the patient undergoes a CT scan, which allows the clinician to quickly verify the treatment plan and the exact location of the tumour and adjacent critical structures. Without moving the patient from the treatment table, the RoboCouch System then transitions the patient from the CT scanner to the CyberKnife System where the patient receives radiosurgery treatment.

Accuray has also introduced three new products designed to improve the way lung cancer is treated. These products - Xsight Lung Tracking System, Xchange Robotic Collimator Changer and 4D Treatment Optimisation and Planning System - combine with the Accuray CyberKnife Robotic Radiosurgery System to offer a non-invasive, fiducial-free lung cancer treatment option that eliminates the risk of complications common with the implantation of markers or fiducials. Moreover, the products can shorten treatment times through treatment planning optimisation and reduced treatment delivery interruptions.

"Lung cancer radiosurgery using the CyberKnife System is growing, with more than a 130 percent increase in the number of patients treated in the last year alone. The Xsight Lung Tracking System offers a significant technological breakthrough which further enhances the CyberKnife System's position to become the standard of care for lung radiosurgery", stated Euan S. Thomson. "With the first and only non-invasive radiosurgical means to precisely target and treat tumours, Accuray is breaking down barriers for patients who may not otherwise be able to receive treatment."

The Xsight Lung Tracking System uses sophisticated image processing and registration techniques to directly lock onto and track the tumour throughout the treatment. It works seamlessly with Accuray's Synchrony Respiratory Tracking System to track, detect and correct for tumour and patient movement, allowing patients to breathe normally without the need for gating or breath holding techniques. Xsight Lung's radiosurgery accuracy may eliminate the need for the invasive placement or tracking of radiographic markers or fiducials reducing the risk inherent to traditional treatment methods.

Designed to offer a non-invasive, more comfortable alternative for patients, the Xsight Lung Tracking System maintains the precision and accuracy required for radiosurgery treatments. Published data states that there is a risk of pneumothorax when fiducials are used to mark lung tumours. By using non-invasive means to precisely target lung tumours, oncologists will be able to more quickly and effectively treat patients, including ones who are now considered to be medically inoperable. (Reichner, Cristina A., et al. The Placement of Gold Fiducials for CyberKnife Stereotactic Radiosurgery Using a Modified Transbronchial Needle Aspiration Technique. J. Bronchol. 2005;12:193-195.)

"Radiosurgery with the CyberKnife System has proven to be quite successful in treating our lung cancer patients", stated John J. Kresl, MD, PhD of Arizona Oncology Services at St. Joseph's Hospital and Barrow Neurological Institute. "Because these new tools from Accuray are non-invasive, we believe they will enhance our ability to treat lung tumours, including those in patients who may not be able to withstand the complications that could result from the implantation of fiducials."

"A study in the most recent issue of the New England Journal of Medicine showed that regular screenings detected lung cancer in its earliest stages, and was curable when treatment quickly followed", stated Eric P. Lindquist, senior vice president and chief marketing officer. "We believe the Accuray CyberKnife System offers these stage I lung cancer patients an ideal alternative. With over 1000 lung tumour patients treated on the CyberKnife System to date, we believe that radiosurgery will continue to be a viable treatment option for lung cancer patients."

Also debuting at the American Society for Therapeutic Radiology and Oncology (ASTRO) Annual Meeting at the Pennsylvania Convention Center in Philadelphia were the:

  • Xchange Robotic Collimator Changer, which has the automated ability to change secondary collimators during the treatment, eliminating the need to re-enter the treatment room, while also minimising related treatment delays.
  • 4D Treatment Optimisation and Planning System, which takes into account not only the movement of the tumour, but also the movement and deformation of tissue. Using this system, clinicians can better deliver the prescribed radiation dose to the targeted area while minimising the damage to surrounding healthy tissue.

The CyberKnife System is the world's first and only radiosurgery system that utilizes intelligent robotics to treat tumours anywhere in the body with sub-millimeter accuracy. The CyberKnife System treats patients in single or staged - typically 2 to 5 - sessions by delivering multiple beams of precisely directed radiation that converge upon the tumour while minimizing injury to surrounding healthy tissue. Image guidance and computer controlled robotics combine to continuously track, detect and correct for tumour and patient movement throughout the treatment. Because of this precision and accuracy, no head or body frame is required.

More than 100 CyberKnife Systems have been purchased by medical centres throughout the world and a large body of peer-reviewed papers supports its clinical practice. To date, the CyberKnife System has treated more than 25.000 patients worldwide. More company news is available in the VMW June 2005 article CyberKnife Radiosurgery System now eliminates need for surgical procedure with XSight tracking to treat spine tumours.

Leslie Versweyveld

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