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ExacTrac X-Ray

Highly Accurate Patient Monitoring

ExacTrac Image Guided Radiation Therapy ensures submillimetric precision during radiotherapy and radiosurgery treatments

Ceiling panels for X-Ray image guided radiotherapy system

Experience the latest generation of ExacTrac with ExacTrac Dynamic

Achieve submillimetric accuracy during radiotherapy and radiosurgery treatments.

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Display of an X-Ray radiotherapy patient treatment monitoring system

Patient Position Monitoring

ExacTrac® is an in-room X-Ray based monitoring system that detects intra-fractional tumor motion during treatment delivery, regardless of the couch angle or gantry position. Instantaneous X-Ray imaging with proprietary 6D fusion provides fast and highly accurate positioning information and reduces the possibility of geographical miss due to patient motion or internal anatomical shifts.

  • Room based setup
  • Two KV X-Ray units
  • Independent verification tool

Spy glass view helps users assess the fusion of bony anatomy for cranial SRS

Precision Based on Internal Anatomy

ExacTrac X-Ray monitoring provides clinicians with a unique position verification tool based on the patient’s internal anatomy. Deviations or unintended shifts from the prescribed treatment position are automatically detected during treatment delivery and immediately displayed to the user.

  • Monitoring throughout the entire treatment
  • Precise image fusion based on bony anatomy
  • Immediate alert to the user in case of deviations

X-Ray Monitoring with ExacTrac is possible at any couch or gantry angle during radiotherapy and radiosurgery treatments

Non-Coplanar Verification

ExacTrac X-Ray monitoring complements existing IGRT solutions by providing the added possibility of detecting intra-fraction motion, regardless of couch and gantry angle. It allows the patient’s initial position, set by the linac-based IGRT system, to be continuously verified with X-Ray imaging throughout the entire treatment delivery. Even at non-coplanar couch angles and during beam-on, ExacTrac can detect potential misalignment of the patient.

  • Offers intra-fractional motion management to linac-based IGRT systems
  • Provides internal verification of the patients position regardless of couch and gantry angle
  • Gives confidence that the prescribed treatment has been delivered

A non-invasive head frame for immobilization during radiosurgery and radiotherapy treatments

Frameless Cranial Radiosurgery

The ExacTrac frameless radiosurgery system offers highly accurate delivery of single- or multi-fraction treatment without a conventional, invasive head ring. A patient-friendly head-to-shoulder mask facilitates a streamlined workflow, overcoming the restrictions of frame-based radiosurgery and improving scheduling flexibility for imaging, planning and treatment.

  • Highly accurate delivery of cranial SRS without conventional head ring
  • Precise non-invasive stereotactic mask system designed for reproducible conformity
  • Time-saving, patient friendly procedure without compromising treatment accuracy

Image guided radiation therapy system controls that allow for X-Ray confirmation of patients position during treatment

Optional Automated Patient Positioning

Efficiency is an important attribute for any IGRT system, especially given the ever growing demand on centers with increased patient referrals to radiation therapy departments. One method to improve efficiency is to provide a more automated approach to patient setup. The optional automatic positioning packages for ExacTrac allow the user to remotely position the patient from the control area. Positioning packages are available for either 4D or full 6D robotic alignment.

  • Enable patient positioning based on X-Ray
  • Remote control of couch movement without need to enter treatment room
  • Improved efficiency by reducing overall treatment times

IGRT therapy technology from both Brainlab and Varian can be integrated

Compatibility with Varian

For more than a decade, Brainlab has been collaborating with Varian on the integration of ExacTrac. The system provides an integrated workflow with Varian linacs, ranging from Unique™ Performance, Clinac® and Trilogy® to the TrueBeam™ platform. ExacTrac software ensures that the same treatment plan is automatically loaded on both systems and provides DICOM RT export of the ExacTrac positioning data to ARIA®. This allows any detected patient setup errors to be corrected with the Varian couch and Brainlab Robotics in an integrated and automated process.

  • Long lasting partnership with large worldwide installations
  • Validated workflows and advanced integration
  • Compatibility with most Varian linacs

ExacTrac IGRT system is compatible with linear accelerators from Elekta

Compatibility with Elekta

The enhanced partnership between Elekta and Brainlab combines the seamless integration of ExacTrac with Elekta linacs: Versa HD™, Axesse™, Infinity™, Synergy® and Precise. Integrated workflows offer automatic loading of the patient treatment plan to ExacTrac from MOSAIQ®, as well as the integration of the ExacTrac stereotactic frameless radiosurgery system in combination with the Elekta HexaPOD™ evo RT system for patient positioning in 6 degrees of freedom.

  • Compatibility with Versa HD™, Axesse™, Infinity™, Synergy® and Precise
  • Enables positioning for stereotactic frameless radiosurgery
  • Patient positioning in 6 degrees of freedom with HexaPOD™ evo RT system

ExacTrac IGRT system is compatible with linear accelerators from Siemens

Compatibility with Siemens

ExacTrac can provide a range of benefits to extend the capabilities of Siemens linacs. It allows for quick and efficient setup of cranial and extra cranial cases and offers the ability to detect intra-fractional motion, ensuring confidence in treatment delivery for each fraction. If a Siemens linac with ExacTrac is replaced by a Varian or Elekta device, the room based ExacTrac can easily be refitted to most linacs.

  • Provides fast daily image guidance with high precision
  • Detects intra-fractional motion providing confidence in treatment delivery
  • Flexibility to refit ExacTrac with another linac at a later date

Image guided radiotherapy system detecting implanted markers to help locate the tumor or target

Implanted Marker Support

In treatment indications where there is difficulty visualizing the tumor or the need to compensate for tumor motion due to respiration or random motion, fiducial markers may be implanted prior to treatment. ExacTrac offers a simple, automated approach to visualize, detect and register implanted markers using a proprietary software solution and 6D fusion.

  • Automatic marker detection offers clinical consistency
  • 6D fusion and setup compensates for motion
  • Wide range of markers supported

Selective anatomical fusion is possible with the Volume of Interest tool

Selective Anatomical Fusion

The Volume of Interest (VOI) tool improves clinical accuracy and confidence in image fusion by focusing on the most relevant anatomy. The user can exclude areas such as ribs, adjacent vertebrae or other non-rigidly correlated objects from the 6D fusion, ensuring precise patient setup. The defined VOI is automatically used for subsequent imaging during setup and to monitor intra-fractional motion.

  • Focus on relevant anatomy provides improved targeting
  • Exclusion of non-rigidly correlated objects removes potential inaccuracies
  • Consistent fusion results for better targeting