by John R. Fischer
, Senior Reporter | October 25, 2018
Brainlab took aim at improving radiotherapy patient positioning last weekend with the unveiling of its ExacTrac Dynamic system at the 2018 annual ASTRO meeting in San Antonio.
The next generation of ExacTrac X-ray, the positioning and monitoring solution is equipped with high-precision tracking and verification, and is capable of addressing challenges associated with the treatment of external and internal moving targets, ensuring delivery of extremely effective and high doses in precision radiotherapy.
“We can use the surface of the patient to trigger X-ray imaging, and to verify, if the surface of the patient moves, that there was an internal anatomy shift,” Patrick Murphy, director of Brainlab’s radiation oncology portfolio, told HCB News. “That’s the big difference with ExacTrac, because clinicians today are put into a difficult situation, and they have to sometimes make compromises in terms of what technology or what monitoring they offer to their patients. There’s no one really good workflow right now to set up and monitor the patient throughout the entire treatment. They have to combine multiple technologies to do that.”
Seamlessly integrated with a wide range of linear accelerators, ExacTrac Dynamic offers both internal and external monitoring. Ensuring patient positioning is correct externally is the solution’s high-speed surface tracking, made possible with the use of 300,000 3D surface points that detect movement during treatment. The ExacTrac Dynamic structured light system acquires the points, which are then matched to a heat signal of the patient generated by a thermal camera, enabling clinicians to track positioning accurately and consistently, with no interference from room lighting, reflections or skin tone.
If patient movement does occur, the system automatically cuts off the beam and activates integrated X-ray monitoring to internally assess anatomical shifts with real-time imaging due to outer movement or internal motion, such as respiration. Using additional workflows such as deep inspiration breath hold and internal anatomy verification, the system is capable of monitoring clinical indications that are complicated by internal motion and protect critical anatomy from unnecessary dosage.
Access to features on previous versions of ExacTrac X-ray will remain available to customers, including non-coplanar capabilities, submillimetric precision, cranial positioning and monitoring, as well as the new features of Dynamic that include Mu-triggered monitoring, and gantry-angle triggered monitoring.
Brainlab also showcased the latest versions of its Elements software platform for multiple brain metastases, spine, and cranial specialized radiosurgeries.
The system is FDA and CE pending, and expected to launch at some point in 2019.