Radiotherapy is a frontline treatment for cancer given its effectiveness and low cost. Additionally, heart irradiation has recently emerged as a non-invasive option for treatment-resistant cardiac arrhythmia. In both instances, collateral damage to healthy cardiac tissue can lead to heart disease and poor long-term outcomes. To avoid cardiac toxicity, I invented Voxelmap, the first method for simultaneous target and organ tracking during image-guided radiotherapy.
A unique challenge in precisely irradiating cancers in the thorax and heart tissue is motion. Notably, while cardiac motion can involve shifts of 2-3mm, respiratory-induced motion of >5cm has been observed clinically. Contemporary radiotherapy treatments irradiate volumes that are 30% larger than the target to encompass its position over the entire respiratory cycle. This approach incurs clinically unacceptable healthy tissue in 21% of cases.
A number of motion tracking techniques have been developed, but these require expensive, dedicated systems that are not available in the vast majority of treatment centres. Moreover, even the most advanced techniques focus exclusively on targets while ignoring the surrounding healthy tissue. We address these issues by achieving simultaneous target and organ tracking with the resources already available in standard clinical workflows.
This proposal details my 2-year vision to implement cardiac-sparing adaptive radiotherapy on a clinical system. Using in silico studies, I have demonstrated that lung tumours and healthy tissue can be tracked to submillimetre accuracy and that heart irradiation can be achieved using target volumes that are 25% smaller than the current standard-of-care. These results significantly de-risk the project and place us in a unique position to advance a paradigm shift in radiotherapy practice. Leveraging ties to the University of Sydney, Royal North Shore Hospital, and a consumer member of the COSA/CSANZ Cardio Oncology Working Group, this project will establish the safety and feasibility of Voxelmap for a planned first-in-human trial in 2027.
Last updated14 October 2025