Auto ROI™ Module

Consistency and Automation
for your AlignRT® Patient Prep
Defining the right area to monitor on each patient is a critical step for successful motion management.
Previously, drawing a Region of Interest (ROI) was done manually, using an array of tools within AlignRT. Ensuring uniform best practice across all users has been key to repeatability, and requires clinical resources and attention.
Now with AlignRT’s new Auto ROI™ module, regions of interest (ROI) for the most common body sites are defined automatically.
Automating ROI definition is intended to save clinics time in patient preparation, while ensuring consistency between users and patients. Different ROI templates are available to automate for supine breast, chest wall, abdomen, pelvis, brain and intracranial SRS. These can be used unedited or serve as a starting point for ROI construction.
Hear from users on their clinical experiences:
“It is much easier to prepare and edit the patient data in AlignRT Advance. The best feature is the Postural Video module because it allows fast recognition of misalignments. It is a powerful tool to understand exactly where the changes happen when the patient falls outside tolerance during the treatment.”

Dr. Vania Batista, Medical Physicist Heidelberg University Hospital
“Vision RT decreases both the time of breast setup for right and left breast lesions, and has really improved our accuracy. Vision RT has also improved the setup for many other disease sites … it is improving our accuracy and throughput.”

Nancy Wiggers MD Radiation Oncologist, Department Chair, Northside Hospital
“What we were really after was equivalent positional accuracy. If we could find a technology and justify to ourselves that it is equivalent to existing technologies, that’s what we were going for. Enter Vision RT and their AlignRT product, and we had the tool that we were looking for.”

Todd Pawlicki, PhD DABR FAAP Vice Chair and Professor, Dept. of Radiation Medicine and Applied Sciences, UCSD
“Vision RT provides a simple-to-use and very effective way to save dose to the heart and lung in these patients. Our ambition is to widen the use of respiratory gating in the future.”

Mathias Dierl Head of Medical Physics, Klinikum Bayreuth, Germany
“We see significant value in three areas: checking patient position at CT to ensure a robust setup and avoid unnecessary dose from scans in an unusable position; enhancing planning through increasing the range of beam options; improving the use of resources and the patient experience by avoiding dry runs and delays due to last minute replans.”

Helen Convery Senior Dosimetrist (Development & Clinical Trials)
“Cherenkoscopy is a unique method for visualizing surface dose, resulting in real-time quality control. We propose that this system could detect radiation therapy errors in everyday clinical practice at a time when these errors can be corrected to result in improved safety and quality of radiation therapy.”
Lesley Jarvis, MD, PhD Radiation Oncology Dartmouth Hitchcock Medical Center
“The location of the tracking point in non-SGRT techniques can allow errors to be introduced such as a patient arching their back or belly breathing. By using SimRT and placing the tracking point on the stable part of the captured anatomy you can ensure that the patient is breathing correctly by filling their lungs. SimRT software will also allow the therapist to see if the patient can achieve the same results when repeated breathholds are required.”
Breda Horan, Clinical Specialist Radiation Therapist St. Vincent’s Private Hospital
“SimRT is close to being the ideal 4DCT gating system. The use of surface imaging and the markerless approach is an elegant, simple solution which is (in my opinion) superior to using a marker block or any other device requiring physical contact with the patient.”
Feedback from an early clinical user
“AlignRT InBore allows us to combine the benefits of fast CBCT, high dose rate and continuous monitoring of patient motion to perform safe DIBH treatments”.
Daniel Nguyen, Medical Physicist Orlam Group
“There was definitely a time and accuracy advantage with implementing AlignRT Advance, especially with the postural positioning element. It has helped us increase our patient volume without extending our hours or straining our resources and we are still able to maintain a very high-level quality of care, while still keeping our patients comfortable.”

Felicia Gretah, Radiation Therapist Cleveland Clinic Florida, USA
“We use thermoplastic open masks with head and shoulder support, this helps ensure reproducible positioning, we use multiple ROI’s to position the patient and CBCT comparisons has shown accurate positioning and excellent correlation with internal imaging.”

Kirsten Hierholz Chief Medical Physicist, Klinikum Darmstadt, Institut für Radioonkologie und Strahlentherapie, Germany

Julie McCrossin Head & neck cancer survivor and patient advocate
“There are a number of publications now on minimal immobilization in head and neck treatments: clinical research is finding that it’s actually better in many cases to drastically minimize the extent of immobilization, not only for patient comfort but also for patient stability. AlignRT offers the advantage of open-face masks combined with directly tracking the patient surface, allowing for highly accurate treatments whilst minimizing the level of immobilization.”

Daniel Bailey, PhD Head of Physics, Sarah Cannon, Atlanta, GA, USA
“The AlignRT SGRT system has enabled us to treat some of our breast cancer patients incorporating IMRT APBI based on the Florence Trial; these patients receive a total of 5 fractions treated every other day. This is a huge benefit for our patients as their treatments are reduced from 4-6 weeks to less than 2 weeks. AlignRT reassures us that our patients are correctly positioned, and treatments are delivered safely and accurately every time.”

Delonie Gregory MHSc, MHL, RT(T)(CT) Radiation Oncology Supervisor
“AlignRT has given us a more efficient way to reach our goals. We have been able to treat 70 more SRS and SBRT patients in the same time and with the same staff as we could previously. We are able to offer our patients an innovative, safe, accurate, and time-saving alternative to traditional positioning.”

Felicia Gretah, RT (T) Radiation Therapist
“Vision RT is a major step forward in improving the accuracy of radiation delivery, given its continuous monitoring throughout the duration of treatment. The system is efficient, easy-to-use, and improves our confidence that the precise area we want to target is actually receiving the prescribed radiation dose. It is very well accepted by our patients as it is a completely non-invasive system and avoids the need for unsightly permanent tattoos.”

Vinay Sharma, MD, FRCPC Radiation Oncologist
“I am very pleased with the fact that I did not have to get tattooed for my treatment. I did not want a constant reminder of my diagnosis. The Vision RT system I feel is quite amazing, and it tracks the body surface for accuracy, and I am glad to be getting treated at a center that utilizes the state-of-the-art technology.”
Nicolas Mancini GenesisCare patient
“As clinicians, we should consider technology, not for increased revenue, but also to see how we can minimize post-treatment costs as well as complications. We want to use it on every patient…it’s helped with their daily setup, improved their workflow [and] decreased setup times.”

Snehal Desai, MD Medical Director, Radiation Oncology Kelsey-Seybold Cancer Center, Houston TX
“The AlignRT SGRT system has enabled us to treat some of our breast cancer patients incorporating IMRT APBI based on the Florence Trial; these patients receive a total of 5 fractions treated every other day. This is a huge benefit for our patients as their treatments are reduced from 4-6 weeks to less than 2 weeks. AlignRT reassures us that our patients are correctly positioned, and treatments are delivered safely and accurately every time.”

Delonie Gregory MHSc, MHL, RT(T)(CT) Radiation Oncology Supervisor
“What sets AlignRT apart is its real-time monitoring capabilities. Before and during radiation therapy, the system actively tracks your position, allowing for quick adjustments to ensure accuracy. AlignRT automatically signals the treatment delivery system to pause the radiation beam if there is any deviation from the intended position. This dynamic feature eliminates the need for radiation therapy tattoos or the discomfort of headgear and closed masks.”

Natasha Calle FCS Lead Radiation Therapist, Florida Cancer Specialists & Research Institute
“Intrafraction motion is a real thing, and it happens. We have collected data that shows even in a framed stereotactic case, patients move millimeters. Without having a way to observe the treatment, you’re walking in the dark. With AlignRT, you feel like you’re walking in the light, you know where you’re going. AlignRT allows us to deliver stereotactic treatments comfortably, accurately, and safely.”

Habeeb Saleh, Ph.D., DABR FCS Director of Medical Physics
“At Beacon Hospital, AlignRT is central to the safe and accurate delivery of SBRT for multiple treatment sites. AlignRT offers several benefits for SBRT treatment delivery at our facility including real-time monitoring of the patient, management of respiratory motion and continuous and high precision monitoring of patient movement during cone-beam CT image matching. The use of AlignRT for SBRT has increased our confidence in providing an accurate treatment delivery”

Luke Rock MSc, DABR Chief Medical Physicist, Beacon Hospital, Ireland
“Traditionally SBRT technologies have offered gains in accuracy but often at the cost of things like efficiency, customization, and comfort for the patient; current evidence seems to suggest that SGRT has overcome this trade-off challenge.”

Mike Tallhamer, DABR Chief of Radiation Physics, AdventHealth, Denver
“We were thrilled to find that incorporating SGRT into the prostate patient setup process reduced reimaging rates and therefore reduced the amount of time our patients had to maintain a full bladder.”

Stephanie Parker, MS, FAAPM Medical Physicist
“With the introduction of the postural module, we have now started to use AlignRT to set up our pelvis patients. It has been a tremendous help in reducing the pitch and rotations prior to imaging. We are seeing an improvement in our CBCT data as a result.”

Suzanne Coupland Advanced Imaging Lead Radiographer Raigmore Hospital, Inverness, Scotland
“AlignRT has certainly helped reduce the pitch and roll in our pelvis patients as well as reducing the number of CBCT’s required per patient. This means a reduction of dose and time in the room for the patient.”

Catherine Russell Assistant RT Manager Alfred Health Radiation Oncology Melbourne, Australia
« À l’hôpital Beacon, AlignRT permet une délivrance sûre et précise de la SBRT pour plusieurs localisations. AlignRT offre plusieurs avantages pour la délivrance du traitement SBRT dans notre établissement, notamment la surveillance en temps réel du patient, la gestion des mouvements respiratoires, la surveillance continue et de haute précision des mouvements du patient pendant la CBCT. L’utilisation d’AlignRT pour la SBRT a renforcé notre confiance dans la délivrance d’un traitement précis »

Luke Rock MSc, DABR Physicien Médical en Chef Département de radiothérapie, Beacon Hospital, Irlande
« Traditionnellement, les techniques SBRT ont offert des gains en matière de précision, mais souvent au prix de facteurs tels que l’efficacité, la personnalisation et le confort du patient; les données actuelles semblent suggérer que la SGRT a surmonté ce défi de compromis »

Mike Tallhamer, DABR Chef de la radiophysique, AdventHealth
“Incorporating a personalized, whole-body clearance map in the treatment planning workflow can facilitate the adoption of non-coplanar beams or arcs that benefit the SBRT plan dosimetry.”
Quantification of Dosimetry Improvement With or Without Patient Surface Guidance Sheng, K. et al. (2024)
“Radiotherapy is all about striking up a balance between comfort and accuracy. This technique represents a significant step forward for both, and I am thrilled to be able to offer it to our patients.”

Jacob Curran SABR & Motion Management Radiographer, Lincoln County Hospital
“You’ve also got the benefit of being able to track promotion of the patients while you’re treating them… so you can be more accurate with treatments.”

Joshua Student Therapeutic Radiographer
When we first got AlignRT, we did not realize how much it would positively impact our patients’ treatments. At first, we utilized it for mostly breast patients. After seeing the impact and how it is extremely beneficial, we now use it for nearly all patients.
Nicole Schmidt, RT(T), BS Radiation Oncology Supervisor
“When we first acquired AlignRT, our therapists felt it was cumbersome and we struggled to implement the technology in a meaningful way. Our group came up with a plan to investigate expanding our indications, agreeing to take a stepwise approach and collect some data. AlignRT has now become an important tool in our toolkit, and I wouldn’t have guessed the positive impact it has had on our setups and efficiencies or the number of sites we are using it on today.”
Dennis Sopka, M.D. Chairman of Radiation Oncology/Radiation Oncologist
“I love how accurate and fast it is to set up patients with the AlignRT system. Not only is it great for setup, but it allows us to monitor patient movement during treatment. This lets us have shorter treatment times so patients are not on the treatment table as long.”
Jennifer Slivka, RT(T), BS Radiation Therapist
Patient ID fits in really well with our overall workflow. The focus on patient safety and the fact that we definitely know we’ve got the right patient in the room every time is a real benefit to us, and our conversation with the patient can focus on what really matters to them.

Kyle Woods Principal Radiographer, GenesisCare, UK
AlignRT surface-guided radiation therapy is accurate, efficient, and comfortable for patients. The fact that we can achieve SRS-level accuracy with an efficient setup and deliver while providing optimal comfort for the patient is a game-changer for radiation therapy. We have been using this approach for frameless SRS for over 10 years now and couldn’t imagine doing it any other way.

Todd Pawlicki, PhD, FAAPM, FASTRO Director of Medical Physics
“We know patients can be really tense when you’re setting them up for treatment. Prior to SGRT we would chase shifts, and not take into account that patients relax and re-adjust after set-up. We couldn’t always measure if our patients moved a millimeter or a degree. Now, with AlignRT InBore monitoring the patients inside the bore, we know if they moved. That alone should make you want a system like this.”

Michelle Physic, RT(T) Director of Radiation Therapy, Dana-Farber Cancer Institute/Brigham Cancer Center
Intrafraction motion is a real thing, and it happens. We have collected data that shows even in a framed stereotactic case, patients move millimeters. Without having a way to observe the treatment, you’re walking in the dark. With AlignRT, you feel like you’re walking in the light. You know where you’re going. AlignRT allows us to deliver stereotactic treatments comfortably, accurately, and safely.
Habeeb Saleh, Ph.D., DABR FCS Director of Medical Physics
“MapRT allows us to use non-coplanar treatments where before we would not have considered rotating the couch. This can be beneficial for organ at risk dose, especially for all lung treatments – with even more improvement for those close to the main bronchus. It took less than a week for us to implement scanning, with additional planning skills taking a few weeks to acquire.”

Kirsten Hierholz Senior Medical Physicist, Klinikum Darmstadt, Germany
“More freedom, better plans…better outcomes, less side effects.”

Kirsten Hierholz Senior Medical Physicist, Klinikum Darmstadt, Germany
“We succeeded in reducing the dose to the organs at risk while having the same coverage to the target and to the tumour, without huge additional time in terms of treatment. The quality of the treatment is improved, keeping the same level of security and delivering the treatment safety.”

Igor Bessières PhD Medical Physicist, Centre Georges-François Leclerc
“This technique represents a significant step forward for both comfort and accuracy, and I am thrilled to be able to offer it to our patients.”
Jacob Curran SABR & Motion Management Radiographer, Lincoln County Hospital
“SGRT has improved patient comfort by eliminating the need for skin markers, which many patients find unpleasant or psychologically distressing.”
Dr Terribilini Chief Medical Physicist, Biel-Seeland-Berner Jura AG
“AlignRT helps us increase confidence in every treatment we use it for, allowing for more accurate treatment delivery.”
Luke Rock Head of Medical Physics, The Beacon
“With SGRT, we spend less time on reimaging and now have more time to focus on each patient. This allows us to confidently take on more complex treatments.”
Andrew Leek Lead Therapist, New Mexico Cancer Center
“The key improvements with SGRT are not just in time reduction but in treatment precision, patient comfort, ease of technician positioning, dosimetric accuracy, and safety due to constant monitoring.”
Adriana Hurtad Radiotherapy Technicians Supervisor, Hospital Universitario Fundación Jiménez Díaz
“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.”
Dr Dario Terribilini Chief Medical Physicist, Biel-Seeland-Berner Jura AG
“AlignRT has enabled us to increase patient safety and comfort, as we no longer have to tattoo and mark our patients, as we had to using traditional radiation therapy, to set patients up for daily treatment.”

Kim Kyung Su Head of the Department of Radiation Oncology, EWHA Woman’s University Seoul Hospital
“SGRT has improved our workflows and reduced the need for repeat imaging, ensuring the patient is consistently in the correct position.”
Mark Wanklyn Senior Medical Physics Specialist, GenesisCare Crows Nest
“Cherenkov imaging is detecting approximately 8% errors with our patients. We can do better for our patients”
Adi Robinson, PhD, DABR Senior Medical Physicist, AdventHealth Celebration
“This is a big innovation from a quality and safety perspective. We don’t know what we don’t know. 6-8% of errors is a lot of errors.”
Matt Spraker, MD, PhD Radiation Oncologist, AdventHealth Parker
“Using SGRT for prostate setups has increased staff efficiency and patient satisfaction – we are so grateful to have this in our clinic.”
Ashley Towers RT(T) Radiation Oncology Supervisor, Wake Forest Baptist Health
“With MapRT we eliminated the need for dry runs or collision checks. Even with a simple supine breast treatment, a patient’s elbow position can be in the way of the gantry, and we will not find out until the first day of treatment. With MapRT we can ensure that there are no collisions with the patient, couch or accessories that would cause harm to the patient or delay their treatment due to a replan.”
Adi Robinson, Ph.D., DABR Senior Medical Physicist, AdventHealth Celebration
“AlignRT has been a great advance for our patients. They are always so glad to hear that “we don’t do tattoos” anymore. As a radiation oncologist, AlignRT assures me that essentially all patients can have daily image guidance. The margins around our treatment volumes are smaller now, and radiation side effects are greatly improved because of daily AlignRT.”
Richard Aucher MD Radiation Oncologist, SSM Health St. Mary’s Hospital – Janesville
“We like the fact that with AlignRT, we not only improve setup efficiency but with higher setup accuracy, and with real-time monitoring, we ensure treatment is being delivered safely and accurately.”
Heli Zhong Chief Physicist, Shenzhen People’s Hospital
Overall, our experience with the AlignRT InBore system has been very high in therapist satisfaction. There’s a reduction in setup time and reimaging dose. It also gives better patient motion monitoring while the beam is on.”
Mindy Joo, PhD, DABR Inova Health
“Having this tool adds to the department’s efficiency and minimizes the amount of time the patient is on the table.”
Sandra Urrutia, RT(T) University of San Diego Health (UCSD)
“This is going to become the standard of care in radiotherapy.”
Mike Tallhamer Chief of Radiation Physics, AdventHealth
“A simple thing like adding one non-coplanar arc can make a dramatic difference in the plan quality, can significantly reduce the dose to OARs and have a meaningful impact on the patient’s quality of life.”
Kiran Kumar, MD University of Texas Southwestern
“From the MD Standpoint, what I would encourage everyone to do is not ‘pretty good treatments’, but to do the best treatment for your patients.”

Kiran Kumar, MD University of Texas Southwestern
“We measured a lot of our appointments and [by using SimRT] we were able to reduce appointment times by 60%, from 1 hour to 20 minutes.”

Adi Robinson Senior Medical Physicist, AdventHealth Celebration
“SimRT played a crucial role in our transition to SGRT, allowing us to validate breath-hold reproducibility and integrate SGRT with confidence. This transition demonstrates the power of innovation in radiation therapy – improving efficiency, patient comfort, and therapist experience.”
Jaculin Mariyadas Radiation Therapist, Olivia Newton-John Cancer Wellness & Research Centre
“The OIS reports module automated our SGRT reporting process. Now we never miss an SGRT report, and the physician can review and approve them together with the IGRT daily review.”

Adi Robinson, PhD, DABR AdventHealth Florida, USA
“AlignRT has helped our workflows and treatment times, and the amount of imaging has gone down. We have a lot more confidence when we’re setting up the patient and it’s been a massive benefit for us.”
Bryan Hammers, RT(T) Oklahoma Proton Center
“Non-coplanar beams have long been used for creating high-quality plans for treatment of brain tumors due to the freedom to choose couch and gantry angles with little risk of collision. With the collision risk mitigated through the use of software like MapRT, then treatments in the head and neck and trunk using non-coplanar beams will similarly produce superior plans compared to coplanar beam arrangements. Significant additional organ-at-risk sparing can be achieved in most cases with non-coplanar beams along with improved target dose fall-off. It’s time to utilize our linear accelerators for all the degrees of freedom they offer for optimizing treatments.”
Arthur Olch, Ph.D., FAAPM University of Southern California Keck School of Medicine
“Setup time can be significantly reduced without compromising setup accuracy.”
Mojgan Heydari, Medical Physicist Oslo University Hospital, Oslo, Norway
FAQs
The SRS Module consists of a stereotactic calibration cube phantom, leveling plate, and software.
The calibration cube is a single phantom solution that enables direct calibration to radiographic isocentre for daily quality assurance of imaging – including radiographic and surface imaging (CBCT, SGRT, MV, kV).
A 3-degree couch-top head adjuster is available as an optional add-on. The head adjuster allows for easy, precise correction of pitch, yaw and roll for cranial treatments, allowing adjustments to be made to within a tenth of a degree. This means that a 6 degrees of freedom couch is not required.
Varian is currently developing an interface to connect motion management technology with Halcyon and Ethos Radiotherapy Systems. This architecture, similar to MMI on TrueBeam, is expected to be released soon. Once the interface specification is available, Vision RT will have access through Varian’s Interoperability program.
Open-face masks are less claustrophobic than frames or closed masks, allow continuous surface monitoring in real-time during setup and treatment, and enable easy dialogue with the clinical team during setup.
Click here to see a list of compatible masks that have been evaluated by Vision RT for use with AlignRT. (https://visionrt.com/vision-rt-compatible/)
No. All customer data remains on the customer site on equipment (that Vision RT provides) which the customer maintains. Vision RT does not house, store or backup this data. Vision RT does not provide any data processing capability on this data. It is possible for Vision RT service staff to view the data during customer-initiated service interactions. Vision RT’s policy is for customer data not to be copied under any circumstances. Inadvertent transmission of ePHI data by customers to Vision RT is treated as a data loss and is reported by Vision RT to the customer (along with immediate deletion of the data on Vision RT’s systems).
Auto ROI™ is not for clinical use in the USA, 510(k) pending.
Images are for illustration purposes only. Clinical templates will vary.
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