{"id":42655,"date":"2025-11-19T13:00:48","date_gmt":"2025-11-19T18:00:48","guid":{"rendered":"https:\/\/www.accuray.com\/?post_type=studies&p=42655"},"modified":"2025-11-24T16:02:45","modified_gmt":"2025-11-24T21:02:45","slug":"real-time-motion-management-for-a-smalltarget-in-the-right-lower-lobe-with-largetumor-motion-using-radixact-synchronya-case-report","status":"publish","type":"studies","link":"https:\/\/www.accuray.com\/ja\/case-studies\/real-time-motion-management-for-a-smalltarget-in-the-right-lower-lobe-with-largetumor-motion-using-radixact-synchronya-case-report\/","title":{"rendered":"Real-time Motion Management for a Small Target in the Right Lower Lobe With Large Tumor Motion Using Radixact\u00ae Synchrony\u00ae: A Case Report"},"content":{"rendered":"\t\t
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\n\t\t\t\t\t\t\t\t\t< View All Case Studies<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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CASE STUDY | MEDICAL COLLEGE OF WISCONSIN<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Real-time Motion Management for a Small\nTarget in the Right Lower Lobe With Large\nTumor Motion Using Radixact\u00ae Synchrony\u00ae:\nA Case Report<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tDownload Case Study<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Authors:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tGuang-Pei Chen, An Tai, Lindsay Puckett, Eric Paulson (Radiation\nOncology, Medical College of Wisconsin, Milwaukee, WI USA)\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Challenge:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tThe lesion in the right lower lobe (RLL) was only 6 mm in size but\nexhibited 18 mm of motion in the superior-inferior direction. Traditional\nmotion management techniques (e.g., abdominal compression, breath\nhold) are often uncomfortable or inefficient.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Solution:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tSynchrony\u00ae real-time adaptive motion management with markerless\ntracking was used on the Radixact\u00ae System.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Case Information:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Patient<\/strong><\/span><\/td>73-year-old woman with a history of metastatic rectal cancer with oligoprogressive disease to the liver and lung.<\/span><\/td><\/tr>
History<\/strong><\/span><\/td>Received previous SBRT treatment to a right lung lesion 1.5 years earlier.<\/span><\/td><\/tr>
Current
Presentation<\/strong><\/span><\/td>		New lesion in the right lower lobe (Figure 1).<\/span><\/td>\t\t\t<\/tr>\r\n\t\t<\/tbody>\r\n\r\n\t\t\r\n\t\t\t<\/table>\r\n\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Figure1: Patient\u2019s planning CT image with target tracking volume (TTV) and GTV indicated by red and orange contours, respectively, in axial (A), coronal (B), and sagittal (C) views. The image window width and level were set to the lung preset<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Treatment:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Margins<\/strong><\/span><\/td>PTV was a 5 mm expansion of GTV.<\/span><\/td><\/tr>
Tracking Technique<\/strong><\/span><\/td>Synchrony\u00ae fiducial-free tracking with 4 radiographic image angles per rotation was used. A simulation session confirmed the feasibility of accurate tracking using external LED markers and radiographic imaging.<\/span><\/td><\/tr>
Dose<\/strong><\/span><\/td>54 Gy in 3 fractions.<\/span><\/td><\/tr>
Planning Constraints<\/strong><\/span><\/td>All organ at risk constraints of the RTOG 0234 protocol were met.<\/span><\/td><\/tr>
Beam-on-time<\/strong><\/span><\/td>10.41 minutes.<\/span><\/td>\t\t\t<\/tr>\r\n\t\t<\/tbody>\r\n\r\n\t\t\r\n\t\t\t<\/table>\r\n\t\t<\/div>\r\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Outcomes:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tTracking accuracy was high, with strong model confidence and low prediction error. At 20-month follow-up, the patient showed complete response with no evidence of recurrence or significant side effects.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Key advantages of Synchrony on the Radixact\u00ae System :<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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  • Continuous real-time motion tracking without fiducials<\/li>\n
  • High tracking accuracy despite large motion amplitude<\/li>\n
  • Minimized treatment margins, reducing normal lung exposure<\/li>\n
  • Efficient dose delivery with no significant increase in treatment time<\/li>\n<\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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    Conclusion:<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    \u201cSmall lung lesions with large motion are more prone to being missed during treatment, and treatment with a large margin increases radiation exposure to healthy tissue. This case study demonstrates the clinical feasibility and effectiveness of Radixact\u00ae Synchrony in managing significant respiratory-induced tumor motion for a small lesion in the lung. Future studies should explore long-term outcomes and dosimetric refinements for further optimization\u201d<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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    Chen G, Tai A, Puckett L, et al. (June 01, 2025) Real-Time Motion Management for a Small Target in the Right Lower Lobe With Large Tumor Motion Using Radixact Synchrony: A Case Report. Cureus 17(6): e85195. doi:10.7759\/cureus.8519<\/p>\n

    Synchrony\u00ae is available in the US and EU markets. This feature may not be commercially available in all markets and is subject to regulatory clearance or approval. Kindly contact your regional Accuray representative or distributor to confirm the regulatory status.<\/p>\n

    Important Safety Information:<\/p>\n

    Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury, and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), and the patient\u2019s general medical condition, to name a few. For more details about the side effects of your radiation therapy, and to see if treatment with an Accuray product is right for you, ask your doctor. Accuray Incorporated as a medical device manufacturer cannot and does not recommend specific treatment approaches. Individual results may vary.<\/p>\n

    \u00a9 2025 Accuray Incorporated. All Rights Reserved. Accuray, the Accuray logo, and other trademarks are trademarks or registered trademarks of Accuray Incorporated and may not be used without permission. For more information on Accuray and its trademarks, please visit www.accuray.com\/trademarks. MKTRXCSCC17092025#5<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    The lesion in the right lower lobe (RLL) was only 6 mm in size but exhibited 18 mm of motion in the superior-inferior direction. Traditional motion management techniques (e.g., abdominal compression, breath hold) are often uncomfortable or inefficient.<\/p>\n","protected":false},"featured_media":42656,"menu_order":0,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"_links_to":"","_links_to_target":""},"categories":[1866],"studies_products":[],"case_studies_products":[1861,1268],"class_list":["post-42655","studies","type-studies","status-publish","has-post-thumbnail","hentry","category-synchrony-on-radixact","case_studies_products-synchrony","case_studies_products-tomotherapy-radixact"],"acf":[],"yoast_head":"\nPediatric Total Body Irradiation on the Radixact System - Accuray<\/title>\n<meta name=\"description\" content=\"Learn how the Radixact System was used to treat pediatric total body irradiation (TBI) treatment at University Hospitals Birmingham\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.accuray.com\/case-studies\/real-time-motion-management-for-a-smalltarget-in-the-right-lower-lobe-with-largetumor-motion-using-radixact-synchronya-case-report\/\" \/>\n<meta property=\"og:locale\" content=\"ja_JP\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Real-time Motion Management for a Small Target in the Right Lower Lobe With Large Tumor Motion Using Radixact\u00ae Synchrony\u00ae: A Case Report\" \/>\n<meta property=\"og:description\" content=\"Learn how the Radixact System was used to treat pediatric total body irradiation (TBI) treatment at University Hospitals Birmingham\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.accuray.com\/case-studies\/real-time-motion-management-for-a-smalltarget-in-the-right-lower-lobe-with-largetumor-motion-using-radixact-synchronya-case-report\/\" \/>\n<meta property=\"og:site_name\" content=\"Accuray\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/AccurayIncorporated\" \/>\n<meta property=\"article:modified_time\" content=\"2025-11-24T21:02:45+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.accuray.com\/wp-content\/uploads\/88c239303c2211f0ac09590a2340f3bb-20250527_001-Fig1.png\" \/>\n\t<meta property=\"og:image:width\" content=\"986\" \/>\n\t<meta property=\"og:image:height\" content=\"641\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@Accuray\" \/>\n<meta name=\"twitter:label1\" content=\"\u63a8\u5b9a\u8aad\u307f\u53d6\u308a\u6642\u9593\" \/>\n\t<meta name=\"twitter:data1\" content=\"4\u5206\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.accuray.com\/case-studies\/real-time-motion-management-for-a-smalltarget-in-the-right-lower-lobe-with-largetumor-motion-using-radixact-synchronya-case-report\/\",\"url\":\"https:\/\/www.accuray.com\/case-studies\/real-time-motion-management-for-a-smalltarget-in-the-right-lower-lobe-with-largetumor-motion-using-radixact-synchronya-case-report\/\",\"name\":\"Pediatric Total Body Irradiation on the Radixact System - 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