Exactrac x ray system

Manufactured by Brainlab

The ExacTrac X-ray system is a product developed by Brainlab. It is an image-guided radiation therapy system that uses X-ray imaging to assist in the precise positioning of the patient during radiation treatment.

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Lab products found in correlation

Clinac ix, by Agilent Technologies (1 mentions) Vero4drt, by Hitachi (1 mentions) Eclipse version 8, by Agilent Technologies (1 mentions) Lightspeed rt, by GE Healthcare (1 mentions) Brainscan version 5, by Brainlab (1 mentions)

2 protocols using exactrac x ray system

CFSRT for Brain Tumor Treatment

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Patients were immobilized in a thermoplastic flat shell (Klarity) with infrared markers for image guidance. Contrast-enhanced computed tomography (CT) images were acquired with a Light Speed RT instrument (GE Healthcare) at a slice thickness of 1.25 mm. Treatment plans were developed with BrainSCAN version 5.3.1 (BrainLAB), iPlan RT Dose version 4.5.1 (BrainLAB), or Eclipse version 8.6 (Varian Medical Systems). Contrast-enhanced CT images were fused with contrast-enhanced magnetic resonance imaging (MRI) images on a radiotherapy planning system.
Thirty-five patients underwent radiotherapy using the Novalis system with 6-MV linear accelerator, m3 micro-multileaf collimator, the ExacTrac X-ray system, and the Robotic Tilt Motion mounted on the Exact Couch top (BrainLAB). Five patients were treated with the Vero4DRT (Hitachi, Ltd.), and one patient was treated with the Clinac iX (Varian Medical Systems).
Gross tumor volume (GTV) was defined as the volume of the tumor on contrast-enhanced T1-weighted MRI. The clinical target volume (CTV) was defined as the GTV with a thickened dural tail. The planning target volume (PTV) was defined as the CTV plus a 1–2-mm margin in all directions. CFSRT was performed using multiple dynamic conformal arc therapy (DCAT) or by intensity-modulated radiotherapy (IMRT). The PTV was covered by 90% of the prescribed dose in both the DCAT and IMRT plans.

Takehana K., Nakamura D., Abdelghaffar A., Uto M., Katagiri T., Arakawa Y., Mineharu Y., Miyamoto S, & Mizowaki T. (2021). Short diameter may be a useful simple indicator of the tumor response in skull base meningiomas after conventionally fractionated stereotactic radiotherapy. European Radiology, 31(8), 6367-6373.

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Adaptive DTT-SBRT with Tumor Tracking

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A gimbal-mounted linac on the Vero4DRT system was used for DTT-SBRT delivery. Set-up error was corrected for bony structures using the ExacTrac X-ray system (BrainLab AG) before treatment beam delivery. Then, a 4D model was built to correlate abdominal motion with internal tumor motion. The treatment beams were delivered with tumor motion tracked according to the 4D model. Internal fiducials were monitored with kV imagers during treatment delivery. If the fiducial markers were displaced from the predicted positions by ≥3 mm, the treatment was interrupted and the 4D model was rebuilt. The patients were treated with one fraction per day and 2-4 fractions per week. Concurrent chemotherapy was not administered during treatment. The treatment was discontinued in the following cases: if the patient was diagnosed unfit for DTT-SBRT after the daily check before each treatment fraction (e.g., rapid exacerbation of comorbidities or complications); if a technical problem was found in the treatment processes, including the 4D-model and tracking; if a grade 4 or worse adverse event, or other adverse events occurred that required discontinuation of the treatment; and if the patient wished to discontinue the treatment.

Matsuo Y., Hiraoka M., Karasawa K., Kokubo M., Sakamoto T., Mukumoto N., Nakamura M., Morita S, & Mizowaki T. (2022). Multi-institutional phase II study on the safety and efficacy of dynamic tumor tracking-stereotactic body radiotherapy for lung tumors. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 172.

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