https://www.accuray.com/

• Tenth anniversary of the Young DEGRO Team Trial-reflecting on the past, shaping the future
• Ureter tolerance in patients treated with SBRT on abdominopelvic lymph nodes: analysis on dose-related late toxicity
• The Early Experience of Synchrony in Ultra-Hypofractionation for Prostate Cancer: A Case Series
• Prognostic Impact of Tumor Solid Components in Stereotactic Body Radiotherapy for Clinical Stage Tis-1N0M0 Lung Cancer
• CyberKnife radiation therapy for malignant myopericytoma in a pediatric patient: a case report and review of the literature
• Recursive partitioning for radionecrosis: filling the gaps in post-SRS risk prediction
• Intensity-modulated moderately hypofractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-C): early toxicity results from a randomised, open-label, phase 3, non-inferiority trial
• Hypofractionation/Ultra-hypofractionation for Prostate Cancer Radiotherapy

Accuray develops radiosurgery systems applicable to intracranial lesions, brain tumors, and functional disorders through the following platforms:

Non-invasive, robotic stereotactic radiosurgery (SRS) system designed for:

• Benign and malignant brain tumors (e.g. meningiomas, metastases, acoustic neuromas)
• Arteriovenous malformations (AVMs)
• Trigeminal neuralgia
• Functional targets (e.g. thalamotomy)

Key Features:

• Sub-millimetric accuracy with image-guided robotics
• Frameless, non-isocentric delivery
• Adaptive capabilities (real-time motion tracking)
• No need for rigid immobilization frames (unlike Gamma Knife)

Limitations:

• Slower treatment times compared to single-isocenter systems
• Limited adoption in high-volume cranial-only centers

Primarily used for body indications, but applicable to certain neuro-oncological cases:

• Spinal tumors (primary or metastatic)
• Postoperative stereotactic radiotherapy
• Extended craniospinal axis coverage

Technology Base:

• Helical IMRT (intensity-modulated radiotherapy)
• Tomographic delivery
• Compatible with Accuray’s Synchrony® real-time tracking system

Announced features include:

• High-fidelity imaging
• Neurosurgical workflow optimization
• Enhanced cranial targeting tools

❗ *Status: Under development — not FDA-cleared or CE-marked at this time*

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Official source: https://www.accuray.com/

Accuray itself acknowledges that its CyberKnife Neuro Package and “High‑Fidelity Imaging” are *under development* and may *never reach the market*.

❗ Red Flag: In neurosurgical tech, vaporware isn’t innovation—it’s delay disguised as strategy.

Elekta's Gamma Knife continues to dominate intracranial stereotactic radiosurgery. Despite CyberKnife's flexibility, it lacks the targeted precision and robust evidence to displace it.

• No demonstrated superiority in cranial indications
• Underrepresented in comparative academic studies
• Limited adoption for single-lesion brain SRS

❗ CyberKnife is a generalist tool in a field that rewards specialization.

Accuray promotes its technology at congresses like ESTRO, but fails to produce landmark trials proving clinical superiority in neurosurgical applications.

❗ Repetition isn’t validation. Without rigorous multicenter data, the claims remain unconvincing.

The partnership with Brainlab is primarily about compatibility, not technological leadership.

• No AI-powered planning tools
• No adaptive or real-time MR-guided workflows
• Just basic system interoperability—expected in 2025

❗ “It integrates” is not a breakthrough; it’s the bare minimum.

Recent approvals (e.g. Radixact SynC in China) show geographic expansion, but not technical advancement.

❗ Compliance is not innovation. There’s no paradigm shift—just market access.

Accuray’s current neurosurgical strategy lacks:

• 💡 Clear clinical leadership
• 📊 Outcome-driven superiority
• 🧠 Advanced neuroimaging or AI integration

🚨 Without urgent action, CyberKnife risks becoming a legacy system in a fast-evolving, precision-first landscape.