In September 2006, Accuray improved the radio wave knife treatment bed to a robot-controlled bed, the collimator replacement was changed from manual to computerized automatic identification and replacement, the amorphous silicon image plate (X-ray digital camera) on the ground in a mutually perpendicular position was improved to below the ground, which increased the nodes of exposure of the radio wave knife, especially with the introduction of the Multiplan dose planning system, which brought the radio wave knife treatment into a new era. The new generation of the radio wave knife is called the fourth generation (G4) radio wave knife by Accuray. There are no significant technical differences in software between the G4 and the widely used G3, but the treatment process is much more streamlined. The G4 technology is based on the G3 technology, which inherits all the features of the previous three generations of the radio wave knife and modifies the treatment process. Compared with the third generation, the fourth generation of the radio wave knife technology has greater mobility in the treatment space. The third generation of the device is only free to move from five spatial directions: X, Y, Z axial position and head and treatment bed tilt, while the fourth generation of the radio wave knife adds left and right rotation of the treatment bed in the horizontal direction, which greatly improves the smoothness of the treatment, and the staff no longer needs to spend more time and energy on patient positioning. The fourth-generation radio wave knife’s target positioning system, respiratory tracking system, treatment planning system, and integrated computer network control system are all superior to the third-generation device. It is worth mentioning that the fourth-generation device has improved in precision, with lower errors in all directions, reducing side effects for patients’ treatment. At present, the third and fourth generations of domestic radio wave knife devices are mainly used in China, and the sixth generation (M6) models have been applied in the clinic abroad, which further improves the treatment efficiency, but from the treatment effect, there is no significant difference between the efficacy of most tumors and G4.