Show pageBacklinksCite current pageExport to PDFBack to top This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong. ===== Radiosurgery Systems ===== //[[J.Sales-Llopis]]// //Neurosurgery Department, [[General University Hospital Alicante]], [[Spain]]// ---- ---- Radiosurgery is a non-invasive treatment modality using focused radiation to target brain tumors, AVMs, and functional targets with sub-millimetric precision. Below is a classification of the main systems used globally in **neurosurgery**: ==== 1. Gamma Knife (Elekta) ==== * **Modality**: Cobalt-60 based photon beams * **Indications**: Intracranial only * **Notable models**: Perfexion®, Icon™ * **Strengths**: * High precision (sub-mm) * Proven track record (>1 million patients treated) * Widely used for AVMs, vestibular schwannomas, trigeminal neuralgia * **Limitations**: * Requires rigid head frame (except Icon with mask-based option) * Cranial-only use ==== 2. CyberKnife (Accuray) ==== * **Modality**: Linear accelerator with robotic arm * **Indications**: Cranial + body * **Strengths**: * Frameless, non-isocentric delivery * Real-time motion tracking (Synchrony®) * Useful for irregular and multiple brain metastases * **Limitations**: * Longer treatment times * Lower cranial-specific adoption ==== 3. Zap-X (Zap Surgical) ==== * **Modality**: Self-shielded gyroscopic LINAC * **Indications**: Intracranial and head & neck * **Strengths**: * No need for vault/shielded room * Designed specifically for neurosurgeons/radiosurgeons * Modern targeting and imaging suite * **Limitations**: * New market entrant (adoption limited) * Few long-term clinical outcome studies ==== 4. Novalis/ExacTrac (Brainlab) ==== * **Modality**: LINAC with advanced positioning * **Use**: Platform for multiple linear accelerators (e.g. TrueBeam, Versa HD) * **Strengths**: * Sub-mm accuracy via ExacTrac * Versatile (integrates with multiple LINACs) * **Limitations**: * Not a standalone radiosurgery device—relies on partner hardware ==== 5. TrueBeam STx (Varian/Siemens Healthineers) ==== * **Modality**: LINAC with image-guidance * **Indications**: Body + brain * **Strengths**: * Widely used in radiation oncology * RapidArc, HyperArc for intracranial radiosurgery * **Limitations**: * General-purpose; cranial radiosurgery is not primary focus ==== 6. Edge® (Varian) ==== * **Modality**: LINAC-based SRS system * **Indications**: Intracranial and extracranial * **Strengths**: * Combines precise beam shaping with IGRT * Often paired with couch and respiratory motion management * **Limitations**: * Still shares base platform with standard radiotherapy LINACs ==== 7. TomoTherapy / Radixact (Accuray) ==== * **Modality**: Helical IMRT * **Use**: Spine and craniospinal cases; rarely primary choice for brain SRS * **Strengths**: * Excellent for extended fields (e.g. craniospinal irradiation) * **Limitations**: * Not optimized for single-lesion radiosurgery ---- ===== Comparison Table ===== ^ System ^ Intracranial Only ^ Frame-free ^ Robotic ^ Real-time Tracking ^ Manufacturer ^ | Gamma Knife | ✔️ | Icon: ✔️ | ❌ | ❌ | Elekta | | CyberKnife | ❌ | ✔️ | ✔️ | ✔️ | Accuray | | Zap-X | ✔️ | ✔️ | ❌ | ❌ | Zap Surgical | | TrueBeam STx | ❌ | ✔️ | ❌ | Optional | Varian | | Novalis ExacTrac | ❌ | ✔️ | ❌ | ✔️ | Brainlab + LINAC | | Edge | ❌ | ✔️ | ❌ | Optional | Varian | | Radixact | ❌ | ✔️ | ❌ | Optional | Accuray | ---- ====== Future of Radiosurgery Systems in Neurosurgery ====== ===== 🚀 Summary and Outlook ===== Neurosurgical radiosurgery is evolving rapidly. Among current technologies, only a few show clear potential for long-term leadership in **precision**, **cost-efficiency**, and **adaptability**. * 🥇 **Zap-X**: Compact, frameless, self-shielded, and neurosurgery-specific. Poised to disrupt. * 🥈 **Gamma Knife Icon**: Proven gold standard, now frameless. Stable, conservative. * ⚠️ **CyberKnife**: Flexible but unfocused. Needs reinvention to avoid obsolescence. > The future belongs to **dedicated, AI-ready systems** with low setup cost, no vault, and optimized cranial workflows. ---- ===== 📊 Cost and Technical Comparison Table ===== ^ System ^ Cost per Treatment (USD) ^ Treatment Time (min) ^ Setup Cost (Million USD) ^ Brain-Specific ^ Vault Required ^ AI/Automation Ready ^ | Gamma Knife Icon | $8,000 | 60 | 5.0 | ✅ Yes | ✅ Yes | ❌ No | | Zap-X | $5,000 | 45 | 2.5 | ✅ Yes | ❌ No | ✅ Limited | | CyberKnife | $7,000 | 90 | 3.5 | ❌ No | ❌ No | ✅ Limited | | TrueBeam STx | $4,000 | 30 | 3.0 | ❌ No | ✅ Yes | ✅ Optional | | Edge (Varian) | $4,500 | 40 | 3.2 | ❌ No | ✅ Yes | ✅ Optional | | Radixact | $6,000 | 70 | 4.0 | ❌ No | ✅ Yes | ❌ No | ---- ===== 🔎 Key Definitions and Interpretation ===== * **Cost per Treatment**: Average operational + amortized capital cost per session. * **Treatment Time**: Time per radiosurgical session for a single cranial lesion. * **Setup Cost**: Estimated infrastructure and hardware investment. * **Brain-Specific**: Designed specifically for cranial neurosurgical use. * **Vault Requirement**: Needs radiation-shielded vault (adds to infrastructure cost). * **AI/Automation Ready**: Includes or supports motion tracking, adaptive therapy, AI planning. ---- ===== 💡 Final Insight ===== <WRAP round info 90% center> Systems like **Zap-X** and **Gamma Knife Icon** combine specialization with practical usability. General-purpose LINACs (TrueBeam, Edge) will persist in radiotherapy, but **lack competitive edge in neurosurgery**. **CyberKnife must redefine itself**, or risk irrelevance. </WRAP> ====== ✅ Recommended System: Zap-X for Neurosurgical Radiosurgery ====== Zap-X is the only system designed **exclusively for cranial radiosurgery**, offering a future-ready, cost-efficient, and patient-friendly platform. It combines **clinical focus** with **infrastructure flexibility**, making it ideal for both private and public neurosurgical centers. ===== 🔍 Why Choose Zap-X? ===== ^ Feature ^ Zap-X ^ Why It Matters ^ | **Brain-Specific** | ✅ Yes | 100% focused on cranial applications — not a multipurpose LINAC | | **Frameless Workflow** | ✅ Yes | Non-invasive, patient-friendly treatment | | **Vault-Free Installation** | ✅ Yes | Self-shielded → no need for radiation vault, reducing infrastructure cost | | **Setup Cost** | 💰 Low (~$2.5M) | Much cheaper than Gamma Knife (~$5M) or CyberKnife (~$3.5M) | | **Outpatient-Friendly** | ✅ Yes | Can be deployed in ambulatory surgical centers or small hospitals | | **AI & Future-Ready** | 🚀 High | MRI compatibility and automation support in development | | **Design & Innovation** | 🆕 Modern | Designed post-2018, based on CyberKnife/Gamma Knife lessons | | **Creator Credentials** | 🧠 John Adler (CyberKnife inventor) | Deep insight into radiosurgical evolution | ===== 💬 Final Justification ===== <WRAP round info 100% center> Zap-X is the **first and only self-contained, self-shielded, frameless radiosurgery system** built entirely for **neurosurgeons**. It breaks the dependency on radiation oncology departments and opens the door to **autonomous neurosurgical radiosurgery units**. </WRAP> ===== 💡 Strategic Advantage ===== Zap-X enables: * Cost-efficient radiosurgery in **non-hospital settings** * **Rapid ROI** for private clinics and university spin-offs * Expansion into underserved regions where vault construction is not feasible * True **ownership and control by neurosurgeons** ===== 📌 Summary Verdict ===== <WRAP round tip 90% center> **Recommendation**: Choose **Zap-X** as your radiosurgery platform if your goal is: * Neurosurgery-led radiosurgery * Low setup costs * Frameless workflows * Long-term strategic autonomy </WRAP> ---- ((More information: https://www.zapsurgical.com/)) radiosurgery_systems.txt Last modified: 2025/06/15 14:01by administrador