Treatment Plan Comparison Between Self-Shielding Gyroscopic Radiosurgery and Robotic Radiosurgery

Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) pr...

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Vydané v:Curēus (Palo Alto, CA) Ročník 17; číslo 4; s. e82990
Hlavní autori: Hofmann, Theresa, Sammer, Matthias, Kohlhase, Nadja, Eftimova, Dochka, Ehret, Felix, Santacroce, Antonio, Muacevic, Alexander, Fürweger, Christoph
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Springer Nature B.V 25.04.2025
Cureus
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ISSN:2168-8184, 2168-8184
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Abstract Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) promises high plan quality due to advantageous beam properties. However, the clinically usable workspace in GRS is reduced due to potential collisions with a spacious headrest. A novel "conformal" headrest was introduced to GRS in December 2023 to remedy this, using narrower masks to minimize collision zones and maximize the usable solid angle. This study analyzes the GRS plan quality for 30 simple and complex cases, comparing GRS plans with the old and new headrests to robotic radiosurgery (RRS) as an established reference platform. The GRS system consists of a 3 MV linear accelerator mounted on coupled gimbals for non-coplanar beam delivery, a collimator wheel for circular beam shaping, and a kV image guidance system. The RRS system is a full-body treatment platform with a 6 MV linear accelerator on a robotic arm for non-coplanar, non-isocentric beam delivery. A total of 30 clinical single-fraction plans treated with the GRS system prior to the headrest update is selected. Clinical GRS treatment plans are created by manually placing isocenters within the target volume and using an inverse optimization algorithm. GRS plans are reoptimized using the new software and headrest (further referred to as GRS*) for comparison. RRS plans are generated using circular apertures and the VOLO™ optimization technique. Treatment plans from the GRS, GRS*, and RRS platforms are compared with respect to quality metrics, number of beams, total monitor units (MU), and expected treatment time. The updated GRS* plans show a significantly better new conformity index (nCI) and gradient index (GI) than the clinical GRS plans. The volume of the brainstem receiving 8 Gy or more is significantly reduced with the GRS* platform. The number of beams, total MU, and expected treatment time increase significantly with the new GRS* treatment planning system. Compared to GRS* plans, the nCI of RRS plans is better, but the GI is worse. The total number of beams and MU were significantly lower with the RRS platform, while the expected treatment times were equivalent. The introduction of the new headrest design in the GRS* system has led to a notable improvement in the treatment plans of GRS. As a trade-off for the overall improvement in dosimetric quality, the number of beams and the expected treatment time increase. RRS and GRS* systems now exhibit equivalent plan quality, with a trend of the GRS* toward sharper dose gradients but lower conformity, attributed to the specialized delivery design.
AbstractList Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X® platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) promises high plan quality due to advantageous beam properties. However, the clinically usable workspace in GRS is reduced due to potential collisions with a spacious headrest. A novel "conformal" headrest was introduced to GRS in December 2023 to remedy this, using narrower masks to minimize collision zones and maximize the usable solid angle. This study analyzes the GRS plan quality for 30 simple and complex cases, comparing GRS plans with the old and new headrests to robotic radiosurgery (RRS) as an established reference platform.The GRS system consists of a 3 MV linear accelerator mounted on coupled gimbals for non-coplanar beam delivery, a collimator wheel for circular beam shaping, and a kV image guidance system. The RRS system is a full-body treatment platform with a 6 MV linear accelerator on a robotic arm for non-coplanar, non-isocentric beam delivery. A total of 30 clinical single-fraction plans treated with the GRS system prior to the headrest update is selected. Clinical GRS treatment plans are created by manually placing isocenters within the target volume and using an inverse optimization algorithm. GRS plans are reoptimized using the new software and headrest (further referred to as GRS*) for comparison. RRS plans are generated using circular apertures and the VOLO™ optimization technique. Treatment plans from the GRS, GRS*, and RRS platforms are compared with respect to quality metrics, number of beams, total monitor units (MU), and expected treatment time.The updated GRS* plans show a significantly better new conformity index (nCI) and gradient index (GI) than the clinical GRS plans. The volume of the brainstem receiving 8 Gy or more is significantly reduced with the GRS* platform. The number of beams, total MU, and expected treatment time increase significantly with the new GRS* treatment planning system. Compared to GRS* plans, the nCI of RRS plans is better, but the GI is worse. The total number of beams and MU were significantly lower with the RRS platform, while the expected treatment times were equivalent.The introduction of the new headrest design in the GRS* system has led to a notable improvement in the treatment plans of GRS. As a trade-off for the overall improvement in dosimetric quality, the number of beams and the expected treatment time increase. RRS and GRS* systems now exhibit equivalent plan quality, with a trend of the GRS* toward sharper dose gradients but lower conformity, attributed to the specialized delivery design.
Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) promises high plan quality due to advantageous beam properties. However, the clinically usable workspace in GRS is reduced due to potential collisions with a spacious headrest. A novel "conformal" headrest was introduced to GRS in December 2023 to remedy this, using narrower masks to minimize collision zones and maximize the usable solid angle. This study analyzes the GRS plan quality for 30 simple and complex cases, comparing GRS plans with the old and new headrests to robotic radiosurgery (RRS) as an established reference platform. The GRS system consists of a 3 MV linear accelerator mounted on coupled gimbals for non-coplanar beam delivery, a collimator wheel for circular beam shaping, and a kV image guidance system. The RRS system is a full-body treatment platform with a 6 MV linear accelerator on a robotic arm for non-coplanar, non-isocentric beam delivery. A total of 30 clinical single-fraction plans treated with the GRS system prior to the headrest update is selected. Clinical GRS treatment plans are created by manually placing isocenters within the target volume and using an inverse optimization algorithm. GRS plans are reoptimized using the new software and headrest (further referred to as GRS*) for comparison. RRS plans are generated using circular apertures and the VOLO™ optimization technique. Treatment plans from the GRS, GRS*, and RRS platforms are compared with respect to quality metrics, number of beams, total monitor units (MU), and expected treatment time. The updated GRS* plans show a significantly better new conformity index (nCI) and gradient index (GI) than the clinical GRS plans. The volume of the brainstem receiving 8 Gy or more is significantly reduced with the GRS* platform. The number of beams, total MU, and expected treatment time increase significantly with the new GRS* treatment planning system. Compared to GRS* plans, the nCI of RRS plans is better, but the GI is worse. The total number of beams and MU were significantly lower with the RRS platform, while the expected treatment times were equivalent. The introduction of the new headrest design in the GRS* system has led to a notable improvement in the treatment plans of GRS. As a trade-off for the overall improvement in dosimetric quality, the number of beams and the expected treatment time increase. RRS and GRS* systems now exhibit equivalent plan quality, with a trend of the GRS* toward sharper dose gradients but lower conformity, attributed to the specialized delivery design.
Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X® platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) promises high plan quality due to advantageous beam properties. However, the clinically usable workspace in GRS is reduced due to potential collisions with a spacious headrest. A novel "conformal" headrest was introduced to GRS in December 2023 to remedy this, using narrower masks to minimize collision zones and maximize the usable solid angle. This study analyzes the GRS plan quality for 30 simple and complex cases, comparing GRS plans with the old and new headrests to robotic radiosurgery (RRS) as an established reference platform. The GRS system consists of a 3 MV linear accelerator mounted on coupled gimbals for non-coplanar beam delivery, a collimator wheel for circular beam shaping, and a kV image guidance system. The RRS system is a full-body treatment platform with a 6 MV linear accelerator on a robotic arm for non-coplanar, non-isocentric beam delivery. A total of 30 clinical single-fraction plans treated with the GRS system prior to the headrest update is selected. Clinical GRS treatment plans are created by manually placing isocenters within the target volume and using an inverse optimization algorithm. GRS plans are reoptimized using the new software and headrest (further referred to as GRS*) for comparison. RRS plans are generated using circular apertures and the VOLO™ optimization technique. Treatment plans from the GRS, GRS*, and RRS platforms are compared with respect to quality metrics, number of beams, total monitor units (MU), and expected treatment time. The updated GRS* plans show a significantly better new conformity index (nCI) and gradient index (GI) than the clinical GRS plans. The volume of the brainstem receiving 8 Gy or more is significantly reduced with the GRS* platform. The number of beams, total MU, and expected treatment time increase significantly with the new GRS* treatment planning system. Compared to GRS* plans, the nCI of RRS plans is better, but the GI is worse. The total number of beams and MU were significantly lower with the RRS platform, while the expected treatment times were equivalent. The introduction of the new headrest design in the GRS* system has led to a notable improvement in the treatment plans of GRS. As a trade-off for the overall improvement in dosimetric quality, the number of beams and the expected treatment time increase. RRS and GRS* systems now exhibit equivalent plan quality, with a trend of the GRS* toward sharper dose gradients but lower conformity, attributed to the specialized delivery design.
Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X® platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) promises high plan quality due to advantageous beam properties. However, the clinically usable workspace in GRS is reduced due to potential collisions with a spacious headrest. A novel "conformal" headrest was introduced to GRS in December 2023 to remedy this, using narrower masks to minimize collision zones and maximize the usable solid angle. This study analyzes the GRS plan quality for 30 simple and complex cases, comparing GRS plans with the old and new headrests to robotic radiosurgery (RRS) as an established reference platform. The GRS system consists of a 3 MV linear accelerator mounted on coupled gimbals for non-coplanar beam delivery, a collimator wheel for circular beam shaping, and a kV image guidance system. The RRS system is a full-body treatment platform with a 6 MV linear accelerator on a robotic arm for non-coplanar, non-isocentric beam delivery. A total of 30 clinical single-fraction plans treated with the GRS system prior to the headrest update is selected. Clinical GRS treatment plans are created by manually placing isocenters within the target volume and using an inverse optimization algorithm. GRS plans are reoptimized using the new software and headrest (further referred to as GRS*) for comparison. RRS plans are generated using circular apertures and the VOLO™ optimization technique. Treatment plans from the GRS, GRS*, and RRS platforms are compared with respect to quality metrics, number of beams, total monitor units (MU), and expected treatment time. The updated GRS* plans show a significantly better new conformity index (nCI) and gradient index (GI) than the clinical GRS plans. The volume of the brainstem receiving 8 Gy or more is significantly reduced with the GRS* platform. The number of beams, total MU, and expected treatment time increase significantly with the new GRS* treatment planning system. Compared to GRS* plans, the nCI of RRS plans is better, but the GI is worse. The total number of beams and MU were significantly lower with the RRS platform, while the expected treatment times were equivalent. The introduction of the new headrest design in the GRS* system has led to a notable improvement in the treatment plans of GRS. As a trade-off for the overall improvement in dosimetric quality, the number of beams and the expected treatment time increase. RRS and GRS* systems now exhibit equivalent plan quality, with a trend of the GRS* toward sharper dose gradients but lower conformity, attributed to the specialized delivery design.Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment concept. The novel ZAP-X® platform (ZAP Surgical Systems Inc., San Carlos, CA, USA) for vault-free, self-shielding gyroscopic radiosurgery (GRS) promises high plan quality due to advantageous beam properties. However, the clinically usable workspace in GRS is reduced due to potential collisions with a spacious headrest. A novel "conformal" headrest was introduced to GRS in December 2023 to remedy this, using narrower masks to minimize collision zones and maximize the usable solid angle. This study analyzes the GRS plan quality for 30 simple and complex cases, comparing GRS plans with the old and new headrests to robotic radiosurgery (RRS) as an established reference platform. The GRS system consists of a 3 MV linear accelerator mounted on coupled gimbals for non-coplanar beam delivery, a collimator wheel for circular beam shaping, and a kV image guidance system. The RRS system is a full-body treatment platform with a 6 MV linear accelerator on a robotic arm for non-coplanar, non-isocentric beam delivery. A total of 30 clinical single-fraction plans treated with the GRS system prior to the headrest update is selected. Clinical GRS treatment plans are created by manually placing isocenters within the target volume and using an inverse optimization algorithm. GRS plans are reoptimized using the new software and headrest (further referred to as GRS*) for comparison. RRS plans are generated using circular apertures and the VOLO™ optimization technique. Treatment plans from the GRS, GRS*, and RRS platforms are compared with respect to quality metrics, number of beams, total monitor units (MU), and expected treatment time. The updated GRS* plans show a significantly better new conformity index (nCI) and gradient index (GI) than the clinical GRS plans. The volume of the brainstem receiving 8 Gy or more is significantly reduced with the GRS* platform. The number of beams, total MU, and expected treatment time increase significantly with the new GRS* treatment planning system. Compared to GRS* plans, the nCI of RRS plans is better, but the GI is worse. The total number of beams and MU were significantly lower with the RRS platform, while the expected treatment times were equivalent. The introduction of the new headrest design in the GRS* system has led to a notable improvement in the treatment plans of GRS. As a trade-off for the overall improvement in dosimetric quality, the number of beams and the expected treatment time increase. RRS and GRS* systems now exhibit equivalent plan quality, with a trend of the GRS* toward sharper dose gradients but lower conformity, attributed to the specialized delivery design.
Author Fürweger, Christoph
Muacevic, Alexander
Eftimova, Dochka
Santacroce, Antonio
Kohlhase, Nadja
Ehret, Felix
Sammer, Matthias
Hofmann, Theresa
AuthorAffiliation 2 Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, DEU
4 Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, DEU
3 Radiation Oncology, German Cancer Consortium (DKTK) partner site Berlin, a partnership between DKFZ and Charité – Universitätsmedizin Berlin, Berlin, DEU
5 Medicine, Faculty of Health, Witten/Herdecke University, Witten, DEU
6 Stereotactic and Functional Neurosurgery, Medical Faculty, University Hospital Cologne, Cologne, DEU
1 Radiosurgery, European Radiosurgery Center Munich, Munich, DEU
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CitedBy_id crossref_primary_10_7759_cureus_87692
Cites_doi 10.7759/cureus.4275
10.7759/cureus.2146
10.3171/2010.8.GKS101002
10.1016/S0360-3016(01)01757-6
10.1118/1.3438081
10.1038/s41592-019-0686-2
10.1007/s11060-009-9802-y
10.1159/000519862
10.1186/s12885-024-12710-y
10.7759/cureus.1663
10.7759/cureus.13972
10.1159/000460259
10.1016/j.wneu.2022.04.120
10.7759/cureus.56035
10.1120/jacmp.v15i1.4095
10.7759/cureus.57452
10.1016/j.ijrobp.2021.09.027
10.3171/sup.2006.105.7.194
10.1002/mp.16436
10.1093/bjro/tzae003
10.1016/j.ejmp.2019.07.020
10.1093/jrr/rrw130
10.1016/j.prro.2018.02.006
10.7759/cureus.1917
10.3171/2019.1.JNS182769
10.3389/fonc.2024.1453256
10.1016/j.prro.2023.05.005
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Copyright © 2025, Hofmann et al. 2025 Hofmann et al.
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Keywords zap-x
single-fraction radiotherapy
dosimetric evaluation
gyroscopic radiosurgery
robotic radiosurgery
treatment plan comparison
cyberknife
stereotactic radiosurgery
Language English
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References Murai T (ref25) 2017; 58
Wowra B (ref5) 2009; 94
Weidlich GA (ref23) 2021; 13
Paddick I (ref19) 2006; 105 Suppl
Zeverino M (ref15) 2019; 64
Eaton DJ (ref26) 2018; 8
Hendricks BK (ref7) 2022; 100
Weidlich GA (ref9) 2017; 9
Descovich M (ref3) 2010; 113 Suppl
Nakamura JL (ref18) 2001; 51
Paddick I (ref11) 2023; 13
Kuo CY (ref2) 2017; 95
Sio TT (ref4) 2014; 15
Virtanen P (ref20) 2020; 17
Weidlich GA (ref22) 2018; 10
Marianayagam NJ (ref12) 2024; 16
Hanvey S (ref21) 2024; 6
Han EY (ref1) 2020; 132
Ehret F (ref14) 2024; 16
Chao PJ (ref24) 2024; 14
Wang J (ref10) 2024; 24
Adler JR (ref13) 2017; 9
Timmerman R (ref16) 2022; 112
Stapper C (ref27) 2023; 50
Muacevic A (ref6) 2022; 164
Benedict SH (ref17) 2010; 37
Weidlich GA (ref8) 2019; 11
References_xml – volume: 11
  year: 2019
  ident: ref8
  article-title: Characterization of a novel 3 megavolt linear accelerator for dedicated intracranial stereotactic radiosurgery
  publication-title: Cureus
  doi: 10.7759/cureus.4275
– volume: 10
  year: 2018
  ident: ref22
  article-title: Characterization of a novel revolving radiation collimator
  publication-title: Cureus
  doi: 10.7759/cureus.2146
– volume: 113 Suppl
  year: 2010
  ident: ref3
  article-title: A dosimetric comparison between Gamma Knife and CyberKnife treatment plans for trigeminal neuralgia
  publication-title: J Neurosurg
  doi: 10.3171/2010.8.GKS101002
– volume: 51
  year: 2001
  ident: ref18
  article-title: Dose conformity of Gamma Knife radiosurgery and risk factors for complications
  publication-title: Int J Radiat Oncol Biol Phys
  doi: 10.1016/S0360-3016(01)01757-6
– volume: 37
  year: 2010
  ident: ref17
  article-title: Stereotactic body radiation therapy: the report of AAPM Task Group 101
  publication-title: Med Phys
  doi: 10.1118/1.3438081
– volume: 17
  year: 2020
  ident: ref20
  article-title: SciPy 1.0: fundamental algorithms for scientific computing in Python
  publication-title: Nat Methods
  doi: 10.1038/s41592-019-0686-2
– volume: 94
  year: 2009
  ident: ref5
  article-title: Quality of radiosurgery for single brain metastases with respect to treatment technology: a matched-pair analysis
  publication-title: J Neurooncol
  doi: 10.1007/s11060-009-9802-y
– volume: 100
  year: 2022
  ident: ref7
  article-title: ZAP-X gyroscopic radiosurgery system: a preliminary analysis of clinical applications within a retrospective case series
  publication-title: Stereotact Funct Neurosurg
  doi: 10.1159/000519862
– volume: 24
  year: 2024
  ident: ref10
  article-title: Dosimetric comparison of ZAP-X, Gamma Knife, and CyberKnife stereotactic radiosurgery for single brain metastasis
  publication-title: BMC Cancer
  doi: 10.1186/s12885-024-12710-y
– volume: 9
  year: 2017
  ident: ref13
  article-title: Treatment planning for self-shielded radiosurgery
  publication-title: Cureus
  doi: 10.7759/cureus.1663
– volume: 13
  year: 2021
  ident: ref23
  article-title: Characterization of the ZAP-X® peripheral dose fall-off
  publication-title: Cureus
  doi: 10.7759/cureus.13972
– volume: 95
  year: 2017
  ident: ref2
  article-title: Evaluation of clinical application and dosimetric comparison of treatment plans of Gamma Knife and CyberKnife in treating arteriovenous malformations
  publication-title: Stereotact Funct Neurosurg
  doi: 10.1159/000460259
– volume: 164
  year: 2022
  ident: ref6
  article-title: Self-shielding gyroscopic radiosurgery-a first clinical experience, case series, and dosimetric comparison
  publication-title: World Neurosurg
  doi: 10.1016/j.wneu.2022.04.120
– volume: 16
  year: 2024
  ident: ref14
  article-title: Self-shielding gyroscopic radiosurgery: a prospective experience and analysis of the first 100 patients
  publication-title: Cureus
  doi: 10.7759/cureus.56035
– volume: 15
  year: 2014
  ident: ref4
  article-title: Comparing Gamma Knife and CyberKnife in patients with brain metastases
  publication-title: J Appl Clin Med Phys
  doi: 10.1120/jacmp.v15i1.4095
– volume: 16
  year: 2024
  ident: ref12
  article-title: Dosimetric comparison of dedicated radiosurgery platforms for the treatment of essential tremor: technical report
  publication-title: Cureus
  doi: 10.7759/cureus.57452
– volume: 112
  year: 2022
  ident: ref16
  article-title: A story of hypofractionation and the table on the wall
  publication-title: Int J Radiat Oncol Biol Phys
  doi: 10.1016/j.ijrobp.2021.09.027
– volume: 105 Suppl
  year: 2006
  ident: ref19
  article-title: A simple dose gradient measurement tool to complement the conformity index
  publication-title: J Neurosurg
  doi: 10.3171/sup.2006.105.7.194
– volume: 50
  year: 2023
  ident: ref27
  article-title: Automated isocenter optimization approach for treatment planning for gyroscopic radiosurgery
  publication-title: Med Phys
  doi: 10.1002/mp.16436
– volume: 6
  year: 2024
  ident: ref21
  article-title: A multi-centre stereotactic radiosurgery planning study of multiple brain metastases using isocentric linear accelerators with 5 and 2.5 mm width multi-leaf collimators, CyberKnife and Gamma Knife
  publication-title: BJR Open
  doi: 10.1093/bjro/tzae003
– volume: 64
  year: 2019
  ident: ref15
  article-title: Novel inverse planning optimization algorithm for robotic radiosurgery: first clinical implementation and dosimetric evaluation
  publication-title: Phys Med
  doi: 10.1016/j.ejmp.2019.07.020
– volume: 58
  year: 2017
  ident: ref25
  article-title: Comparison of multileaf collimator and conventional circular collimator systems in Cyberknife stereotactic radiotherapy
  publication-title: J Radiat Res
  doi: 10.1093/jrr/rrw130
– volume: 8
  year: 2018
  ident: ref26
  article-title: Stereotactic radiosurgery for benign brain tumors: results of multicenter benchmark planning studies
  publication-title: Pract Radiat Oncol
  doi: 10.1016/j.prro.2018.02.006
– volume: 9
  year: 2017
  ident: ref9
  article-title: Self-shielding analysis of the Zap-X system
  publication-title: Cureus
  doi: 10.7759/cureus.1917
– volume: 132
  year: 2020
  ident: ref1
  article-title: Dosimetric comparison of fractionated radiosurgery plans using frameless Gamma Knife ICON and CyberKnife systems with linear accelerator-based radiosurgery plans for multiple large brain metastases
  publication-title: J Neurosurg
  doi: 10.3171/2019.1.JNS182769
– volume: 14
  year: 2024
  ident: ref24
  article-title: A mini review of plan quality and secondary cancer risk in CyberKnife M6 radiosurgery for benign intracranial tumors
  publication-title: Front Oncol
  doi: 10.3389/fonc.2024.1453256
– volume: 13
  year: 2023
  ident: ref11
  article-title: Benchmarking tests of contemporary SRS platforms: have technological developments resulted in improved treatment plan quality?
  publication-title: Pract Radiat Oncol
  doi: 10.1016/j.prro.2023.05.005
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Snippet Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment...
Stereotactic radiosurgery with established systems like the Gamma Knife and CyberKnife (Accuray Inc., Madison, WI, USA) is a well-characterized treatment...
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StartPage e82990
SubjectTerms Dosimetry
Medical Physics
Oncology
Optimization techniques
Planning
Radiation Oncology
Radiosurgery
Robotics
Title Treatment Plan Comparison Between Self-Shielding Gyroscopic Radiosurgery and Robotic Radiosurgery
URI https://www.ncbi.nlm.nih.gov/pubmed/40416107
https://www.proquest.com/docview/3214252967
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https://pubmed.ncbi.nlm.nih.gov/PMC12103933
Volume 17
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