Loading
A radiotherapy machine with PET detectors built in: the tumour's own radioactive tracer signal tells the beam where to fire, hundreds of times a second, so moving tumours and several metastases can be tracked and treated without external markers.
RefleXion's X1 is a ring-gantry linac that also carries PET detector arcs and a fan-beam kilovoltage CT. In SCINTIX mode the patient receives a dose of fluorodeoxyglucose, and as the gantry rotates the machine detects pairs of annihilation photons from the tumour and, within a fraction of a second, fires short beamlets back along the lines they came from. The tumour therefore steers its own treatment, motion is handled without fiducials or breath-hold, and in principle several metastases can be treated in one session with the emissions from each guiding its own dose. The system was authorised in the United States in 2023 for lung and bone tumours, primary or metastatic, that take up FDG, and can also deliver conventional image-guided and stereotactic treatments with CT guidance.
It is one vendor's platform with a small number of installations, treatment requires a tracer injection and tumours with enough uptake, sessions are longer than standard radiotherapy, and the clinical claim that biology guidance improves outcomes in oligometastatic and polymetastatic disease is still being tested. Tracers other than FDG, such as PSMA ligands for prostate cancer, are the obvious next step.
PET detectors on a rotating ring gantry detect coincident annihilation photons from a tracer in the tumour and trigger linac beamlets back along the detected lines of response with sub-second latency, so emissions from the target steer the dose.
Query for this technology: (TITLE:"Biology-guided radiotherapy" OR ABSTRACT:"Biology-guided radiotherapy" OR TITLE:"RefleXion X1, SCINTIX" OR ABSTRACT:"RefleXion X1, SCINTIX") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Biology-guided radiotherapy (RefleXion X1, SCINTIX), not a curated reading list.
Shares Stereotactic ablative radiotherapy for oligometastatic disease, Stanford Health Care / Stanford Cancer Institute, SBRT / SABR (stereotactic radiotherapy), Metastatic cancer (cancer that has spread) and the tag machines-wave.
Shares MR-guided adaptive radiotherapy, SBRT / SABR (stereotactic radiotherapy), Prostate cancer and the tag machines-wave.
Shares Ring-gantry linacs (Halcyon, Ethos), SBRT / SABR (stereotactic radiotherapy), IMRT / IGRT (modern external beam), Prostate cancer and the tag machines-wave.
Shares Ring-gantry linacs (Halcyon, Ethos), IMRT / IGRT (modern external beam), Prostate cancer and the tag machines-wave.
Shares Metastatic cancer (cancer that has spread), Prostate cancer and the tag machines-wave.
Shares SBRT / SABR (stereotactic radiotherapy), Metastatic cancer (cancer that has spread) and the tag machines-wave.
Shares Metastatic cancer (cancer that has spread), Prostate cancer, Non-small-cell lung cancer and the tag machines-wave.
Shares PET/CT and the tag machines-wave.