When comparing MRI-guided linear accelerators to CyberKnife for radiation therapy, the choice depends on clinical context, tumor characteristics, and institutional capabilities. Both technologies achieve sub-millimeter accuracy, but they differ in key areas:

CyberKnife excels at sparing nearby critical structures by creating steep dose gradients, particularly in complex cases like cardiac or prostate treatments. Its robotic arm allows non-isocentric beam angles for precise targeting of small lesions.

Linac-based systems (including MRI Linac) show advantages in reducing high-dose spillage to distant tissues and achieving faster treatment times. MRI Linac adds real-time soft-tissue visualization, enabling adaptive replanning during sessions.

For prostate SBRT, studies show no significant outcome differences between CyberKnife and Linac-based approaches. CyberKnife demonstrates slightly better organ-at-risk sparing, while Linac platforms offer comparable target coverage with shorter delivery times

Hard to pick one as better than the other.