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CyberKnife Outpatient Process

Step 1: Treatment Set-up 

Fiducial Placement

When undergoing CyberKnife treatment for a spine or body lesions, an outpatient procedure may be required to implant several small metal markers (fiducials) near the tumor.  These small markers (left) enable tumor tracking during the CyberKnife treatment ensuring accuracy of the radiation. The markers remain in your body permanently and are usually not noticeable.

Making a mask or body mold

A custom soft mask (for head and neck treatment) or a body mold is formed and used to help minimize movement during the treatment and ensure comfort. The process is simple and painless.  Please notify the therapist of any movement limitations you may have such as a stiff shoulder or limited arm movement.


A CT scan is performed after the immobilization device has been made.  Sometimes physicians order a MRI or PET scan in addition.  These imaging studies are used by the physicians to identify the exact size, shape and location of the area being targeted for treatment as well as vital structures to be avoided. 

Step 2: Treatment Planning  

The imaging data is downloaded to the CyberKnife planning computer.  Then, the physician uses advanced software to customize the number, intensity and direction of the radiation beams that will be sent to the target area by the robot.  This process may take several days.  Patients are notified when the planning process is complete and treatment will begin.

Step 3: Treatment Delivery 


On the day of treatment, wear comfortable clothing and no jewelry.  Please bring your favorite music CD or cassette tape or book on tape to listen to during the treatment.  Bring someone to drive you home.  Do not drink coffee or caffeine products two hours before treatment for bladder comfort.  The nurse will instruct you regarding your medications.


You will be asked to lie on the treatment table and positioned with the custom mask or body mold made earlier during the set-up process.  Generally, no sedation or anesthesia is used since the treatment is painless.

Painless Treatment

During treatment you will need to lie still.  The entire procedure could last from 30-90 minutes depending on the complexity of your case.   The image guidance system periodically takes x-ray images and compares them to data from the CT scan and other imaging studies.  This enables the Cyberknife robot to compensate for minute movement and accurately target the treatment area.


Patients undergoing single-session radiosurgery will be able to go home immediately after the first treatment.  If the physician prescribes staged treatments (fractionated treatments), you will return for additional 2-5 treatments.  Theses treatments are generally scheduled daily or every other day. 


Follow-up appointments with your physicians will be scheduled on the last treatment day. Follow-up imaging studies will be ordered by your physician as needed to monitor your care.