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Radiosurgical image-guided computer-aided stereotactic surgical systems designed to aid in the performance of surgical procedures from the exterior of the body using a single high dose of ionizing radiation provided by linear accelerators (i.e., linacs). These systems typically combine medical imaging, dedicated computer software, and a dedicated linear accelerator with a movable gantry and a single or multileaf collimator. Standard linacs may be adapted also for limited radiosurgery applications. Image-guided linac radiosurgical systems typically incorporate a miniature linac mounted on a flexible robotic arm and an image-guidance system that can track target location during treatment using fiducials as references without the need for an invasive head frame. Radiosurgical linac stereotactic systems are mainly intended to provide a single high dose of ionizing radiation; they are used in neurosurgery (i.e., for brain, neck, and spinal tumors) and, less frequently, for radiosurgery of extracranial tumors (e.g., to ablate abdominal tumors). Dedicated linac systems that can be used in any location in the body and employ computer-controlled beam-shaping (known as intensity modulated radiation therapy [IMRT]) to conform the radiation dose to the shape of the tumor or other lesion are also available.
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