Global Growth and Distribution of CyberKnife Stereotactic Radiosurgery: A Bibliometric Analysis

CyberKnife (CK) is advanced stereotactic radiosurgery (SRS) technology indicated for brain metastases, arteriovenous malformations, functional disease, and a number of other neurosurgical conditions that combines a linear accelerator with a highly maneuverable robotic arm and real-time imaging, allowing for several advantages including the ability to deliver radiation from a wide variety of angles and frameless delivery of therapy. We seek to explore the current trend and evolution of publications related to CK SRS using bibliometric approach, with a particular focus on neurosurgical disease applications.

The Web of Science database was queried for data collection, using keyword "CyberKnife". Network visualization figures representing exported Web of Science data were created using visualization of similarities viewer. Statistics were completed in R.

In total, 3980 articles from 12 077 authors were identified for analysis. Annual publication number has expressed growth from 1 article in 1996 to 263 articles in 2023. Most frequently reported conditions were brain metastases, followed by vestibular schwannoma and meningiomas. The top 5 most prolific authors in the field are Andrew Muacevic, Steven D. Chang, Oliver Blanck, Christian Baues, and John R. Adler. The top 3 most prolific institutions are the University of Cologne, Stanford University, and the University of Munich. Institutional collaboration is strongest between institutions within countries. Through authorial key word analysis, we identified that articles related to pituitary adenoma, brain metastases, meningioma, hemangioma, and cavernous sinus have increased. Through the same analysis, we noticed an increase in key words potentially associated with interdisciplinary applications of CK, such as immunotherapy, machine learning, and deep learning.

CK SRS is an emergent technology with increasingly more neurological conditions and diseases being researched for treatment options. The rise in academic focus on CK SRS has been spearheaded by international effort from the United States, Japan, and Italy. There remains significant potential for future international collaboration.