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Image-Guided Radiosurgery for the Spine and Lungs
Daniel
Kim, Neurosurgery
John Adler, Neurosurgery
Ken Salisbury, Computer Science
Martin
Murphy, Radiation Oncology
Chang-ming Ma, Radiation Oncology
Bernard Widrow, Electrical EngineeringCancer treatment is an ongoing challenge as many
tumors cannot be treated optimally with current
conventional methods. Radiation therapy exposes
a wide area around a tumor, resulting in side
effects. Stereotactic radiosurgery was developed
to treat brain tumors with tremendous accuracy.
This accuracy was made possible by fixing the
patient’s head to a rigid frame that could
be used as a reference by which to target lesions.
Increased accuracy enabled increasing the radiation
dose and, hence, the efficacy, while limiting
injury to surrounding tissue . As the frame was
both uncomfortable and limited to head application,
researchers at Stanford University developed image-guided
radiosurgery. In this system, lesions are referenced with respect
to skeletal landmarks derived from x-rays pictures
and obviates the need for a frame. This system,
the CyberKnife, has been shown to deliver radiation
as accurately as frame-based systems. In addition,
this system uses a robotic arm that can deliver
precisely shaped radiation doses by freely moving
the radiation source around the patient during
treatment. With no frame limitations and more
degrees of spatial freedom, this system can theoretically
be applied anywhere skeletal landmarks or other
x-ray visible markers can be imaged. We are exploring
the application of image-based radiosurgery to
lesions of the spine and the feasibility of treating
lung lesions. This project will combine advances
in image-guided robotics and knowledge of medical
radiation dosimetry to improve and extend the
range of the CyberKnife to tumors in the spine
and within the lung.
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