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Discuss SGRT for stereotactic body radiation therapy, including breath hold techniques.
By sarah_bartlett
Does anyone have any experience with SGRT and upper extremity SBRT?  Recommendations for optimal ROI?  Best immobilization?

How well do you find that OSMS is capturing smaller patient movements during treatment?
By ellen_herron_bsrtt

We've used on many extremities and SGRT has been extremely helpful. Depending on what part of extremity you are treating, you could use vac-loc but the key is to help support and not to build up too much on sides. Leave plenty of room on both sides of extremity in order to draw sufficient ROI so SGRT system can give accurate reading for the movements needed.

We've also done without vac-loc but would depend on what part of arm you are treating. For example: We treated a forearm and had the patient lay in prone position with arm stretched out. We immobilized the hand and wrist and had the forearm exposed so we could get a great ROI for setup and for monitoring during treatment.

When you use the SGRT system for initial setup on an extremity you will see how sensitive to movement the system actually is. It is excellent at detecting the difference in roll and pitch from initial CT (more than marks could ever detect).

Hope this helps. Let me know which area you are treating and I can give you more specific answers!
By nienke_weitkamp
Hello Sarah,

We have done Extremities treatment with Align RT.
Mostly we still use a vac-loc, but as Elle already said; we make sure the side of this vac-loc are not high (but give a bit of support) in order to make sure the Align RT camera`s are gonna be able to detect also rotations.

Another tip which might help you, is to include a joint in the ROI, or something that is gonna help you define the longitudinal position of the patient. If you would use a middle part of the under limb for example, there is nothing for the system to detect where on the leg we would like to be.
What also could help you set-up the patient is to use the fuction of making a treatment capture. Here you can see big shifts/rotations.

Hopefully this will help you further!