CYBERKNIFE
®
TREATMENT
DELIVERY SYSTEM
Technical Specications
02 Treatment Delivery System Technical Specications
The CyberKnife
®
Treatment Delivery System offers a comprehensive
toolkit of clinical features. Indication-specic tumor tracking with
automatic correction throughout treatment; true robotic mobility
and advanced secondary collimation integrate seamlessly into the
only system to stay on target despite patient and tumor movement.
Accurately treat tumors throughout the body with condence and
without compromise.
Key Features and Benets:
• Every treatment is delivered in an industry exclusive 3D workspace featuring the exibility to treat patients with robotic precision
utilizing scores of beam angles in non-coplanar, isocentric or non-isocentric environments. This exibility and precision instill great
condence in clinicians who treat patients with CyberKnife Treatment Delivery System technology.
• Fully integrated, indication-specic tracking applications precisely monitor patient motion, as well as static tumors and tumors
in motion. Constant intra-fraction position tracking and correction provide condence that the target is being treated to the
prescribed dose. The industry-leading targeting and delivery technology can help to improve patient outcomes.
• Clinical studies have indicated that the CyberKnife Treatment Delivery System’s unrivaled ability to precisely target and treat disease
helps clinicians destroy the tumors and not healthy tissue or organs at risk, thus potentially reducing patient side effects.
• The CyberKnife Treatment Delivery System provides more exibility than ever with the InCise2
™
Multileaf Collimator (MLC): faster
treatment times, improved patient handling processes, streamlined setup and treatment, and an optimized linear accelerator
workspace, to help improve clinician and patient experience.
Treatment System Overview
Treatment Room
X-Ray Sources
(Ceiling Mounted)
Image Detectors
(In-oor Mounted)
Robotic Manipulator
Xchange
®
Robotic
Collimator Changer
Patient Positioning
Support System
Treatment Vault Environment
Temperature: 10-35˚ C
Pressure: 103 kPa to 65 kPa
Humidity: 30% to 75% RH (non-condensing)
Mechanical Features
Robotic Manipulator
• 6-axis robotic manipulator mounted
on a pedestal at the head of patient area
• SmartPAD Teach Pendant with a
touch screen interface
Treatment Delivery System Technical Specications 03
Installation
2144 mm [84 in]
2003 mm [79 in]
ROBOTIC MANIPULATOR
SPECIFICATIONS
Payload 300 kg (661 lb)
Maximum Reach 2500 mm (98 in)
Number of Axes 6
Work Envelope 41 m
3
Weight 1220 kg (2690 lb)
830 mm [33 in]
Patient Positioning Support
Two types of patient positioning support systems are available with the CyberKnife
®
Treatment Delivery System: The RoboCouch
®
Patient Positioning System (optional) or the Standard Treatment Couch.
Standard Treatment Couch RoboCouch System (Optional)
Payload 159 kg (350 lb) 227 kg (500 lb)
Range of Motion
• Anterior/Posterior 28 cm 42 cm (full vertical range)
• Right/Left ±15 cm ±18 cm
• Superior/Inferior ≥91 cm ≥100 cm
• Head Up/Head Down (pitch) ±5˚ ±5˚
• Right/Left Tilt (roll) ±5˚ ±5˚
• Yaw (CW/CCW) N/A ±5˚
Control Remote Workstation (UCC) Remote Workstation (UCC)
Local Hand Pendant Local Hand Pendant
Local SmartPAD Teach Pendant
Repeatability
• Translational 0.3 mm 0.1 mm
• Rotational 0.3˚ 0.1˚
Motion Corrections Most degrees of freedom are All degrees of freedom are corrected
corrected serially simultaneously
Point of Rotation Fixed: Determined by mechanical Variable: All axes can move simultaneously
assembly of the actuators about a set point in space
Treatment Couch Top Specifications
Radiolucency Maximum: <1.1 mm aluminum equivalence at 120 kVp for the length
of at least 62 inches from the superior most point
Immobilization Alpha Cradle
®
(Compatibility) Vacuum Lock Bags
Thermoplastic masks
Indexing Compatible with CIVCO indexing systems
Flat with Standard Flat with RoboCouch
®
System
Minimum Load Height ≤64 cm (25 in) ≤56 cm (22 in)
Dimensions Length: 213 cm (84 in) Length: 206 cm (81 in)
Width: 53 cm (21 in) Width: 53 cm (21 in)
Thickness: 7.6 cm (3 in) Thickness: 5.7 cm (2.25 in)
04 Treatment Delivery System Technical Specications
RoboCouch
®
Robotic Patient Positioning System (OPTIONAL)
The RoboCouch System provides a highly exible six degrees-of-freedom (DOF) mechanism for automatically positioning the
patient. The combination of the RoboCouch System and the robotic manipulator for linac positioning enables the CyberKnife
®
Treatment Delivery System to deliver dose precisely and to the right location automatically. The upper manipulator arm (between
axes A2 and A3) integrates a contact sensor on its outer surface and an E-STOP is triggered if an object comes in contact with it.
The RoboCouch System is available with a at carbon ber couch top (standard with the RoboCouch System). The RoboCouch
System has ve rotational axes and one linear axis.
A2
A1
A3
A4
A5
A6
Standard Treatment Couch
The Standard Treatment Couch is the standard patient support system of the CyberKnife System. It provides the user with exibility
in patient positioning by providing 5 DOF motion capabilities.
Treatment Delivery System Technical Specications 05
3D Workspace
The robotic manipulator moves within a 3D workspace. This workspace is subdivided into anatomy-specic paths through which
the robotic manipulator can travel safely from one treatment position to another, accounting for the positions of objects in the
treatment suite, including the treatment couch, patient, imaging components and detectors. The workspace is comprised of
pre-assigned point-in-space, called nodes, from which the manipulator can deliver radiation. The linac can deliver radiation from
multiple beam angles at each node position. The conceptual representations below illustrate the 3D workspace. The actual
treatment path chosen by the robotic manipulator depends on many factors, including the location of the target, the size of the
patient and the anatomy being treated.
Workspace Geometry
06 Treatment Delivery System Technical Specications
Workspace
Patient Plane
Simplied Diagram, 6MV Linear Accelerator
(shown with InCise2
™
Multileaf Collimator)
Linear Accelerator
• Nominal Source to Axis Distance (SAD) and Normal Treatment Distance (NTD) is 800 mm
Treatment Delivery System Technical Specications 07
Electron Gun
9.3GHz X-Band
Magnetron
Waveguide
Linear Accelerator
4 Port Circulator
Dosimetry Specication
• Chamber type Dose Chamber A: Sealed ion chamber
Dose Chamber B: Sealed ion chamber segmented for
symmetry monitoring
• Resolution ≥ 25 counts per MU
PHOTON BEAM SPECIFICATION
Dosimetry System A two-channel primary/secondary dosimetry system is provided
X-ray Energy 6MV nominal photon energy
Depth of Maximum Dose (Dmax) 15 mm ±2 mm
Dose Rate 1000 MU/min ± 10% measured at 800 mm SAD at a depth
of 15 mm in water for a 60 mm eld size
Temperature and Pressure Adjustments Within the specied operating temperature and pressure range,
the dose rate and MU to dose calibration is independent of
temperature and pressure
Dosimetry Linearity Dosimetry linearity with total dose is less than ±1% or ±1 cGy,
whichever is greater over an accumulated range of 10 cGy
to 1000 cGy, measured at 800 mm SAD within the operating
temperature and pressure range
Quality Index Between 0.62 and 0.67 for a 60 mm xed collimator
TPR 20/10 ratio of dose rate in water
tank at 20 to 10 cm depth
Leakage Leakage in the patient plane is less than 0.2% maximum and
Measured anywhere in the patient plane 0.1% average
(800 mm SAD) in a circular area of radius 2 m
Scatter 1 m from the radiation head is less than 0.1%
centered on the beam’s central axis, excluding
the area within the treatment beam
(as dened by IEC 60601-2-1)
The leakage values are given with respect to
the absorbed dose on the central axis at the
reference treatment distance of 800 mm SAD
and 15 mm depth with the 60 mm xed collimator
08 Treatment Delivery System Technical Specications
UCC (User Control Console) Workstation
The UCC Workstation is installed in the Equipment Room. The workstation includes mouse, keyboard and display at the Control
Console area. Power is provided to the UCC Workstation through the cabinet UPS.
UCC WORKSTATION SPECIFICATION
CPU Dual Six-Core CPUs
Memory 32GB DDR4 2133MHz
Storage 2x 300 GB SAS 2.0 15 K Drives mirrored for a total of
300 GB of storage
Graphics Card Nvidia Quadro M2000
Ethernet Port 2x Gigabit ethernet port
Power Supply Dual redundant power supply
Equipment Room
EQUIPMENT ROOM COMPONENTS
PDU (Power Distribution Unit)
Robot Controllers
Mechanical Rack, including: Chiller
Air compressor
SF6
AMM (Advanced Magnetron Modulator)
Rack, including: LCC (Linac Control Computer)
LPDU (Linac Power Distribution Unit)
MCC (Modulator Control Chassis)
Gun driver
Modulator
Modulator HVPS
Computer Rack, including: KVM extender
UPS
Iris
™
temperature controller
Monitor and keyboard
ELCC (E-Stop Interlock Control Chassis)
TLS (Target Locating System) workstation
UCC (User Control Console) workstation
SFB (Secondary Feedback) workstation
iDMS
™
Data Management System
Storage Vault (option)
Network delivery switch
Network delivery rewall
Core switch
Gateway workstation
Treatment Delivery System Technical Specications 09
iDMS
™
Data Management System
The iDMS System houses patient records, system commissioning data, and system licensing information and may be housed in the
CyberKnife
®
Treatment Delivery System equipment room, or elsewhere, depending on single/multi-system conguration. The iDMS
System, congured without the Storage Vault option, is intended to store at least 300 patient records. With the Storage Vault option,
the iDMS System is intended to store at least 5,400 patient records (depending on plan size, these numbers may change).
DATA SERVER SPECIFICATION
CPU Quantity: 4, Dual Intel
®
Xeon E5-2620 v3
Memory (RAM) 32GB DDR4 2133 MHz
C Drive Storage 2x2TB drives congured in a RAID 1 providing ~2TB storage.
Operating system host
D Drive Storage: 4x600GB SAS 15k drives congured in a RAID 6 providing
~1TB storage. Live patient database and conguration
parameters host
E Drive Storage 4x2TB drives congured in a RAID 6 providing ~2TB storage.
Database snapshot and archived patient records host
Operating System Microsoft
®
Windows OS
Database SQL Server 2014
Storage Vault (OPTION)
The Storage Vault is one option that can be used for the redundant backup of the iDMS System. It is housed in the equipment room.
STORAGE VAULT SPECIFICATION
Quad-Core CPU Intel
®
Xeon 64-Bit Quad Core CPU, 4 Threads
Memory 8GB DDR3
Hard Disk Drive Conguration SATA II, 10TB/25TB storage capacity
RAID Conguration RAID 6
Network Interface 2 x Gigabit ethernet ports
USB Interface 4 x USB 2.0 ports, 2 x USB 3.0 ports
10 Treatment Delivery System Technical Specications
MD Suite – Physician Workstation (OPTION)
The MD Suite – Physician Workstation provides remote secure access to patient record data from the CyberKnife Treatment
Delivery System database. The MD Suite workstation is housed in a remote location.
MD SUITE WORKSTATION SPECIFICATION
CPU Dual Six-Core CPUs
Memory 24 GB DDR4 2133 MHz
Storage 2x240 GB SATA (RAID 1)
Ethernet Port 1 Gigabit
Power Supply >1000W
Monitor LCD monitor with a native resolution of 1600 x 1200
or 1920 x 1200
Operating System Microsoft
®
Windows
®
x64 Bit OS
Accuray Precision
®
Treatment Planning System
The Accuray Precision
®
Treatment Planning System offers a common and complete treatment planning solution for the
CyberKnife
®
Treatment Delivery System. The Accuray Precision System is a fully featured, powerful planning workstation
featuring AutoSegmentation
™
(autocontouring of brain, head and neck, and male pelvis regions), multimodality image fusion
with deformable registration and plan comparison/summing plans. Additionally, this planning system offers the PreciseRTX
™
Retreatment Option. The Accuray Precision System utilizes a common, integrated database: The iDMS
™
Data Management System.
ACCURAY PRECISION TREATMENT PLANNING
SYSTEM WORKSTATION SPECIFICATION
CPU Dual Six-Core CPUs
Memory 48GB DDR4 2133 MHz
Storage 2x240GB SATA (RAID1)
Ethernet Port 1 Gigabit
Power Supply >1000 W
Monitor LCD monitor with a native resolution of 1600x1200 or 1920x1200
Operating System Microsoft
®
Windows
®
7 x64 Bit OS
Treatment Delivery System Technical Specications 11
Operator Panel
12 Treatment Delivery System Technical Specications
Treatment Control Area
The Treatment Control Area contains equipment necessary for operators to monitor and control the CyberKnife
®
Treatment
Delivery System.
TREATMENT CONTROL AREA COMPONENTS
Treatment Delivery System Two high-resolution 24”, 1920x1200 pixel monitors
Keyboard and mouse for the user control computer
Operator Panel MV Beam indicator
KV Image acquisition indicator
Remote/local control indicator
High voltage indicator
High voltage enable button
Key switch to enable high voltage
Emergency stop button
Audible tones for KV and MV radiation
Dual screens showing the Delivery Interface
Collimation Systems
SECONDARY COLLIMATION
The CyberKnife
®
Treatment Delivery System features three secondary collimator housing types: xed, Iris
™
Variable Aperture and
the InCise2
™
Multileaf Collimator. Collimator housing types are automatically changed by the robotic manipulator at the Xchange
®
table. Clinicians can choose the best collimator for the given treatment during the planning process.
FIXED COLLIMATORS
There are 12 xed secondary collimators with circular eld sizes ranging from 5 mm to 60 mm in diameter at 800 mm SAD. These
collimators can be changed manually to vary the beam size required by the treatment plan.
FIXED COLLIMATOR SPECIFICATION
Collimator Transmission X-ray transmission through the blank collimator at 800 mm SAD
does not exceed 0.2% of the central axis (CAX) dose rate of a
60 mm xed collimator
Available Apertures Collimation sizes: 5, 7.5, 10, 12.5, 15, 20, 25, 30, 35, 40, 50
and 60 mm nominal eld sizes at 800 mm SAD
Penumbra (At 800mm SAD and 50mm Better than 3.5 mm for a 10 mm collimator
Depth per IEC 60976 (2007) 9.3.1) Better than 4.5 mm for a 40 mm collimator
Better than 8 mm for a 60 mm collimator
Treatment Delivery System Technical Specications 13
Table holding Fixed Collimators
IRIS VARIABLE APERTURE COLLIMATOR
SPECIFICATION
Circularity The standard deviation of the radial distance from the beam
axis to the 50% dose level is less than 2% of the average
radial distance
Collimator Transmission X-ray transmission through the Iris Collimator tungsten segments
at 800 mm SAD does not exceed 0.2% of the CAX dose rate of
the Iris Collimator when opened to a 60 mm eld
• Maximum: < 0.2% of the delivered dose rate
• Average: < 0.1% of the delivered dose rate
Reproducibility Mechanical: less than 0.1 mm
Treatment Field Size: ≤ 0.2 mm at 800 mm SAD
distance of 800 mm SAD
Available Apertures Effective collimation sizes: 5, 7.5, 10, 12.5, 15, 20, 25, 30, 35,
40, 50 and 60 mm diameter eld sizes at 800 mm SAD
Penumbra (At 800mm SAD and 50mm Better than 3.5 mm for a 10 mm collimator
Depth per IEC 60976 (2007) 9.3.1) Better than 4.5 mm for a 40 mm collimator
Better than 8 mm for a 60 mm collimator
IRIS
™
VARIABLE APERTURE COLLIMATOR (OPTION)
The Iris Variable Aperture Collimator creates beams with characteristics virtually identical to those of the xed collimators and is
only able to replicate the xed 12 collimator sizes. The variable aperture is created by two banks of six tungsten segments, each
creating a hexagonal aperture. The two banks are offset by 30˚, resulting in a dodecahedral aperture (virtually circular) when
viewed through the collimator.
14 Treatment Delivery System Technical Specications
Iris Variable Aperture Collimator (NTD not to scale) Example of Iris Variable Aperture sizes
Upper Tungsten
Segment Bank
Lower Tungsten
Segment Bank
Drive
Motor
23.6 mm
23.6 mm
257.5 mm SAD
337.4 mm SAD
800 mm SAD NTD
InCise 2 MULTILEAF COLLIMATOR
SPECIFICATION
Beam Targeting Non-Coplanar beam targeting
Secondary Check for Leaf Position Internal optical camera provides live images used during
treatment to verify leaf position
Maximum Geometric Field Size 115 mm (leaf motion direction) x 100 mm*
Leaf Tilt Leaves tilted 0.5˚
Leaf Tip Design Three-Sided
Leaf Width 3.85 mm at 800 mm SAD (normalized for leaf pitch)
Leaf Material Tungsten
Leaf Positioning Accuracy Better than ± 0.95 mm at 800 mm SAD from either direction
at all possible orientations
Leaf Over-Travel 100%
Leaf Inter-Digitation Full Leaf Inter-Digitation
Transmission <0.3% average (<0.5% maximum) relative to a 100 mm x 100 mm
Includes intra-leaf and inter-leaf eld size at 800 mm SAD
Penumbra (At 800mm SAD and 50mm Better than 3.5 mm in X and Y for 10 mm x 10 mm eld size
Depth per IEC 60976 (2007) 9.3.1) Better than 12 mm in X and 20 mm in Y for a 100 mm x 100 mm eld size
InCise
™
2 MULTILEAF COLLIMATOR (OPTION)
The InCise
™
2 Multileaf Collimator creates highly conformal
beam shapes in relation to the treatment targets and has a
larger eld size than the Iris
™
or xed collimators, enabling
the system to treat much larger targets with signicantly
fewer beams and delivered MU. This results in much faster
treatment times and greatly expands the clinical utility of
the CyberKnife
®
Treatment Delivery System.
Guide Block
Secondary
Feedback
Camera
425 mm SAD
800 mm SAD NTD
Side Protection
Mount
Side Protection
Plate
Basic beam line for InCise 2 Multileaf Collimator (NTD not to scale)Patient’s eye view of InCise 2 Multileaf Collimator
* Congured by software
Treatment Delivery System Technical Specications 15
90 mm
310 mm SAD
16 Treatment Delivery System Technical Specications
Imaging System
The CyberKnife
®
Treatment Delivery System uses kV X-ray imaging to pinpoint and track the target throughout treatment. The
imaging system consists of two ceiling-mounted X-ray sources and two corresponding in-oor image detectors. The X-ray sources
are positioned at 45˚ such that the generated beams intersect orthogonally at an imaging center located 92 cm above the oor.
Treatments on the CyberKnife Treatment Delivery System are based on the patient positioning table accurately bringing the
patient to the imaging eld of view. Live X-ray images are then digitized and compared with images synthesized from the patient’s
treatment plan. Prior to treatment starting, this imaging technology enables the system to automatically adjust the patient
positioning table as target motion is detected. During treatment, the image system automatically adjusts the robot position to
ensure constant beam accuracy throughout treatment.
Imaging System Geometry
Xchange
®
Robotic Collimator Changer
The Xchange
®
Robotic Collimator Changer gives treatment operators the ability to automatically change the collimator housing
type (Fixed, Iris
™
, MLC), specic to the patient treatment plan.
Side view of Xchange Table Top view of Xchange Table
COMPACT X-RAY GENERATOR
SPECIFICATIONS
Constant Potential Power Rating 50.0 kW
Radiographic Range 40-150 kVp ± (5% + 1 kVp)
X-RAY SOURCES SPECIFICATIONS
Electrical
• Nominal Tube Voltage 40-150 kV
• Nominal Focal Spot Value Large focus: 1.2 mm
Small focus: 0.6 mm
• Nominal Anode Input Power Large focus: 100 kW
Small focus: 40 kW
Aluminum Filter 2.5 mm
Collimator Type Fixed Aperture
X-RAY DETECTOR SPECIFICATIONS
Lower Spec Limit
Detector Type Amorphous silicon with cesium iodide scintillator
Pixel Pitch 400 µm
Total Area 40 x 40 cm
2
MTF @ 0.25 lp/mm 80%
MTF @ 1 lp/mm 33%
DQE @ 0.25 lp/mm, 1 μGy 56%
DQE @ 1 lp/mm, 1 μGy 28%
Treatment Delivery System Technical Specications 17
System Targeting Accuracy
System targeting accuracy is a function of many contributing attributes including system calibrations, imaging alignment
and efcacy of clinical elements (patient CT acquisition, treatment planning, delivery). System targeting accuracy can be
impacted by errors generated by these attributes and others like dose delivery. Overall, these elements combine to comprise
the clinically relevant LINAC pointing accuracy, also termed the CyberKnife
®
Treatment Delivery System total targeting error
(TTE). The CyberKnife Treatment Delivery System TTE for each tracking algorithm and collimator housing is shown to be less
than 0.95 mm root mean square (RMS) when a planning CT slice spacing of 1.25 mm or less is used.
Target Tracking
Accurate target tracking and compensating for target motion are an integral part of the CyberKnife
®
Treatment Delivery System and
its capabilities. The target is tracked throughout the treatment and delivery is automatically altered to compensate for any motion.
CT REQUIREMENTS FOR TARGET TRACKING
Maximum Slices 512
kVp 120
mAs Scanner maximum (minimum 400)
Slice Thickness Contiguous slice (no gaps); < 1.25 mm slice thickness
18 Treatment Delivery System Technical Specications
Target Tracking Method
6D SKULL TRACKING SYSTEM
The 6D Skull Tracking System enables direct tracking of the bony anatomy of the skull when treating intracranial lesions. Target
tracking and motion compensation are accomplished by using image intensity and brightness differences between the DRR
and live images.
FIDUCIAL TRACKING
For extracranial lesions, targets can be tracked in soft tissue through the use of ducials.
• General guidelines for ducials:
o Gold seeds or gold sphere
o Diameter: 0.7 mm to 1.2 mm
o Length: 3 mm to 6 mm
• A minimum of three ducials are required for 6D target tracking correction (X, Y, Z, Roll, Pitch and Yaw).
XSIGHT
®
SPINE TRACKING SYSTEM
The Xsight Spine Tracking System, with the patient in the supine position, enables the tracking of skeletal structures in the cervical,
thoracic, lumbar and sacral regions of the spine without the need for implanted ducials.
XSIGHT SPINE PRONE TRACKING SYSTEM (OPTION)
The Xsight Spine Prone Tracking System provides support for treating spine targets with the patient in the prone position. The
tracking mode combines the Xsight Spine Tracking algorithm with the Synchrony
®
Respiratory Tracking System to offer continuous
real-time tracking and compensation for target motion resulting from respiration. In this tracking mode, the patient is rst aligned
using the Xsight Spine Tracking workow, then a Synchrony correlation model is created to compensate for target translational
motion during delivery.
XSIGHT LUNG TRACKING SYSTEM (OPTION)
The Xsight Lung Tracking System (also called 2-View Lung Tracking) tracks tumors in the lung without the use of implanted ducials
by identifying image intensity differences between the lesion and the background. The patient is initially aligned using the Xsight
Spine Tracking workow. After the lesion has been identied, a Synchrony correlation model is created to compensate for target
translational motion during delivery.
LUNG OPTIMIZED TREATMENT: 1-VIEW LUNG TRACKING AND 0-VIEW LUNG TRACKING (OPTION)
Lung Optimized Treatment includes a simulation application and two tracking modes: 1-View Lung Tracking and 0-View Lung
Tracking. These two tracking methods supplement the ducial-free capability of Xsight
®
Lung, regardless of the location of the
tumor.
• The simulation application provides a workow to select the most appropriate tracking mode
• 1-View Lung Tracking is used when the treatment target is visible and can be tracked in only one X-ray projection
o Provides direct tracking of lung lesions in two dimensions
o Uses an ITV in the non-visible third dimension
• 0-View Lung Tracking is used when the treatment target is not visible in either X-ray projection. The system tracks the bony
anatomy of the vertebral column during treatment
o Provides direct tracking of the spine without ducials
o Uses an ITV in all dimensions to compensate for respiratory motion of the tumor
Treatment Delivery System Technical Specications 19
Motion Tracking
Motion tracking on the CyberKnife
®
Treatment Delivery System uses the Synchrony
®
Respiratory Tracking or the InTempo
™
Adaptive Imaging System. Motion tracking is used in conjunction with an applicable target tracking method.
SYNCHRONY RESPIRATORY TRACKING SYSTEM WITH IMAGE BURST
The Synchrony Respiratory Tracking System continuously synchronizes treatment beam delivery to the motion of a target that is
moving with respiration. The Synchrony System can be used in conjunction with the following target tracking methods: Fiducial
Tracking, Xsight Lung Tracking, Xsight Spine Prone Tracking and 1-View Tracking.
The Synchrony System creates a correlation model between the patient’s breathing pattern (monitored in real-time) and the
precise location of the target (from the imaging system) at various points in the respiration cycle. The target location is determined
from X-ray imaging, while the breathing pattern is tracked and monitored using external markers (LED-based, ber optic tracking
markers with a tracking frequency of > 25 Hz) in real-time.
The system automatically determines the best correlation model for the treatment which minimizes overall correlation error. The
model is chosen from linear, curvilnear, and bi-curvilinear (dual-poly) forms. The model is based on the latest 15 sets of X-ray
images and is updated every time a new image is acquired. This update is further enhanced by the Image Burst feature, which
provides a 3x increase in the imaging data points that are used to update the breathing model during inter-beam, in-treatment,
imaging. This equates to a robust breathing model that stays relevant and accurate for the duration of the treatment, ensuring
condence in the treatment of moving targets.
INTEMPO
™
ADAPTIVE IMAGING SYSTEM (OPTION)
The InTempo Adaptive Imaging System is a time-based technology used to compensate for non-periodic intra-fraction motion of
the target. The InTempo System can be used in conjunction with the following target tracking methods: Fiducial Tracking, 6D Skull
Tracking and Xsight Spine Tracking.
Image Age
Image age is the time elapsed since the most recent image acquisition. The system uses the image age parameter to ensure
that no treatment beam is delivered based on an image that is older than that user-specied value.
Adaptive Imaging
The user may optionally enable the system to trigger adaptive imaging in the event that the target motion is greater than a
user-dened threshold, which automatically reduces the image age to 15 seconds.
Safety Features
• Contact Detection
o Contact detection sensor at the distal end of the secondary collimator housing on the linac
o Contact detection sensor on back of robot arm
o Contact with the sensor causes an Emergency Stop (E-STOP) condition halting all motion of the system
• Safety Zones: The robot workspace also takes into consideration the position of the patient and is designed to avoid contact with
the patient. This is achieved by creation of a safety zone around the patient and the treatment couch. The safety zone consists of
two elements: Fixed and Dynamic.
o The xed safety zone is rigidly attached to the imaging center and thereby the part of the patient body being treated
o The dynamic safety zone is designed to encompass the entire patient body and always lies within the xed safety zone
o The size of the dynamic safety zone is user selectable based on individual patient sizes (small, medium or large)
20 Treatment Delivery System Technical Specications
Network Diagram
Network
System Interfaces
• DICOM Import/Export included:
o DICOM Image Import
o DICOM RT Structure Set Import
o DICOM Image Export
o DICOM RT Structure Set Export
o DICOM RT Dose Export
• OIS License Required to generate objects:
o DICOM RT Plan Export
OIS Requirements*
Treatment Room Equipment Room
Computer Rack Power Distribution Unit
X-ray Source A
and B Generators
KUKA RoboCouch
™
Robot Controller
(if purchased)
• Robotic manipulator containing LINAC
w/attached secondary collimator
• Xchange
®
Robotic Collimator Changer
• Imaging subsystem (including X-ray
sources and detectors)
• Patient Couch
KUKA Robot Controller
Operator
Panel
Accuray Precision
Treatment Planning System/MD Suite
(can be inside or outside of CK LAN)
Accuray Precision
™
Treatment Planning System/MD Suite
(can be inside or outside of CK LAN)
Mechanical Rack
AMM Rack
(Advanced
Magnetron and
Modulator)
Imaging Modalities
CT, MRI
OIS Server
(MOSAIC/ARIA)
HIS
PACS
Accuray TxView
™
(option)
Remote Accuray Service
Connection (option)
Accuray PlanTouch
™
(option)
CyberKnife System LAN
Hospital LAN Outside Hospital LAN
(remote access)
Treatment Planning Room
Operator Station
ARIA
®
Oncology Information System MOSAIQ
®
Oncology Information System
Requirements for OIS interface CyberKnife
®
System: CK version 9.6 or higher CyberKnife
®
System: CK version 9.6 or higher
OIS Software ARIA version 10.0 - 11.0 MOSAIQ version 2.3 - 2.6
Network RTPLAN export: TCP port 57347
RTRECORD export: TCP port 57345
WorkList Server: TCP port 50505
RTPLAN export: TCP port 104
RTRECORD export: TCP port 10401
WorkList Server: TCP port 10401
License iDMS License with OIS enabled
ARIA License enabling interface with CyberKnife System
iDMS License with OIS enabled
MOSAIQ License enabling interface with CyberKnife System
* OIS requirements shown are a generic example of how network may be setup; actual configuration site-to-site may change.
Treatment Delivery System Technical Specications 21
22 Treatment Delivery System Technical Specifications
Feature M6 FIM M6 FI+ M6 FM M6 FI
Image Guidance System
Robotic Manipulator
Treatment Delivery Control Console
1000 MU/min linac
Fixed Collimators
Iris
™
Variable Aperture Collimator
InCise
™
2 MultiLeaf Collimator
Xchange
®
Robotic Collimator Changer
Standard Treatment Couch
RoboCouch
®
Patient Positioning System
Fiducial Tracking System
CNS Package Including:
• 6D Skull Tracking System
• Xsight
®
Spine Tracking System
• Brain AutoSegmentation
™
Prostate Package
• Male Pelvis AutoSegmentation
™
• In Tempo
™
Adaptive Imaging System
Spine Prone Package
• Synchrony
®
Respiratory Tracking System
• Xsight Spine Prone Tracking
Lung Package
• Synchrony
®
Respiratory Tracking System
• Xsight Lung Tracking System
• Lung Optimized Treatment
• Monte Carlo Dose Calculation
• 4D Treatment Optimization
and Planning System
M6 Base System Configurations
–
STANDARD FEATURE
–
OPTIONAL FEATURE
M6 Base System Congurations
22 Treatment Delivery System Technical Specications
M6 Base System Congurations
Treatment Delivery System Technical Specifications 23
Feature M6 FIM M6 FI+ M6 FM M6 FI
Spine Prone + Lung Package
• Xsight Spine Prone Tracking
• Synchrony
®
Respiratory Tracking System
• Xsight
®
Lung Tracking System
• Lung Optimized Treatment
• Monte Carlo Dose Calculation
• 4D Treatment Optimization
and Planning System
Accuray Precision
®
Treatment Planning Workstation (x2)
Additional Accuray Precision Treatment
Planning Workstation
PlanTouch
™
iPad Plan Review & Authorization
Application
MD Suite
iDMS
™
Data Management System
Radiosurgery DICOM Interface (ARIA or MOSAIQ)
Clinical Efficiency Package
• Report Administration Application
• Storage Vault
• TxView
™
–
STANDARD FEATURE
–
OPTIONAL FEATURE
M6 Base System Configurations
Treatment Delivery System Technical Specications 23
Regulatory Classication
The CyberKnife
®
System is classied as follows:
• Protection against electric shock: Class I, permanently connected
• Applied part: Patient treatment table only, Type B
• Protection against harmful ingress of water: IPXO – no protection against ingress of water
• Methods of sterilization or disinfection: Not required
• Degree of safety in the presence of ammable mixtures: Not suitable for use in the presence of ammable mixtures
• Mode of operation: Continuous
© 2013 Accuray Incorporated. All Rights Reserved. Accuray, the stylized logo, CyberKnife, Synchrony, Xsight, Xchange, RoboCouch, TomoTherapy, Hi·Art, and TomoHD are among the trademarks and/or registered trademarks of Accuray Incorporated
in the United States and other countries. TomoTherapy is a wholly owned subsidiary of Accuray. 500986.A
UNITED STATES
Accuray Corporate Headquarters
1310 Chesapeake Terrace
Sunnyvale, CA 94089
USA
Tel: +1.408.716.4600
Toll Free: 1.888.522.3740
Fax: +1.408.716.4601
Email: [email protected]
Accuray Incorporated
1240 Deming Way
Madison, WI 53717
USA
Tel: +1 608 824 2800
Fax: +1 608 824 2996
ASIA
Accuray Japan K.K.
Shin Otemachi Building 7F
2-2-1 Otemachi, Chiyoda-ku
Tokyo 100-0004
Japan
Tel: +81.3.6265.1526
Fax: +81.3.3272.6166
Accuray Asia Ltd.
Suites 1702 - 1704, Tower 6
The Gateway, Harbour City
9 Canton Road, T.S.T.
Hong Kong
Tel: +852.2247.8688
Fax: +852.2175.5799
Accuray Accelerator Technology
#39 Huatai Road, Longtan
Industrial Zone,
Section 2 East, 3rd Ring Road,
Chengdu, Sichuan 610051
People's Republic of China
EUROPE
Accuray International Sarl
Route de la Longeraie 9 (3rd floor)
CH – 1110 Morges
Switzerland
Tel: +41.21.545.9500
Fax: +41.21.545.9501
© 2018 Accuray Incorporated, All Rights Reserved, the stylized Accuray logo, CyberKnife, VSI, M6, Iris, Xchange, RoboCouch, InCise, MultiPlan, Xsight, Synchrony, InTempo, TxView, PlanTouch, and QuickPlan are trademarks or registered trademarks
of Accuray Incorporated, in the United States and other countries and may not be used or distributed without written authorization from Accuray Incorporated. Use of Accuray Incorporated’s trademarks requires written authorization from Accuray
Incorporated. Other trademarks used and identified herein are the property of their respective owners. MKT-CK-0317-0283(3)
UNITED STATES
Accuray Corporate Headquarters
1310 Chesapeake Terrace
Sunnyvale, CA 94089
USA
Tel: +1.408.716.4600
Toll Free: 1.888.522.3740
Fax: +1.408.716.4601
Email: [email protected]
Accuray Incorporated
1240 Deming Way
Madison, WI 53717
USA
Tel: +1.608.824.2800
Fax: +1.608.824.2996
ASIA
Accuray Japan K.K.
Shin Otemachi Building 7F
2-2-1 Otemachi, Chiyoda-ku
Tokyo 100-0004
Japan
Tel: +81.3.6265.1526
Fax: +81.3.3272.6166
Accuray Asia Ltd.
Units 910-11, Ocean Centre
Harbour City
5 Canton Road, T.S.T
Hong Kong
Tel : +852.2247.8688
Fax : +852.2175.5799
Accuray Accelerator Technology
(Chengdu) Co., Ltd.
No. 8, Kexin Road
Hi-Tech Zone (West Area)
Chengdu
611731 Sichuan
China
EUROPE
Accuray International Sarl
Route de la Longeraie 7 – 9
CH – 1110 Morges
Switzerland
Tel: +41.21.545.9500
Fax: +41.21.545.9501
Important Safety Information
Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body
functions for example, urinary or salivary function), deterioration of quality of life, permanent injury, and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and
severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), and the patient’s general medical condition, to name a few. For more details about the
side effects of your radiation therapy, and to see if treatment with an Accuray product is right for you, ask your doctor.
