ExacTrac Dynamic: Tracking the Patient Through Radiotherapy

A radiotherapy plan is only as accurate as the patient's position on the day of treatment. Between setup, breathing and small shifts during a session, the target can move away from where the beam was planned to hit. Brainlab ExacTrac Dynamic is built to close that gap, and Brainz brings it to radiotherapy departments across the UAE and GCC as part of a wider oncology technology program.

Two layers of tracking, one system

ExacTrac Dynamic combines thermal-surface tracking with stereoscopic X-ray imaging in a single integrated system. A 4D Thermal Camera builds a hybrid surface model by correlating the patient's heat signature with their 3D surface, using roughly 300,000 surface points captured by two stereoscopic cameras running at 20 frames per second. Two synchronized X-ray tubes add low-dose, room-based imaging of internal anatomy, with a field of view of 18 by 18 centimeters at the isocenter. Surface and internal imaging are correlated continuously, so the system tracks both the outside and the inside of the patient through the entire session.

Setup without tattoos, monitoring without gaps

Patients can be prepositioned from a CT outer contour or from a surface reference saved at a previous session, without permanent skin marks. During treatment, the thermal-surface camera keeps a constant, unobstructed view of the patient even while the gantry rotates past the X-ray path. If the system detects a deviation, it triggers an automatic beam hold and reports the correction needed across six degrees of freedom, so the team can reposition before treatment continues.

From cranial radiosurgery to breath-hold breast treatment

The same platform supports a wide range of indications: cranial and spine stereotactic radiosurgery, prostate and lung stereotactic body radiotherapy, and conventional treatment courses. A dedicated breath-hold workflow gates the beam to the patient's breathing and is used for tattooless breast treatment, where sparing organs such as the heart depends on consistent, reproducible positioning fraction after fraction.

Built to standardize a department, not just one room

ExacTrac Dynamic integrates with both Varian TrueBeam and Edge systems and Elekta Versa HD, supporting couches in four and six degrees of freedom. A department can also start with ExacTrac Dynamic Surface, the thermal-surface-only configuration, and add the X-ray components later without replacing the system. That upgrade path lets a hospital standardize workflows across multiple linacs and bring every treatment room onto the same positioning and monitoring protocol over time.

What Brainz adds

Brainz manages the installation, linac integration and clinical training that make a positioning system part of daily practice rather than a standalone box in the corner. For a hospital building out its radiotherapy program alongside stereotactic radiosurgery and cranial or spine SRS planning, ExacTrac Dynamic is the layer that keeps the plan and the patient aligned. Talk to the Brainz team about what a positioning and monitoring upgrade would look like for your department.