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The respiratory gating radiotherapy technique is especially useful for tumors that move, such as those in lung and liver cancer. CGMH introduces the Real-time Position Management TM (RPM) respiratory gating system, which gates the beam delivery during treatment to account for organ motion. Information about tumor movement can be realized by using an infrared camera to detect the patient breathing in and out during treatment; then the respiratory gating signal can trigger the linac accelerator x-ray beam to treat the tumor within the gated phase to assure the accuracy of treatment position. A non-invasive marker box is placed on the patient’s body and the infrared system tracks the chest wall’s movement during the CT imaging. The big bore CT simulator with four-dimensional CT capability provides the correlation of respiratory phase and tumor location with a dynamic time frame. During the treatment, the radiation beam is gated to when the target falls within the treatment field while avoiding critical organs. In this case, we can treat patients with high accuracy while minimizing treatment errors, and the patient can breathe normally and remain comfortable and with high compliance during the treatment. This technique takes about five to ten minutes more than regular treatment time.

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