Accuracy

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Radiosurgery Center

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Cyberknife Radiosurgery

One-millimeter accuracy protects surrounding tissues

External Beam Radiotherapy (EBRT)

Intensity-Modulated Radiotherapy (IMRT)

Target area is expanded to include the prostate plus 5-10 millimeters to account for uncertainty

Calypso-Guided EEBRT/IMRT

Target area is expanded to include the prostate plus approximately 5 millimeters to account for uncertainty

High-Dose-Rate (HDR) Brachytherapy

Custom radiation plan delivers radiation dose to within 2-3 millimeters of the target, which spares surrounding tissues
 

Low-Dose-Rate (LDR) Brachytherapy (Seed Implant)

Seeds positioned with 3-5 millimeters accuracy; occasionally some seeds migrate to the lung(s)

  

 

 

Correcting for movement

Method of targeting/tracking

Cyberknife Radiosurgery

Throughout treatment robot automatically adjusts for any movement or rotation
Robot autmotatically locates fiducials

External Beam Radiotherapy (EBRT)

 

Intensity-Modulated Radiotherapy (IMRT)

Technician manually adjusts prior to each treatment session; no real-time correction for any movement or rotation during treatment
Patient's skin is marked and therapist aligns on those two marks, or targets fiducials using X-ray images

Calypso-Guided EEBRT/IMRT

If movement exceeds error threshold (3 mm), treatment stops and technician manually adjusts treatment table; no correction for rotation
Radio-frequency detector determines beacon location. Therapist manually adjusts treatment table accordingly

High-Dose Rate (HDR) Brachytherapy

Physician manually places catheters using ultrasound images for guidance; a customized treatment plan accounts for variation in catheter position
Ultrasound probe placed in rectum visualizes prostate and needle/catheter position

Low-Dose Rate (LDR) Brachytherapy (Seed Implant)

Physician manually places needles using ultrasound images for guidance; no corrections possible after seeds have been implanted
Ultrasound probe placed in rectum visualizes prostate and needle/seed position