The Varian real-time position management system (RPM) uses a surrogate of chest movement for tumour movement. However, it cannot be assumed that the phase of the surrogate matches that of the target, or that the phase relationship between the two is constant. Therefore, verification of treatment is needed on a regular basis to avoid the possibility of a geographic miss. Following the development of additional kilovoltage imaging systems which are mounted to the treatment linear accelerator (eg, Varian onboard imager), this verification is now possible.
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