AlignRT & DIBH for Reduced Radiation Toxicity

AlignRT & DIBH for Reduced Radiation Toxicity

The Challenge

Shandong Province Hospital was looking for a superior DIBH solution for their young mediastinal lymphoma patients as these patients have an increased risk of lung cancer, breast cancer and cardiovascular disease after radiotherapy. In view of the high survival rate of this disease and patients’ young age, extra care needs to be taken to reduce toxicity after radiation therapy and an accurate and highly reproducible DIBH solution is critical.



Implement an accurate and highly reproducible DIBH technique.

Dose Reduction

Find a technology that will help them effectively reduce dose to lung, breast and heart.

Patient Satisfaction

Develop workflows with AlignRT to provide tattoo and mark-free treatment and enhance the patient experience.


Shandong Province Hospital has been using AlignRT on thoracic, breast and cervical patients since 2018. In 2020, Vision RT developed a educational plan to maximize the hospitals utilization and technology for better patient outcomes.

Retraining Program

Vision RT’s Clinical Application Specialist visited the site as part of the retraining program and worked with their staff to develop streamlined workflows and increase their knowledge of AlignRT.

New Workflow

The retraining program helped them devise a unique workflow combining the linac’s automatic couch positioning function with AlignRT’s move couch function to position patients efficiently and accurately. This workflow was published in an abstract which was accepted by ASTRO in 2021.


The Clinical Application Specialist worked with them to develop DIBH technique for their mediastinal lymphoma patients. Eventually, they moved towards tattoo and mark-free treatment after successful implementation of the workflow.



The use of DIBH with AlignRT reduced:

  1. Planning Target Volume (PTV) by 28%
  2. Dose to Heart by 16%
  3. Dose to Lung by 25%
  4. Dose to Breast by 35%


“One of our core values is to be the best and strive to be the first in everything we do. Especially when it comes to our patients, in order to have better and safer treatment, we will be the first to pioneer the latest technique and technology.”

Yin Yong
Chief Physicist

Future plans

Shandong Cancer Hospital plans to expand this technique to all their breast cancer patients. In addition, they plan to expand the use of AlignRT to other sites such as SRS treatment.


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