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• Acquire 4D CT scan

• Select mid-ventilation phase:

Element of 4D scan closest to mid-position

• Optimize treatment plan on mid-ventilation

• Acquire 4D CBCT

• Bone match

Tumor match

• Apply correction

• Validate correction with 2

nd

scan

• Contact physician if

– Shift > 1 cm

– Anatomical changes

Planning

Treatment

SBRT Lung: Protocol at NKI