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For SRS, do you prefer fixed kV imaging (e.g. ExacTrac) or cone-beam CT?

Are there situations in which one imaging modality has clear advantages over the other?
2 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · University of Rochester
Answered on

In our practice (at U Rochester), we have the ExacTrac system which captures orthogonal X-rays for each couch rotation, using 2 imaging sources on the floor and 2 imaging detectors on the ceiling (in a criss-cross orientation). So, you never get typical AP and lateral films (which I have become accu...

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Mednet Member
Mednet Member
Radiation Oncology · Clearview Cancer Institute
Answered on · Updated on

I think of frameless SRS imaging/alignment as being a 2-part process:

  1. Initial setup imaging.
  2. Image guidance throughout treatment once you start doing couch kicks.

For the initial setup, both CBCT and ExacTrac are excellent solutions. I can attach a couple of papers (others are out there) that both s...

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