Axesse™ | Elekta |
- ✓
Beam delivery – wide range of noncoplanar angles - ✓
Beam energy – multiple energy (photon) - ✓
Collimation – MLC - ✓
Design – image-guided robotic linac that combines high-conformance beam shaping with 4D Adaptive™ IGRT technology - ✓
Dose delivery – multiple energy choices - ✓
Imaging – CT/MR imaging with patient in immobilization (no fiducials necessary) - ✓
Patient Positioning/Localization – BodyFIX dual vacuum-activated immobilization and fixation system; automatic reposition in up to 6 degrees of freedom - ✓
Treatment Sessions – single and fractionated
| No | No response from FDA or manufacturer | Spinal metastases, lung, liver, prostate, head, neck |
CyberKnife® robotic radiosurgery system | Accuray Incorporated |
- ✓
Beam delivery – noncoplanar and nonisocentric; anterior beam delivery - ✓
Beam energy – 6 MV nominal (photon) - ✓
Collimation – 12 fixed apertures; Xchange™ Robotic Collimator Changer automatically exchanges collimators - ✓
Design – a treatment radiation generator, linear accelerator, manipulator (robot) with six degrees of freedom, and a target locating subsystem - ✓
Dose delivery – A 6 MV X-band linac - ✓
Field size – determined by the use of interchangeable secondary circular cones with diameters ranging from 5.0 to 60.0 mm - ✓
Imaging – continuously delivers imaging to ensure target accuracy throughout the entire treatment; InTempo™ Adaptive Imaging System tracks and corrects for intra-fraction prostate motion - ✓
Output – available at 800 MU/min at 80 cm, 600 MU/min, and 400 Mu/min - ✓
Patient Positioning/Localization – only radiosurgery system to move to and with the patient; room-based stereo x-ray with 2D kV-kV match - ✓
Tracking – Fiducial tracking, Xsight™ Spine Tracking, Xsight™ Lung Tracking, and Synchrony™ Respiratory Tracking for dynamic positioning and pointing of the linac - ✓
Treatment Sessions – single and fractionated
| Yes | Treatment planning and image-guided SRS and precision RT for lesions, tumors and conditions anywhere in the body | Spine, lung, liver, prostate, pancreas, kidney, head, neck |
Leksell Gamma Knife®
Perfexion™ | Elekta Inc. |
- ✓
Beam delivery – 192 cobalt-60 sources housed in the central body of the unit produce 192 collimated beams directed to a single focal point (isocenter) - ✓
Collimation – 4,8, 16 mm diameter - ✓
Design – a radiation unit with patient-positioning system and an operator console - ✓
Dose delivery – multiple converging fixed beams of ionizing radiation - ✓
Imaging – MRI/CT prior to treatment - ✓
Output – >3 Gy/min - ✓
Patient Fixation – head fixated in the Leksell® Stereotactic Frame. Awaiting approval on re-locatable frame. - ✓
Total cobalt-60 activity at loading (approximate) – <6,300 Curie (2.33 × 1014 Bq) - ✓
Treatment Sessions – single with availability of fractionated upon approval of Extend™ program
| No | Metastatic tumors, and head structure targets (a few millimeters to several centimeters) | Cervical spine, head, neck, larynx tumors |
MHI-TM2000 Linear Accelerator System | Mitsubishi Heavy Industries (MHI) |
- ✓
Beam delivery – Gimballed x-ray irradiation offers tilt and pan-rotation functions enabling fine adjustments in any direction - ✓
Collimation – MLC - ✓
Design – O-ring-shaped mechanical structure provides a high level of rigidity; X-ray generator incorporates a compact accelerator tube - ✓
Image Processing System – ExacTrac 3rd Party by BrainLAB (K072046 approved by FDA on 8/07) - ✓
Treatment Sessions – single and fractionated
| No | Radiation therapy of lesions, tumors and conditions anywhere in the body | NR |
Novalis TX™ | BrainLAB/Varian Medical Systems |
- ✓
Accuracy - millimeter precision utilizing BrainLAB’s iPlan and ExacTrac technologies - ✓
Beam delivery – fixed beam positions and continuous arc delivery with RapidArc; anterior beam delivery and full 180 degree posterior beams - ✓
Beam energy – 6–20 MV/6–20MEV - ✓
Collimation –Varian’s HD120 MLC 120 interleaved ultra thin collimators provides 2.5 mm collimation at isocenter and 5.0 mm collimations at the periphery. - ✓
Design – includes Adaptive Gating and On-Board Imager devices - ✓
Field size – 22 × 40 cm maximum - ✓
Imaging – ExacTrac and x-ray 6D and Snap Verification - ✓
Output – 1,000 MU at 100 cm - ✓
Patient positioning/localization – 6D Robotic couch top, Varian Exact® couch - ✓
Treatment Sessions – single and fractionated
| Yes | The Varian High Energy linear accelerator is intended to provide SRS and precision RT for lesions, tumors and conditions anywhere in the body | Spine, lung, liver, prostate, head, neck |
Oncor ARTISTE, Impression, Avant-Garde, Expression | Siemens | Artiste
- ✓
Beam energy – 6 MV (photon) - ✓
Collimation – 160 leaf MLC - ✓
Design – includes an Electronic Portal Imaging Device (EPID), a 160 leaf MLC, and the syngo™ RT Therapist Express Workspace with MVision™ - ✓
Imaging – OPTIVUE 1000ART amorphous silicon (a-Si) portal imaging system - ✓
Patient-positioning verification – use of the OPTIVUE imaging system, including MVision™ Megavoltage Cone Beam (MVCB) Imaging and/or CTVision - ✓
Respiratory Gating – ANZAI breathing belt system Impression/Avant-Garde/Expression
- ✓
Beam energy – 6/10 MV photon/6–21 MeV - ✓
Collimation – OPTIFOCUS 82 leaf MLC (static and dynamic modes) - ✓
Field size – 40 cm × 40 cm fully-conformal - ✓
Imaging OPTIVUE 1000/ST electronic portal imaging device (EPID) and MVision™ megavoltage cone beam on-board imaging - ✓
Output – 200–500 MU/min, special configuration-1,000 MU/min for maximum 5 × 5 cm field (Avant-Garde); 200–300 MU/min, special configuration-500 MU/min for maximum 5 ×5 field - ✓
Patient position localization and setup – Adaptive Targeting™ supports alignment of 3D planning data with newly acquired 3D Cone Beam data - ✓
Respiratory Gating – standard on Avant-Garde/optional on Impression
| No | The delivery of x-ray radiation for therapeutic treatment of cancer. | Head, neck, extracranial areas |
Synergy®S | Elekta Inc. |
- ✓
Beam delivery – a 62 cm treatment head in combination with industry best isocenter clearance allows for a wide variety of treatment approaches including noncoplanar - ✓
Beam energy – 4, 6, 10, 15, 18, and 25 MV photon; 6, 9, 12, 15, 18, and 25 MeV - ✓
Collimation – Beam Modulator, an integrated high-resolution, multi-leaf collimator designed for extracranial SRS - ✓
Dose delivery system – includes an integrated multi-leaf collimator - ✓
Field size – 16 cm × 21 cm - ✓
Imaging – 4D Adaptive™ IGRT technology - ✓
Patient positioning/localization – BodyFix® and HeadFix® immobilization accessories - ✓
Treatment Sessions – single and fractionated
| No | Radiation therapy treatment of malignant neoplastic diseases | Spine, lung, liver, prostate, pancreas, head, neck |
TomoTherapy® Hi-Art® | TomoTherapy Inc. |
- ✓
Accuracy – beam modulating technology that divides a single beam into “beamlets” to better conform to tumors - ✓
Beam delivery – 360 degree - ✓
Beam energy – 6 MV (photon) - ✓
Collimation – 64 leaf MLC - ✓
Design – linac mounted to a CT scanner-like ring gantry - ✓
Field size – 40 cm × 1.6 meters maximum - ✓
Imaging – integrated, 3D daily CTrue™ imaging - ✓
Output – 850 cGy/min (photon)* - ✓
Patient positioning/localization – AlignRT® (consisting of 2 ceiling- mounted 3D camera units) registers real-time image data and subsequently updates couch coordinates. Complements CTrue™ imaging when tumor is deep-seated or can move internally w/o external evidence - ✓
Treatment Sessions – single and fractionated
| No | To tumors or other targeted tissues | Lung, liver, prostate, head, neck |
Trilogy™ | Varian Medical Systems |
- ✓
Accuracy – beam modulating technology that divides a single beam into “beamlets” to better conform to tumors - ✓
Beam delivery – choice of Intensity modulated radiosurgery (IM-RS) with multi-leaf collimation – for lesions >2.5 cm, irregular shaped and >3 lesions OR Cone-based SRS for lesions <2.5 cm, not irregular and 1–3 lesions - ✓
Beam energy – 6 MV (photon)/4–22 MeV (6 energies) - ✓
Collimation – 120 leaf MLC and conical collimator - ✓
Design – external system gating interface, remote couch motion - ✓
Field size – 15 cm × 15 cm - ✓
Imaging – PortalVision MV imager, On-Board kV Imager (amorphous silicon detector-based radiographic, fluoro and cone-beam CT). - ✓
Output – 1,000 MU/min (photon and electron) - ✓
Patient position/localization – optional optical imaging-based patient positioning (FrameArray, BodyArray, and SonArray) - ✓
Respiratory Gating – Real-time Position Management™ (RPM) System - ✓
Treatment Sessions – single and fractionated
| No | Lesions, tumors and conditions anywhere in the body | Whole body |