Case Study
AlignRT at IPO Lisbon
Surface-Guided Radiation Therapy (SGRT) for Precision Patient Positioning
Institution
IPO Lisbon
Technology
AlignRT (VisionRT)
Installation
February 2026
Application
SGRT
The Challenge
The Portuguese Institute of Oncology in Lisbon (IPO Lisbon) is one of Portugal’s leading oncology institutions, treating thousands of patients annually with radiation therapy. As a national reference centre, IPO Lisbon faces demanding challenges in patient positioning for high-precision treatments:
- Stereotactic Radiosurgery (SRS) — frameless treatments for brain metastases and other intracranial indications require sub-millimetre accuracy, historically dependent on invasive frames or closed masks
- SBRT/SABR — stereotactic body radiation therapy demands precise immobilisation and continuous monitoring to ensure high doses are delivered safely
- Breast with DIBH — left breast treatments with Deep Inspiration Breath Hold require reliable respiratory monitoring for cardiac protection
- Skin markings — positioning tattoos, used for decades, cause discomfort, stigma and have inherent precision limitations
- Intrafraction monitoring — verifying patient position during treatment relied on radiological imaging, adding dose and time
IPO Lisbon sought a solution that would elevate positioning accuracy, monitor the patient in real time throughout treatment, and improve the patient experience — all without compromising existing clinical workflows.
The Solution: AlignRT
In February 2026, IPO Lisbon implemented the AlignRT system from VisionRT, the world’s leading surface-guided radiation therapy (SGRT) system, supplied and supported by Interphysix as the authorised distributor in Portugal.
How It Works
AlignRT uses three stereoscopic 3D camera pods mounted on the treatment room ceiling to capture and reconstruct, in real time, the patient’s body surface. The system continuously compares the current position with the reference position defined in the treatment plan, tracking the patient in six degrees of freedom (6DoF) — three translations and three rotations — with an accuracy of ≤0.5 mm and ≤0.2°.
Implemented Capabilities
- Tattoo-free positioning — replacement of traditional skin tattoos with 3D surface reference
- Continuous intrafraction monitoring — real-time tracking throughout the entire treatment, without additional ionising radiation
- Automatic beam gating — automatic beam hold if the patient moves outside defined tolerances
- Frameless SRS/SBRT — radiosurgery with open mask, maintaining sub-millimetre precision
- DIBH for breast — respiratory monitoring with Real Time Coach™ for visual patient feedback
- Postural Video™ — multi-angle visualisation for faster setup and visual verification
Implementation Timeline
Planning and Preparation
Assessment of the radiotherapy department’s needs, definition of technical requirements and solution sizing. Preparation of the treatment room infrastructure for camera pod installation.
Installation and Commissioning
AlignRT hardware installation by certified engineers. System calibration, acceptance testing and integration with the existing linear accelerator.
Clinical Training
Intensive training programme for medical physicists, radiation therapists and technicians, conducted by VisionRT’s clinical applications team in coordination with Interphysix.
February 2026 — Clinical Use Begins
Start of clinical treatments with AlignRT. System operational for positioning, intrafraction monitoring and DIBH.
Clinical Benefits
🎯 Sub-Millimetre Precision
Continuous 6DoF monitoring with ≤0.5 mm and ≤0.2° accuracy, enabling high-precision treatments such as frameless SRS and SBRT without compromising safety.
🩺 Tattoo-Free Treatment
3D surface positioning replaces permanent skin markings, significantly improving the patient experience and comfort.
💓 Cardiac Protection (DIBH)
Reliable respiratory monitoring for left breast treatments with Deep Inspiration Breath Hold, with visual patient feedback via Real Time Coach™.
⚡ Real-Time Monitoring
Continuous tracking throughout treatment with automatic beam gating — the beam pauses instantly if the patient moves outside tolerance.
🧠 Frameless SRS
Stereotactic radiosurgery with open mask, eliminating the need for invasive frames while maintaining precision comparable to traditional techniques.
⏱️ Operational Efficiency
Reduced setup and treatment time per fraction, with elimination of frequent verification imaging and more efficient workflows.
About IPO Lisbon
The Portuguese Institute of Oncology in Lisbon Francisco Gentil (IPO Lisbon) is one of Portugal’s leading oncology centres, dedicated exclusively to cancer diagnosis, treatment and research. With a nationally renowned radiotherapy department, IPO Lisbon treats one of the country’s largest oncology patient populations.
The installation of AlignRT reinforces IPO Lisbon’s commitment to technological innovation and excellence in oncology care, positioning it as one of the first centres in Portugal to adopt surface-guided radiation therapy.
Interested in SGRT for Your Centre?
Interphysix is the authorised VisionRT distributor in Portugal. Contact us to learn how AlignRT can transform your radiotherapy department.
Última actualização: 26/04/2026