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Updated: May 11, 2026

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Published on: June 7, 2015

Markerless EPID image guided dynamic multi-leaf collimator tracking for lung tumors.

J Rottmann¹, P Keall, R Berbeco

¹Brigham and Women's Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA. jrottmann@lroc.harvard.edu

Physics in Medicine and Biology

|May 30, 2013

Summary

This study presents a real-time system for radiotherapy that tracks tumor motion using soft tissue localization (STiL) and a dynamic multi-leaf collimator (DMLC). The system achieves sub-millimeter accuracy, improving treatment precision for moving tumors.

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Area of Science:

Medical Physics
Radiation Oncology
Image-Guided Therapy

Background:

Radiotherapy accuracy is challenged by target motion, particularly during respiration.
Improving dose conformity and sparing healthy tissues requires real-time compensation for target movement.
Online image guidance systems offer potential for enhanced treatment precision.

Purpose of the Study:

To implement and evaluate an online image-guided radiotherapy system for real-time target motion compensation.
To adapt treatment apertures using a dynamic multi-leaf collimator (DMLC) synchronized with tumor motion.
To assess the system's accuracy and latency in tracking lung tumors without fiducial markers.

Main Methods:

Developed an online image-guided therapy system using soft tissue localization (STiL) from electronic portal images (EPID).

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Last Updated: May 11, 2026

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Published on: June 7, 2015

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

Published on: May 8, 2018

Integrated STiL with a dynamic multi-leaf collimator (DMLC) for real-time treatment aperture adaptation.

Employed a prediction model to overcome system latencies, trained with pre-treatment tumor motion data.

Tested the system using a dynamic chest phantom with recorded lung tumor trajectories on a Varian TX linear accelerator.

Main Results:

Successfully demonstrated DMLC tracking for lung stereotactic body radiation therapy without fiducial markers.
Measured an inherent system latency of (230 ± 11) ms at a frame rate of 12.86 Hz.
Achieved a root mean square deviation smaller than 1 mm between tumor and treatment aperture position.
Validated the feasibility of real-time, markerless DMLC tracking using a standard LINAC-mounted EPID.

Conclusions:

The developed online image-guided system enables real-time, markerless DMLC tracking of moving tumors.
The system significantly improves treatment accuracy and dose conformity by compensating for target motion.
This technology holds promise for enhancing radiotherapy outcomes, especially for lung cancer treatment.