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Real-time Position Management™ (RPM) Respiratory Gating

The Varian Real-time Position Management™ (RPM) system is a non-invasive, video-based system that allows for clean imaging and treatment of lung, breast, and upper abdominal sites. The RPM system is accurate, easy to use, and fast. It is comfortable for the patient and accommodates both breath hold and free breathing protocols.

The RPM system allows clinicians to correlate tumor position in relation to the patient's respiratory cycle. Using an infrared tracking camera and a reflective marker, the system measures the patient's respiratory pattern and range of motion and displays them as a waveform. The gating thresholds are set when the tumor is in the desired portion of the respiratory cycle. These thresholds determine when the gating system turns the treatment beam on and off.

The RPM system facilitates the treatment of the lungs, liver, and pancreas, and helps minimize the dose to the heart in breast treatments. The system provides clean images for planning so that clinicians can more clearly visualize the target with fewer of the image artifacts associated with respiratory motion.

Key Features:

  • Varian RPM has interfaces to CT and CT/positron emission tomography scanners
  • A lightweight marker to allow for improved patient comfort
  • The specially designed predictive filter monitors and predicts the patient's breathing pattern and can account for patient's coughing or changes from the predicted breathing pattern
  • Immediate access to gated verification images from the On-Board Imager (OBI) system during the course of the treatment through Eclipse. Recalculation of dose distributions may be necessary.
  • Pretreatment verification can be performed by the OBI fluoroscopy mode
  • Gated radiographic image acquisition uses the OBI during the correct phase of the respiratory cycle
  • Gated port film acquisition acquires megavoltage images during the correct phase of the respiratory cycle
  • The process of image acquisition and gated treatments is fully automated
  • After treatment, a record of the gating trace and image window can be stored for later analysis
  • Treatment beam gating is fully integrated with dynamic MLC leaf motion