CyberKnife® Radiosurgery
Multidisciplinary radiosurgery program • 12 hospital affiliations across New JerseyCyberKnife® radiosurgery is a robotic stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) system that delivers highly focused radiation to brain tumors, spinal tumors, vascular malformations, and selected functional neurological disorders with sub-millimeter accuracy. Unlike conventional radiation therapy, CyberKnife continuously tracks the target during treatment, allowing radiation to be delivered without a rigid head frame or surgical incision. Depending on the condition being treated, therapy is typically completed in one to five outpatient sessions as part of an individualized multidisciplinary treatment plan.
Key takeaways
- CyberKnife uses a robotic arm with a linear accelerator to deliver highly focused radiation beams from hundreds of angles that converge precisely on the treatment target.
- Treatment is typically completed in one to five outpatient sessions with no surgical incision, no general anesthesia, and no hospitalization.
- Real-time image guidance continuously tracks patient and target position, automatically adjusting beam delivery to maintain sub-millimeter accuracy throughout treatment.
- CyberKnife is used for selected brain tumors, spinal tumors, vascular malformations, and functional neurological disorders when stereotactic radiosurgery is the most appropriate treatment option.
- Every case is reviewed by a multidisciplinary team to determine whether radiosurgery, microsurgery, endovascular therapy, conventional radiation therapy, or observation offers the best treatment approach.
| Type of treatment | Robotic stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) |
| Sessions required | One to five outpatient treatments |
| Anesthesia | None |
| Treatment time per session | Approximately 30 to 90 minutes depending on the treatment target |
| Conditions treated | Selected brain tumors, spinal tumors, arteriovenous malformations, trigeminal neuralgia, and other appropriately selected conditions |
| Accuracy | Real-time image guidance with continuous target tracking and automatic beam adjustment |
| Treatment planning | Multidisciplinary planning involving fellowship-trained neurosurgeons, radiation oncologists, and other specialists as indicated |
Timing and stay vary by patient and complexity. Your surgeon will confirm what to expect in your case.
How CyberKnife works
CyberKnife uses a compact linear accelerator mounted on a robotic arm to deliver hundreds of precisely targeted radiation beams from different angles. Individually, each beam carries too little radiation to significantly affect healthy tissue. Together, they converge at the target to deliver a therapeutic dose while minimizing radiation exposure to surrounding normal structures.
Two key features distinguish CyberKnife from other radiation systems:
- Real-time image guidance: X-ray cameras track the patient’s position and target location continuously during treatment. The robotic arm adjusts the beam position in real time, maintaining sub-millimeter targeting accuracy without requiring a rigid head frame.
- Frameless treatment: Unlike Gamma Knife, which uses a metal frame bolted to the skull, CyberKnife uses image tracking to maintain accuracy without any frame allowing fractionated (multi-session) treatment and non-cranial targets.
Conditions treated with CyberKnife at ABS
CyberKnife is used to treat a wide range of neurological conditions, but not every diagnosis or every patientis best treated with stereotactic radiosurgery. Treatment recommendations depend on the diagnosis, tumor size, location, symptoms, prior treatments, and overall goals of care.
- Brain metastases — Often treats one or multiple brain metastases in one to five outpatient sessions, frequently avoiding or delaying whole-brain radiation therapy in appropriately selected patients.
- Meningiomas — Small to medium meningiomas that are not ideal for surgery, as well as residual or recurrent tumor after surgical resection.
- Acoustic neuromas — Controls tumor growth in approximately 90 to 95% of patients while preserving facial nerve function in most cases.
- Gliomas and glioblastoma — May be used as part of a multidisciplinary treatment plan for selected recurrent tumors or as a boost in carefully selected cases.
- Arteriovenous malformations (AVMs) — Causes the AVM to gradually thrombose and obliterate over approximately 2 to 3 years. See AVM Treatment.
- Trigeminal neuralgia — Targets the trigeminal nerve root in patients who are not candidates for or prefer to avoid microvascular decompression (MVD).
- Spinal metastases — Stereotactic body radiation therapy (SBRT) provides highly targeted radiation for pain relief and local tumor control while minimizing radiation exposure to the spinal cord.
Benefits and risks
Potential benefits
- Non-invasive, no incision, no general anesthesia, and no hospitalization
- Completed in 1 to 5 outpatient sessions with little to no interruption of normal daily activities
- Sub-millimeter accuracy with real-time image guidance minimizes radiation exposure to surrounding healthy brain and spinal cord tissue
- Treats tumors and vascular lesions in locations where open surgery may carry greater risk
Possible risks
- Temporary swelling (edema) around the treatment area, may cause symptoms that are managed with corticosteroids when needed
- Rare risk of radiation necrosis (delayed radiation-related tissue injury), which can sometimes resemble tumor recurrence on follow-up imaging
- Condition-specific risks may include hearing loss after treatment for acoustic neuroma or other treatment-related side effects, depending on the target
- CyberKnife works gradually tumors and vascular lesions respond over weeks to months, and some conditions may take longer to achieve their full treatment effect
Your surgeon will review the benefits and risks specific to your diagnosis during your consultation.
What recovery looks like
There is essentially no recovery period after CyberKnife:
- During treatment Treatment is performed on an outpatient basis. Patients lie comfortably on the treatment table while the robotic system delivers radiation. Sessions typically last 30 to 90 minutes, and most patients return home immediately afterward.
- After each session Most patients resume normal daily activities the same day. Mild fatigue or headache may occur for several days, depending on the treatment site.
- Weeks 2 to 8 Radiation continues working after treatment is complete. Temporary swelling around the treatment area may occur and, when needed, is managed with medications such as corticosteroids. No activity restrictions are required unless otherwise directed.
- 3 to 6 months and beyond Follow-up MRI or CT imaging monitors the response to treatment. Because tumors and vascular lesions respond gradually, the full effects of CyberKnife may take months to years depending on the condition being treated. The multidisciplinary treatment team reviews follow-up imaging and determines whether additional treatment or continued surveillance is appropriate.
Frequently asked questions
Is CyberKnife the same as Gamma Knife?
Both are stereotactic radiosurgery systems that deliver precisely convergent radiation beams to a small target. Key differences: Gamma Knife uses a fixed array of cobalt sources and requires a rigid metal head frame bolted to the skull. CyberKnife uses a robotic arm and real-time image guidance, enabling frameless treatment and multi-session fractionation. Both systems achieve comparable outcomes for most intracranial targets.
How many sessions does CyberKnife require?
The number of treatment sessions depends on the target and treatment intent. Single-session SRS is used for small brain metastases, acoustic neuromas, and trigeminal neuralgia. Two to five sessions are used for larger targets, re-irradiation, and spinal lesions where fractionation reduces toxicity risk.
Will I feel anything during CyberKnife treatment?
No. Radiation is painless and undetectable during delivery. The only sensation is lying still on the treatment couch, similar to a CT scan. Some patients feel mild fatigue or headache after treatment but most feel no immediate effects.
How do I know if CyberKnife or surgery is right for me?
The best treatment depends on your diagnosis, the size and location of the lesion, your symptoms, your overall health, and your treatment goals. Some tumors and vascular malformations are best treated with microsurgery because they can be safely removed immediately. Others are better suited to stereotactic radiosurgery because of their location, size, or expected response to radiation. In some cases, observation or other therapies may be the most appropriate option. Every case at Atlantic Brain and Spine is reviewed individually to determine the treatment approach that offers the safest and most effective outcome.
This page is for general education and does not replace medical advice. Treatment decisions should be made with a qualified neurosurgeon based on your individual diagnosis and imaging. To discuss your options, call Atlantic Brain and Spine Brain Tumor Care at 973.993.7100 or request a consultation.
CyberKnife Radiosurgery Specialists at Atlantic Brain and Spine
Your care is provided by Atlantic Brain and Spine's multidisciplinary radiosurgery team, including fellowship-trained neurosurgeons who collaborate closely with radiation oncologists to develop individualized treatment plans.
