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Updated: Feb 1, 2026

Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System
Published on: April 11, 2018
End-to-end evaluation of CyberKnife tracking accuracy with RayStation treatment planning system
Nicolas Perichon1, Marie Fargier-Voiron1, Mireille Conrad1
1Swiss Radio-Oncology Network, Clinique Générale-Beaulieu, Chemin de Beau-Soleil 20, CH, 1206 Genève, Switzerland.
Purpose/Objective:
The CyberKnife system uses different collimators to deliver stereotactic treatments. For accurate delivery, the dosimetric plan and the tracking algorithm both need to be handed correctly in the TPS. The established TPS for CyberKnife treatment planning is Precision from Accuray. Since June 2022, it has also been possible to plan CyberKnife treatments using RayStation from RaySearch Laboratories. The purpose of this work is to assess the tracking accuracy of RayStation TPS plan for CyberKnife by evaluating end-to-end tests (E2E) comparing with Precision. In a quality assurance context, this study that has never been carried out until now is very important because it allows to verify the correct implementation of targeting when using the treatment chain including the RayStation TPS and the CyberKnife treatment machine.
Material/Methods:
E2E were performed for plans prepared in RayStation v12A (RS12A) for different collimator and tracking mode combinations. The results were compared to those obtained using Accuray Precision v3.3.1.0. E2E consisted of a concentric dose distribution around a ball target. Treatment was delivered after positioning with the target locating system for the appropriate tracking mode. Tests were performed at the same time for the plans from both TPS. The deviation on each axis and the radial error between the center of the ball target and the dose distribution were reported.
Results:
For all evaluated combinations of collimators and tracking modes, the RS12A deviation results were under international recommendations threshold (< 0.95 mm). In addition, RS12A deviation results for static targets (used for machine geometrical adjustments) were in agreement with the E2E Precision gold standard results, considering the 0.30mm method uncertainty.
Conclusion:
This study shows that E2E plans for CyberKnife can be generated in RS12A. The validation of the E2E results by comparison with the genuine treatment chain validates the targeting of the RayStation/CyberKnife treatment chain and also allows to use this method for periodic targeting checks and numerical robot position fine tune adjustment.
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