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CyberKnife: From promising technique to proven tumor treatment

Twenty-five years ago, neurosurgeon John Adler, MD, conceived of the idea to invent a system combining computer imaging and robotic motion to treat the most difficult cancers in the brain, lung and spine. Last week, Stanford Cancer Center treated its 5,000th patient with this frameless robotic radiosurgery system, known as the CyberKnife.

A 2005 Silicon Valley/San Jose Business Journal article chronicled Adler's work and discussed how a fellowship with Gamma Knife inventor Lars Leksell, MD, motivated Adler to develop the CyberKnife:

Though impressed and intrigued by Dr. Leksell's invention, Dr. Adler also saw flaws. The technique, called stereotactic radiosurgery, required patients to wear a cage-like contraption that was screwed into their skull to prevent them from moving during the procedure. Aside from its barbaric-looking appearance, it meant the Gamma Knife was only designed to be used on the brain. But Dr. Adler was already pondering new uses, such as on lesions in hard-to-reach places like the spine.

Back at Harvard, he came up with what became the CyberKnife as a way to improve on what Dr. Leksell had done. His radiation device would combine robotics and image guidance technology. It would take pictures of patients and their lesions during the procedure, constantly adjusting to their movements to ensure an accurate target.

It would treat a multitude of lesions, Dr. Adler thought at the time, and help drive the future of neurosurgery.

In 1994, Stanford Hospital became the first to buy and use the device; more than 200 health-care centers worldwide now have one.

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