First European Center to Adopt Tattoo-Free DIBH Treatments Reflects on SGRT Journey

Innovation drives progress in patient care, and Biel-Seeland-Berner Jura AG has embraced it wholeheartedly with SGRT. By adopting AlignRT, the hospital has redefined how breast cancer patients—particularly those undergoing Deep Inspiration Breath Hold (DIBH) treatments—receive care.

“The decision to implement SGRT was largely motivated by the desire to improve the accuracy of DIBH treatments, minimize the need for invasive procedures like tattoo markings, and reduce long-term side effects by protecting vital organs”, explains Dr Dario Terribilini, Chief Medical Physicist at Biel-Seeland-Berner Jura AG.

Protecting Critical Organs with SGRT

One of the most pressing challenges in breast cancer treatment is minimizing radiation exposure to critical organs like the heart and lungs. For DIBH patients, maintaining consistent breath holds is crucial for safeguarding these organs while targeting cancer effectively.

AlignRT’s surface-guided radiotherapy (SGRT) is entirely non-invasive and contact-free technology, using 3D stereo cameras to track the skin’s surface and compare it to the ideal position in the treatment plan with submillimetric† accuracy.

“Real-time monitoring of patient positioning has been vital for ensuring the safety and precision of DIBH treatments,” says Dr Terribilini. “Compared to traditional methods like skin marking and imaging-based verification, SGRT has greatly improved treatment accuracy and precision. The system provides continuous monitoring of patient movement in real-time, which reduces the likelihood of positioning errors. For DIBH cases in particular, the ability to halt treatment immediately if a patient moves out of alignment ensures higher precision. This has reduced the need for frequent imaging during treatment sessions and increased overall treatment efficiency.”

Replacing Tattoos with Comfort

“SGRT has improved patient comfort by eliminating the need for skin markers, which many patients find unpleasant or psychologically distressing,” says Dr Terribilini. “The non-invasive nature of SGRT and the ability to treat patients in a more relaxed position without frequent repositioning increases comfort and reduces anxiety during treatment. The feedback from both staff and patients has been overwhelmingly positive. Clinicians have reported enhanced accuracy in patient positioning, while patients appreciate the comfort of not having to rely on permanent skin markings.”

Enhancing Accuracy and Efficiency

Biel-Seeland-Berner Jura AG also utilizes the AlignRT Postural Video module, which provides a multi-angle, real-time view of the patient’s overall alignment. This advanced tool overlays an outline of the reference surface onto a live video stream of the patient, allowing precise setup and continuous monitoring of their position relative to the reference.

Dr Terribilini: “The use of Postural Videos has further optimized workflows by providing clear visual feedback to both patients and therapists regarding the correct positioning. This helps patients maintain the correct posture throughout the treatment, reducing setup time and the need for repositioning, which in turn improves overall treatment efficiency.”

Setting a New Standard in Breast Cancer Treatment

Ultimately, the decision to adopt SGRT reflects Biel-Seeland-Berner Jura AG’s unwavering commitment to patient-centered care.

“Our goal was to make treatments safer, more accurate, and less invasive,” says Dr Terribilini. “Patients have responded positively, appreciating the non-invasive approach, while therapists have reported greater confidence in the delivery of treatment, knowing that patient positioning is continuously monitored”.