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The scanners built into or beside the radiotherapy machine that photograph the patient seconds before the beam fires, so the tumour is where the plan expects and, on the newest machines, so the plan can be redrawn to that day's anatomy.
Image guidance moved from weekly port films to daily three-dimensional imaging in the 2000s. A kilovoltage X-ray tube and flat panel mounted at right angles to the treatment head (Varian's On-Board Imager, Elekta's XVI) rotate with the gantry to produce a cone-beam CT of the patient on the couch, which is registered to the planning CT to shift the couch; the megavoltage treatment beam and its imaging panel provide a lower-contrast alternative. Brainlab's ExacTrac uses two floor-mounted kV tubes and ceiling detectors for stereoscopic X-rays that verify position at any gantry angle, the standard for frameless brain radiosurgery. CT-on-rails places a diagnostic CT scanner in the treatment room that slides over the couch, giving full-quality images for adaptive planning; TomoTherapy's megavoltage CT and Radixact's ClearRT kV CT image with the treatment ring; Varian's HyperSight on Halcyon and Ethos acquires a CT-quality cone-beam scan in seconds; and MR-linacs replace X-rays with a magnet.
The gains are smaller margins and daily adaptation; the costs are imaging dose that accumulates over a course, time on the couch, image quality that is worse than diagnostic CT for soft tissue on most cone-beam systems, and a heavier physics QA load.
Kilovoltage or megavoltage sources and detectors on or beside the treatment gantry acquire radiographs, cone-beam CT or fan-beam CT of the patient in treatment position, which are registered to the planning images to correct position or to re-plan.
Query for this technology: (TITLE:"In-room imaging for radiotherapy" OR ABSTRACT:"In-room imaging for radiotherapy" OR TITLE:"cone-beam CT, ExacTrac, CT-on-rails, HyperSight" OR ABSTRACT:"cone-beam CT, ExacTrac, CT-on-rails, HyperSight" OR TITLE:"IGRT hardware" OR ABSTRACT:"IGRT hardware" OR TITLE:"kV imaging" OR ABSTRACT:"kV imaging") 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 In-room imaging for radiotherapy (cone-beam CT, ExacTrac, CT-on-rails, HyperSight), not a curated reading list.
Shares Adaptive radiotherapy (online replanning), Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW), Elekta, Varian (Siemens Healthineers) and the tag machines-wave2.
Shares Patient positioning and surface guidance systems (AlignRT, Catalyst, ExacTrac Dynamic), Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony) and the tag machines-wave2.
Shares Patient positioning and surface guidance systems (AlignRT, Catalyst, ExacTrac Dynamic), Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony) and the tag machines-wave2.
Shares Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW), Varian (Siemens Healthineers), Head and neck squamous cell carcinoma and the tag machines-wave2.
Shares Elekta, Varian (Siemens Healthineers), IMRT / IGRT (modern external beam) and the tag machines-wave2.
Shares Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW) and the tag machines-wave2.
Shares Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW) and the tag machines-wave2.
Shares Cervical cancer, Head and neck squamous cell carcinoma, IMRT / IGRT (modern external beam) and the tag machines-wave2.
Commercial and regulated products that serve this technology. Each card says what is behind it: a regulator's database, the literature, a public body's list, or only the company's own words. Listing is not endorsement, and a clearance is a regulatory fact, not a clinical one.
Surface-guided radiotherapy: cameras watch the skin surface and hold the beam if the patient moves, which is how breath-hold breast treatment is delivered without tattoos.
Optical surface scanning and respiratory gating systems for positioning and monitoring a patient during treatment.
The planning and adaptation software behind online adaptive radiotherapy, which re-plans on the day's image while the patient is on the couch.