title: A review of 3 current radiosurgery systems.
abstract: BACKGROUND
  Stereotactic radiosurgery and fractionated stereotactic radiotherapy have become widespread techniques applied to the treatment of a variety of intracranial lesions. Rapid evolution of new technologies has now enabled clinicians to treat tumors outside the cranium and down the spinal axis. This review compares 3 commercially available systems in widespread use throughout the world.
  
  
  METHODS
  Literature review and interviews with practitioners in the United States were performed to establish data for a comparative analysis of the Gamma Knife (Elekta, Sweden), Novalis (BrainLabs, Germany), and CyberKnife systems (Accuray, Sunnyvale, CA). Cost analyses were deliberately excluded because of the need for detailed cost-benefit analysis beyond the scope of the review.
  
  
  RESULTS
  An unbiased comparative analysis was not possible because of the lack of objective data from a standard metric for these systems. Despite this shortcoming, disparate features of each system were compared and contrasted.
  
  
  CONCLUSIONS
  A careful assessment of each system, including its operational features, capabilities, and yearly capacity must be weighed against the composition of the radiosurgery team, the case mix of the practice, and the objectives of the clinical unit to yield the best fit.
authors.affiliation: Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. david.andrews@jefferson.edu
authors.forename: David W
authors.initials: DW
authors.lastname: Andrews
authors.forename: Greg
authors.initials: G
authors.lastname: Bednarz
authors.forename: James J
authors.initials: JJ
authors.lastname: Evans
authors.forename: Beverly
authors.initials: B
authors.lastname: Downes
mesh_terms: D001927:Brain Diseases / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D011785:Quality Assurance, Health Care; D016634:Radiosurgery / Q000295:instrumentation*