ntil now, several different systems have often been used in radiotherapy to meet positioning and monitoring requirements during treatment for all clinical indications. The challenge for Eckstein Design was to develop an innovative and functionally convincing combination of radiotherapy equipment and an X-ray and surface-based system. At the same time, the workflow, image quality and patient monitoring for radiotherapy were to be improved for both patient and physician.

Brainlab’s ExacTrac Dynamic embodies an alternative approach, for the first time combining surface and X-ray based tracking: ExacTrac Dynamic is a high-resolution patient monitoring system for radiotherapy. It provides an extremely precise all-in-one solution that, for the first time, combines revolutionary camera technology with real-time X-ray tracking. The system combines state-of-the-art tracking technology for various patient positioning and monitoring workflows, such as cranial and prostate procedures. Every single detail is designed to make the doctor’s day-to-day work easier and provide a cost-effective and safe treatment for patients.

The key to the user’s heart and mind is good design. Design makes thoughts visible. At Eckstein Design, one way to achieve this is with design thinking methods. These are interdisciplinary, involving the client, developers, users and designers. For our first studies, we developed mood boards and initial sketches. In the subsequent processes, ideas were visualised, interactively experienced and evaluated. The concept developed into a weekly sprint process, in which we worked closely with BrainLab’s engineering, manufacturing, purchasing, marketing and sales teams across functions over the next two years – this also allowed us to make quick decisions on behalf of the client.

The system consists of two kV X-ray tubes mounted on the floor next to the radiotherapy unit, two ceiling-mounted flat panel detectors and a single ceiling-mounted 4D camera module with an SL projector, two high-resolution cameras and an integrated thermal imaging camera. ExacTrack allows for flexible mounting of the X-ray tubes, detectors, additional cameras and projectors. It is the only one on the market that can be used as an on-floor and in-floor system. This opens up a new dimension for position monitoring.

The small footprint of the compactly designed ExacTrack facilitates placement close to the patient, improving safety and seamless coexistence with other equipment in crowded therapy labs. A cable management system ensures that tubes and cables are neatly routed. They are also covered with specially designed panels, which contributes to improved hygiene and safety.