How Brainlab Uses 3D Vision for Accurate Patient Positioning

Thermal image scanning and Brainlab and Cognex 3D machine vision camera

Radiation therapy, or radiotherapy, is a non-invasive medical procedure. It is commonly used as a cancer treatment due to its ability to control cell growth and shrink tumors. The treatment uses ionizing radiation, delivered by a linear accelerator, to damage the genetic material of malignant tissue and prevent further cell division. The aim and calibration of the radiation beams must be accurate as sometimes there are only millimeters separating healthy, extremely important tissue, and the malignant tissue, so the patient's position is closely tracked.

Radiotherapy At-a-Glance

Radiotherapy is typically administered on a daily basis for several weeks, with each treatment session lasting 10 to 30 minutes. The total number of sessions depends on the size and type of cancer. The treatment is non-invasive, so the patient remains awake during the procedure.

At each session, the patient lies on a table and medical professionals position the patient’s body to align the target volume (tumor) in the treatment isocenter. The linear accelerator then rotates around the table to direct the radiation beam at the appropriate angles to fully cover the target. During treatment, the patient must remain exactly in the planned position. With the sub-millimetric margin, it is obvious that even breathing movements of the patient are cause for misalignment. Therefore, the patient’s position is continuously monitored by a medical team in an adjacent room.

Overcoming Challenges in High-Precision Medical Treatments

Although radiotherapy is a common procedure, it is not without challenges. The required level of precision places restrictions on the equipment that can be used during treatment. Fortunately, new technologies are entering treatment rooms, designed to better aid medical professionals in administration of treatment and deliver better care to patients. 

One example of this technological advancement is an innovative positioning and monitoring system developed by Brainlab, a global provider of medical hardware and software. This unique system combines the power of the Brainlab ExacTrac® Dynamic system with Cognex’s 3D-A5060 camera, making it effective for high accuracy applications as it is capable of:

  • Capturing high-resolution 3D surface images of the patient’s body
  • Avoiding obstructions in the field of view
  • Merging heat signature and stereoscopic X-Ray images with the 3D surface images 

Integrated Solution Addresses Complexity and Delivers Sub-Millimetric Accuracy

ExacTrac Dynamic is an automated image-guided radiotherapy system that enables precise patient setup. During radiotherapy treatments, the system tracks the patient’s position in real-time with a thermal surface camera and uses stereoscopic X-rays for internal verification (bony anatomy). ExacTrac Dynamic prevents the patient from inadvertently deviating from the planned position and ensures the radiation is precisely directed at the cancerous tissue, protecting healthy cells.

Cognex’s 3D-A5060 is an area scan 3D camera designed to quickly capture high-resolution 3D images using LightBurst technology. LightBurst technology delivers a full field-of-view 3D point cloud image as fast as 200 milliseconds, delivering higher throughput and shorter cycle times for time-critical applications, like radiotherapy. The 3D point cloud images are constructed from over 1.5 million 3D data points to accurately reconstruct surface features of an image.

Together, ExacTrac Dynamic and the 3D-A5060 make it possible for medical professionals to perform high-precision procedures with sub-millimetric accuracy. The real-time, high-resolution 3D imaging produced by this powerful integrated solution addresses a wide range of clinical challenges that previously required multiple systems.

Animated gif of Brainlab and Cognex 3D machine vision camera

Results and Real-World Applications

Brainlab’s groundbreaking positioning and monitoring solution is in use at medical practices throughout the world. While the initial application for the system was radiotherapy, applicability extends beyond this to offer treatments for an even wider range of patient needs. For instance, medical professionals have successfully deployed the system to treat other challenging medical conditions, such as multiple brain metastases, and prostate and spine tumors. Much like the images captured by ExacTrac Dynamic and the 3D A-5060, the benefits of this solution go beyond surface-level.

About Brainlab

Brainlab logo

Brainlab® provides leading-edge technology that benefits medical patients around the world. The company’s hardware and software provide the ability to plan, monitor, and deliver effective treatment for patients with a range of medical conditions, including cancer and other functional diseases. Brainlab offers advanced tools required for optimized treatment planning, positioning, monitoring, and verification to achieve successful results across various applications including: oncology (specifically radiotherapy and radiosurgery), image-guided surgery, and integrated operating room solutions and image sharing and enhancement.


Research and information regarding the medical treatments and procedures described above were sourced from the following:

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