PET has not been incorporated with radiotherapy systems (e.g., linac) despite the potential of biologically based targeting. New methods using on-board PET was proposed for radiation treatment, and the feasibility of a combined PET-linac system was evaluated for real-time guidance of radiotherapy for moving targets in Monte Carlo simulations. Recently, the PET-linac has been implemented as a commercial product by RefleXion Medical Inc., and UTSW purchased this system for clinical practice and research.
Before the 510k FDA approval of PET-linac, we evaluated the potential and feasibility of PET for dynamic lung tumor tracking during radiation treatment. We proposed a center of mass (CoM) tumor tracking algorithm using gated-PET images combined with a respiratory monitor and investigated the geometric accuracy of the proposed algorithm.