Published Evidence

There are more than 100 peer-reviewed publications reporting studies that involve the use of Vision RT’s technology for SGRT. These span a wide range of indications from brain to breast to sarcoma. In addition, Vision RT supports the SGRT Community, an organization dedicated to education on SGRT by users, for users, which holds biannual meetings and communicates through a dedicated website.  Vision RT’s educational funding has been diverted to the SGRT Community since 2016.

Vision RT technology has been widely researched by numerous users including the some of the most respected centers in radiation oncology. Below you can find a list of the journal papers and conference proceedings that detail the use of the technology. Click on the links to view abstracts and full papers where available Use the menu directly below to see the publications listed and organized by treatment site.


        • Ibrahim Duhaini, Bilal Shahine, Youssef Zeidan, Abbas Mkanna, Ahmad Maarouf & Mahmoud Korek  (2021). “The effectiveness of the DIBH technique in protecting the heart of radiotherapy breast cancer patients treated at the American University of Beirut Medical Center in Lebanon.” Health and Technology (2021)
        • Laaksomaa M, et al. Comparison of three differently shaped ROIs in free-breathing breast radiotherapy setup using surface guidance with AlignRT®.  (2021) Medica Journals: ISSN: 1507-1367. e-ISSN: 2083-4640
        • Hamming, V. C., C. Visser, E. Batin, L. N. McDermott, D. M. Busz, S. Both, J. A. Langendijk and N. M. Sijtsema (2019). “Evaluation of a 3D surface imaging system for deep inspiration breath-hold patient positioning and intra-fraction monitoring.” Radiat. Oncol. 14(1): 125.
        • Zagar T, et al. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study. Int J Radiat Oncol Biol Phys 2017;97 (5):903-909.
        • Zagar TM, Cardinale DM Marks LB. Breast cancer therapy-associated cardiovascular disease. Nat Rev Clin Oncol 2016;13 (3):172-184.
        • Tang X, et al. Dosimetric effect due to the motion during deep inspiration breath hold for left-sided breast cancer radiotherapy. J Appl Clin Med Phys 2015;16 (4):5358.
        • Rochet N, et al. Deep inspiration breath-hold technique in left-sided breast cancer radiation therapy: Evaluating cardiac contact distance as a predictor of cardiac exposure for patient selection. Pract Radiat Oncol 2015;5 (3):e127-134.
        • Cheung, Y., et al. (2015). “SU-F-BRB-03: Quantifying Patient Motion During Deep-Inspiration Breath-Hold Using the ABC System with Simultaneous Surface Photogrammetry.” Medical Physics 42(6Part25): 3530-3530.

        • Tanguturi SK, et al. Prospective assessment of deep inspiration breath-hold using 3-dimensional surface tracking for irradiation of left-sided breast cancer. Pract Radiat Oncol 2015;5 (6):358-365.
        • Taylor CW, et al. Exposure of the Heart in Breast Cancer Radiation Therapy: A Systematic Review of Heart Doses Published During 2003 to 2013. Int J Radiat Oncol Biol Phys 2015;93 (4):845-853.
        • Lemanski C, et al. Image-guided radiotherapy for cardiac sparing in patients with left-sided breast cancer. Front Oncol 2014;4:257.
        • Rong Y, et al. Improving intra-fractional target position accuracy using a 3d surface surrogate for left breast irradiation using the respiratory-gated deep-inspiration breath-hold technique. PLoS One 2014;9 (5):e97933.
        • Darby SC, et al. Risk of Ischemic Heart Disease in Women after Radiotherapy for Breast Cancer. N Engl J Med 2013;368 (11):987-998.
        • Gierga DP, et al. A voluntary breath-hold treatment technique for the left breast with unfavorable cardiac anatomy using surface imaging. Int J Radiat Oncol Biol Phys 2012;84 (5):e663-668.
        • Lyatskaya, Y., et al. (2011). “Validation of Align RT System for Breast Radiation Therapy with Deep Inspiration Breath Hold (DIBH) Technique.” Med Phys 38.
        • Cervino LI, et al. Using surface imaging and visual coaching to improve the reproducibility and stability of deep-inspiration breath hold for left-breast-cancer radiotherapy. Phys Med Biol 2009;54 (22):6853-6865.
        • Harris EE, et al. Late cardiac mortality and morbidity in early-stage breast cancer patients after breast-conservation treatment. J Clin Oncol 2006;24 (25):4100-4106.
        • Flampouri S, et al. Position Verification of Breast Treatment with Breath‐Hold Technique Using 3D‐Surface and Fluoroscopic Imaging. Medical Physics 2008;35 (6):2713-2713.
        • Harris EE. Cardiac mortality and morbidity after breast cancer treatment. Cancer Control 2008;15 (2):120-129.
        • Clarke M, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomised trials. Lancet 2005;366 (9503):2087-2106.
        • Marks LB, et al. The incidence and functional consequences of rt-associated cardiac perfusion defects. Int J Radiat Oncol Biol Phys 2005;63 (1):214-223.
  • Spadea MF, et al. Evaluation and commissioning of a surface based system for respiratory sensing in 4D CT. J Appl Clin Med Phys 2010;12 (1):3288.
  • Hughes S, et al. Assessment of two novel ventilatory surrogates for use in the delivery of gated/tracked radiotherapy for non-small cell lung cancer. Radiother Oncol 2009;91 (3):336-341.
  • Noel C, Klein E Moore K. A Surface‐Based Respiratory Surrogate for 4D Imaging. Medical Physics 2008;35 (6):2682-2682.
  • Nguyen, Farah et al.  Commissioning and performance testing of the first prototype of AlignRT InBore™ a Halcyon™ and Ethos™-dedicated surface guided radiation therapy platform. Phys Med . 2020 Dec;80:159-166. doi: 10.1016/j.ejmp.2020.10.024. Epub 2020 Nov 11

  • Flores-Martinez, E., L. I. Cervino, T. Pawlicki and G. Y. Kim (2020). “Assessment of the use of different imaging and delivery techniques for cranial treatments on the Halcyon linac.”
  • Mark Sueyoshi, MD et al. Eliminating Daily Shifts, Tattoos, and Skin Marks: Streamlining Isocenter Localization With Treatment Plan Embedded Couch Values for External Beam Radiation Therapy. Practical Radiation Oncology January–February, 2019 Volume 9
  • Rwigema JM, et al. Palliative radiation therapy for superior vena cava syndrome in metastatic Wilms tumor using 10XFFF and 3D surface imaging to avoid anesthesia in a pediatric patient-a teaching case. Adv Radiat Oncol. 2017 Jan 7;2(1):101-104
  • Apicella G, et al. (2016). “Three-dimensional surface imaging for detection of intra-fraction setup variations during radiotherapy of pelvic tumors.”
    Radiol Med 2016;121 (10):805-810.
  • Gierga DP, et al. (2014). “Analysis of setup uncertainties for extremity sarcoma patients using surface imaging.”
  • Naumann, Batista et al. Feasibility of Optical Surface-Guidance for Position Verification and Monitoring of Stereotactic Body Radiotherapy in Deep-Inspiration Breath-Hold. Front Oncol . 2020 Sep 25;10:573279. doi: 10.3389/fonc.2020.573279. eCollection 2020.
  • Bo Zhao, et al. Surface Guided Motion Management in Glottic Larynx Stereotactic Body Radiation Therapy.  September 2020, The Green Journal: Radiotherapy & Oncology
  • JH Heinzerling, et al. Use of surface‐guided radiation therapy in combination with IGRT for setup and intrafraction motion monitoring during stereotactic body radiation therapy treatments. February 2020, Journal of Applied Clinical Medical Physics
  • Tanja Alderliesten, et al. 3D surface imaging for monitoring intrafraction motion in frameless stereotactic body radiotherapy of lung cancer. Radiotherapy and Oncology Volume 105, Issue 2, November 2012
  • H Jin, Z Su. A Comprehensive Evaluation of Real-Time Motion Tracking of a Surface Imaging System for Lung Treatment. Med Phys. 2012 Jun;39(6Part13):3755
  • Covington, Stanley, et al. Surface guided imaging during stereotactic radiosurgery with automated delivery. Journal of Applied Clinical Medical Physics. 2020 Dec;21(12):90-95. doi: 10.1002/acm2.13066. Epub 2020 Oct 23
  • Covington EL, et al. Optical surface guidance for submillimeter monitoring of patient position during frameless stereotactic radiotherapy. Journal of Applied Clinical Medical Physics 2019;20 (6):91-98.
  • Jursinic, P. (2018). “Comparison of Head Immobilization with a Metal Frame and Two Different Models of Face Masks.” Journal of Cancer and Cure  1(1): 1-7.
  • Oliver, J. A., et al. (2017). “Orthogonal image pairs coupled with OSMS for noncoplanar beam angle, intracranial, single-isocenter, SRS treatments with multiple targets on the Varian Edge radiosurgery system.” Adv Radiat Oncol 2(3): 494-502.
  • Pham NL, et al. Frameless, real-time, surface imaging-guided radiosurgery: Update on clinical outcomes for brain metastases. Translational Cancer Research 2014;3 (4):351-357.
  • Pan H, et al. Frameless, real-time, surface imaging-guided radiosurgery: Clinical outcomes for brain metastases. Neurosurgery 2012;71 (4):844-851.
  • Li G, et al. Clinical experience with two frameless stereotactic radiosurgery (fSRS) systems using optical surface imaging for motion monitoring. J Appl Clin Med Phys 2015;16 (4):5416.
  • Paravati AJ, et al. Initial clinical experience with surface image guided (SIG) radiosurgery for trigeminal neuralgia. Translational Cancer Research 2014;3 (4):333-337
  • Baker B Sullivan T. Trigeminal Rhizotomy Performed with Modern Image-guided Linac: Case Report. Cureus 2013;5 (9):e139.
  • Li G, et al. Migration from full-head mask to “open-face” mask for immobilization of patients with head and neck cancer. Journal of Applied Medical Physics 2013;14(5):243
  • Wen N, et al. Technical Note: Evaluation of the systematic accuracy of a frameless, multiple image modality guided, linear accelerator based stereotactic radiosurgery system. Med Phys 2016;43 (5):2527.
  • Smith T, et al. Characterization of a High-Definition Optical Patient Surface Tracking System Across Five Installations. Med Phys 2016;43.
  • Chinsky, B., et al. (2016). “Feasibility of Using a Commercially Available Surface Guided Radiotherapy System with An Open- Face SRS Immobilization System.” Medical Physics 43(6): 3611-3611.

  • Mancosu P, et al. Accuracy evaluation of the optical surface monitoring system on edge linear accelerator in a phantom study. Med Dosim 2016;41 (2):173-179.
  • Wen N, et al. Characteristics of a novel treatment system for linear accelerator-based stereotactic radiosurgery. J Appl Clin Med Phys 2015;16 (4):5313.
  • Lau SK, et al. Single-Isocenter Frameless Volumetric Modulated Arc Radiosurgery for Multiple Intracranial Metastases. Neurosurgery 2015;77 (2):233-240; discussion 240.
  • Wiersma RD, et al. Spatial and temporal performance of 3D optical surface imaging for real-time head position tracking. Med Phys 2013;40 (11):111712.
  • Cervino LI, et al. Initial clinical experience with a frameless and maskless stereotactic radiosurgery treatment. Pract Radiat Oncol 2012;2 (1):54-62.
  • Li G, et al. Motion monitoring for cranial frameless stereotactic radiosurgery using video-based three-dimensional optical surface imaging. Med Phys 2011;38 (7):3981-3994.
  • Li G, et al. Optical Surface Imaging for Online Rotation Correction and Real‐Time Motion Monitoring with Threshold Gating for Frameless Cranial Stereotactic Radiosurgery. Med Phys 2011;38.
  • Cervino LI, et al. Frame-less and mask-less cranial stereotactic radiosurgery: A feasibility study. Phys Med Biol 2010;55 (7):1863-1873.
  • Emily C.Merfeld MD et al “Stereotactic Radiotherapy for an Arteriovenous Malformation of the Oral Tongue: A Teaching Case.” Advances in Radiation Oncology (2021).
  • Hania Al-Hallaq et al “The Role of Surface-Guided Radiation Therapy for Improving Patient Safety”
  • Rigley, J., P. Robertson and L. Scattergood (2020). “Radiotherapy without tattoos: Could this work?” Radiography (Lond).
  • Moser, T., M. Creed, R. Walker and G. Meier (2019). “Radiotherapy tattoos: Women’s skin as a carrier of personal memory-What do we cause by tattooing our patients?” Breast J.

  • Hoisak, J. D. P., et al. (2018). “The Role of Optical Surface Imaging Systems in Radiation Therapy.” Semin Radiat Oncol 28(3): 185-193.
  • Mharte, V. (2017). “Quality assurance for clinical implementation of an Optical Surface monitoring system.” Journal of Applied Physics 9(6): 15-22.
  • Paxton, A. B., et al. (2017). “Evaluation of a surface imaging system’s isocenter calibration methods.” J Appl Clin Med Phys 18(2): 85-91.

    Krengli M, et al. Three-dimensional surface and ultrasound imaging for daily IGRT of prostate cancer. Radiat Oncol 2016;11(1):159.

  • Zhao B, et al. Feasibility of Open Mask Immobilization with Optical Imaging Guidance (OIG) for H&N Radiotherapy. Med Phys 2016;43.
  • Li G, et al. Characterization of optical-surface-imaging-based spirometry for respiratory surrogating in radiotherapy. Med Phys 2016;43 (3):1348-1360.
  • Smith, T., et al. (2016). “Characterization of a High-Definition Optical Patient Surface Tracking System Across Five Installations.” Med Phys 43.

  • Wiant D, et al. A prospective evaluation of open face masks for head and neck radiation therapy. Pract Radiat Oncol 2016.
  • Brady, J. L., et al. (2016). “Analysis of Factors Affecting Benefit from Deep Inspiration Breath Hold Technique in Mediastinal Radiation Therapy for Lymphoma.” International Journal of Radiation Oncology • Biology • Physics 96(2): E491.
  • Brady, J. L., et al. (2016). “Deep inspiration breath hold with ‘AlignRT’ in 3D conformal mediastinal radiotherapy for lymphoma.” Radiotherapy and Oncology 119: S813-S814.
  • Mamalui-Hunter M Li Z. Evaluation of the Surface Rendering Patient Localization System for Proton Therapy Facility. Med Phys 2011;2011 (38).
  • Schoffel PJ, et al. Accuracy of a commercial optical 3d surface imaging system for realignment of patients for radiotherapy of the thorax. Phys Med Biol 2007;52 (13):3949-3963.
  • Bert C, et al. A phantom evaluation of a stereo-vision surface imaging system for radiotherapy patient setup. Med Phys 2005;32 (9):2753-2762.
  • Bidmead M, et al. Investigating the correlation between surface and bony anatomy using 3D surface and portal imaging. Radiotherapy and Oncology 2004;73:S233.
  • Johnson U, et al. Real time 3D surface imaging for the analysis of respiratory motion during radiotherapy. Int J Radiat Oncol Biol Phys;60 (1):S603-S604.

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