Toward Submillimeter Accuracy in the Management of Intrafraction Motion: The Integration of Real-Time Internal Position Monitoring and Multileaf Collimator Target Tracking

We have developed and characterized a research version of a novel four-dimensional delivery system that integrates nonionizing radiation-based internal position monitoring and accurate real-time DMLC-based beam adaptation. This system represents a significant step toward achieving the eventual goal of geometrically ideal dose delivery to moving tumors.