CyberKnife� Center
Sinai Hospital is the only Maryland hospital offering CyberKnife�, a recent addition to the Alvin & Lois Lapidus Cancer Institute�s  at LifeBridge Health's sophisticated array of services for cancer patients.

The CyberKnife� Stereotactic Radiosurgery system is a computer-guided, linear accelerator mounted on a robotic arm. This noninvasive outpatient treatment enables doctors to treat multiple sites without making a single incision or immobilizing the patient in a stereotactic head frame. In fact, tumors previously thought to be inoperable can now be treated using the CyberKnife�. The level of accuracy achieved by the system allows for higher doses of radiation, which provide greater potential for killing tumors and curing the disease.

The CyberKnife� has many advantages over its predecessors. The maneuverability of the robotic arm makes treatment of non-isocentric (irregularly shaped) tumors possible and more effective. In the brain, the CyberKnife� can go where the scalpel cannot to remove meningiomas and metastases.

Stereotactic radiosurgery is neither true radiation nor true surgery; it is a hybrid. The surgeon is wielding a mouse, rather than a scalpel, conducting virtual surgery on a tumor that, in many cases, could not be removed with actual surgery.

While surgical removal of many tumors may be preferred, depending on the patient�s age, medical history, the risks associated with surgery and the location of the tumor, the CyberKnife� can now be considered.

The CyberKnife� features two "eyes" to track minute changes in patient position during treatment. The eyes aretwo X-rays positioned on either side of the treatment table that continuously monitor patient movement in three dimensions. Through its tracking system, the CyberKnife� detects even slight movements, thus allowing it to achieve extreme accuracy in dose delivery. Because of its great precision, the total treatment can be administered in as few as one treatment, whereas conventional radiation may require as many as 30 treatment sessions.

The CyberKnife� offers the most amazing form of true artificial intelligence. The technology is truly stunning, and the results have been spectacular for those patients who were not good candidates for surgery, particularly those with brain tumors and spine or back tumors.

Prior to the radiosurgery procedure, physicians gather data about a patient�s actual anatomy and the size, shape and location of the lesion from computed tomography (CT) or magnetic resonance imaging (MRI) scans. Instead of a head frame, a foam mold of the patient is used to immobilize the patient during treatment. Once a frame of reference for the patient and the lesion is determined, a surgeon and a radiation oncologist develop a computer-generated, three-dimensional treatment plan from which to direct the CyberKnife��s rays to a certain depth of tissue.

During surgery, a patient rests comfortably on the operating table without anesthesia while the robotic arm delivers a concentrated radiation dose to the tumor. Total treatment lasts from one-and-a-half to two hours and requires very little recovery time. If necessary, treatments with the CyberKnife� can be given in fractions.

For standard radiation treatment planning, doctors look at the tumor, the radiation dose and the desired solution. With CyberKnife�, inverse planning is used. The tumor is looked at, the normal structures around the tumor are looked at and then limits on the dosage are calculated to avoid damaging the normal structures.

CyberKnife� is currently in use at only 20 locations worldwide. The potential of this technology is just being explored. It is currently used for both benign and malignant conditions in the brain and spine. But developing applications are for lung, abdominal and breast tumors.

To find out if you or your loved one is a candidate for CyberKnife�, call 410-601-WELL.

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