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Limitations of current treatment techniques:

Changes in patient anatomy and differences in shape and location of tumor during the course of treatment present a great challenge to clinicians in developing an optimal treatment plan for radiation therapy. Traditionally, they have relied on diagnostic CT images for treatment planning; but this approach can sometimes be dangerous. It does not provide the means to adjust the plan to account for ongoing bodily changes; making it necessary to radiate a larger area to ensure tumor coverage, but at the expense of damaging healthy tissue.

In the case above, a significant deformation of the rectum occurred during the course of treatment; changing tumor form and position. Using current treatment techiniques, a larger area is radiated in order to ensure tumor coverage, often causing overdose to healthy tissue.

Treatment with original plan missed the target,
overdosing the rectum causing patient discomfort

The introduction of advanced imaging techniques like CT-on-Rails and Cone Beam CT have provided clinicians the ability to track patients’ daily bodily changes, but not the means to adjust treatment plans to accommodate anatomical changes during the course of treatment.

RealART Solution:

RealART solution from Prowess Inc. provides the answer to these problems. It allows real-time plan adaptation based on inter-fractional anatomic variations and incorporates current shape and location of tumor - eliminating the need for patient re-positioning. This technique devises utmost precision of radiation delivery for maximum treatment effectiveness and patient safet


RealART Treatment Process:

This advanced technology is available only from Prowess and can be used in conjunction with CT-on-Rails systems.
*Image above indicates workflow with Siemens CTVision™ Solution.

Dose Volume Histogram Improvements

Benefits of RealART

  • Treat patients with plans based on the shape of the anatomy on the day of treatment.
  • Optimize the plan to a particular treatment fraction.
  • Better dose coverage to targets.
  • Real Control over dose delivered to spare healthy tissues.
  • Patient re-positioning no longer needed.



RealART – Additional features

  • Copy relevant patient volumes from another patient model. This provides a starting point for the RealART process, as the user can quickly adjust the volumes to the current day's image series.

  • Copy plan for the new patient model. The purpose of this feature is to perform the copying of the original IMRT plan into the new patient model, associate the target volumes, and generate the necessary information needed for aperture morphing.

  • Adjust (morphing) beam/segment apertures based on differences between planning contours and the contours on the treatment day.

  • Segment weight optimization: only optimizing the monitor units of the segments. The MLC segment shapes acquired from the aperture morphing will stay unchanged.