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ExacTrac Dynamic Implanted Marker WorkflowIn motion,
on point

ExacTrac Dynamic Implanted Marker Workflow enables precise positioning and monitoring of highly mobile soft tissue tumors, like prostate cancer, when using fiducials to represent the position of the target volume. It can identify and correct intrafractional movements, such as prostatic drifts, mid-treatment to deliver high doses with sub-millimetric accuracy.  

Intrafractional
motion detection
for high accuracy 

ExacTrac Dynamic ensures precise tracking of fiducial-marked soft tissue tumors during beam delivery by frequently triggering verification x-rays and fusing them with CT planning images. This automatic verification allows for low-dose monitoring of the prostate, an organ prone to frequent motion during stereotactic body radiation therapy (SBRT). 

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Mitigating frequent
prostatic drifts

If prostatic movement is detected, the patient position can be corrected mid-treatment. ExacTrac Dynamic allows for intrafractional re-positioning in six degrees of freedom (6DoF), ensuring the target position is correct and the treatment can continue.   

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Margin reduction and hypofractionation

The image guided radiation therapy (IGRT) capabilities of ExacTrac Dynamic enable the reduction of treatment margins, thereby minimizing toxicity. Achieve sub-millimetric accuracy in patient positioning and monitoring, paving the way for hypofractionation and effective treatment protocols.  

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Hear from experts in the field 

Power and precision in prostate care 

Prostate cancer is the second most commonly diagnosed cancer in men, with an estimated 1.4 million diagnoses and almost 400,000 deaths worldwide in 20221. Prostate tumors grow in highly mobile soft tissue, posing a challenge for treatment compared to static tumors. ExacTrac Dynamic Implanted Marker Workflow helps you address these challenges with precise target volume positioning and low-dose monitoring for highly accurate radiation. Transform your external body radiation therapy (EBRT) practice into SBRT for prostate cancer using fiducial markers to ensure precise treatment delivery. 

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Quantifying clinical success

Precision in prostate care starts here 

See how the Implanted Marker Workflow can optimize prostate cancer treatments.  

Automatic marker detection

Enhance soft tissue localization with ExacTrac Dynamic, which automatically detects implanted markers during both positioning and monitoring phases of treatment. This detection occurs in 6DoF, allowing for precise shifts that can be sent to the treatment couch to actively manage the motion of the moving target during SBRT prostate cancer treatments.

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Flexible imaging options: x-ray or CBCT

Customize your workflow with flexible imaging options. Use cone beam CT (CBCT) positioning to assess filling of the bladder and rectum before beam delivery for safe, reproducible and accurate treatment. Alternatively, opt for positioning based on x-rays for minimal imaging dose. No matter your positioning choice, the monitoring is always conducted by x-ray imaging, crucial for prostate SBRT.

Automatic beam hold for treatment safety 

Ensure precise irradiation of the target tissue with the automatic beam hold function. Frequent imaging of internal anatomy and real-time monitoring of the thermal surface in 6DoF detect significant deviations from preset tolerances, triggering an instant beam hold. Automated x-ray imaging at small intervals allows for frequent fiducial marker detection, helping to minimize the risk of irradiating healthy tissue. 

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SGRT and IGRT integration

Benefit from the integration of augmented surface guided radiation therapy (SGRT) and image guided radiation therapy (IGRT) for enhanced tracking. The system utilizes three imaging modalities throughout the treatment steps: live surface matching with CT outer contour during pre-positioning; thermal signature capture at each fraction to enable tracking of small, flat areas with limited topological information; and x-ray imaging for accurate positioning. Finally, monitoring combines thermal-surface and x-ray tracking to support accurate treatment delivery.

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See ExacTrac Dynamic in action 

Interested in better understanding the capabilities of the Implanted Marker Workflow for prostate cancer treatment?   

Learn more

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Enhance lung cancer treatment accuracy with ExacTrac Dynamic integrated Lung Motion Management3, tracking tumor motion due to breathing. 

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Experience precision in prostate cancer treatment

  1. Culp, M.B., et al. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates. Eur Urol, 2020. 77: 38. https://pubmed.ncbi.nlm.nih.gov/31493960.
    Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I, Bray F (2024). Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.who.int/today, accessed [13 November 2024]. https://gco.iarc.who.int/media/globocan/factsheets/cancers/27-prostate-fact-sheet.pdf.

  2. Kishan et al., JAMA Oncol. 2023 Mar 1;9(3):365-373. doi: 10.1001/jamaoncol.2022.6558 | Reduction from 43.4% to 24.4% for grade ≥2 genitourinary (GU) toxicity and reduction from 10.5 % to 0.0% for grade ≥2 gastrointestinal (GI) toxicity. 

  3. Not yet commercially available.