Your ideal solution for Motion management QA

Delta4 HexaMotion is a motion platform that recreates the movement of the tumor in six dimensions and independently simulates patient breathing motion. Together with Delta4 Phantom+, it ensures tumor control in moving targets and answers the vital questions:

  • Am I hitting the target?
  • What do I gain with tumor tracking or gating?
Animation of the Delta4 Motion QA Solution.


What our customers say

​Letting the Delta4 HexaMotion with the Delta4 Phantom+ move realistically- be it a respiratory cycle of a patient´s breathing, or even a prostate system where it’s random omni-static placement, I can only do it with the Delta4 solution. No other solution has that capability and without it, I would be unable to safely deliver the treatment to the patients..

Aaron A. Kempenich MSc, DABR, RSO, Medical physicist and radiation safety officer, Altru Cancer Center, Grand Forks, ND

We chose to work with ScandiDos for our internal testing of the Synchrony® feature for the Radixact® System, because they had a robust solution for comprehensive quality assurance of moving targets. We have found the Delta4 Phantom+ and the Delta4 HexaMotion to be convenient, accurate, and easy to use.

Dylan Casey, PHD Director of Medical Physics & Systems Analysis at Accuray Incorporated

The Hexamotion platform allowed for accurate phantom positioning and motion for a wide range of simple and realistic patient motions and The Delta4 phantom was found to be very reliable, easy to setup and allowed for easy analysis of dose delivery accuracy. The combination of the two allowed for validation of the Radixact Synchrony.

Lee Goddard Medical Physicist, DABR, Montefiore Medical Center, Bronx, NY

4D-RT: Tumor tracking and gating

Intra-fractional motion can cause large geometrical errors or increase PTV size drastically

Techniques such as gating and tumor tracking are good at addressing these issues. However, to ensure the best possible treatment outcome, they require a special QA system that can recreate target movements. With HexaMotion, you can check and verify the effects of intra-fractional motions of the tumor and OAR.

When considering whether or not to apply 4D-RT, there are a couple of questions you should ask: What do I gain from MLC tracking or gating for the individual patient (or group of patients)? Do I hit the target without exceeding the OAR doses?

A QA program for 4D-RT should consider the following parameters. At the end of the day, it’s really the last point, the ability to verify the dosimetric effect, that is most important.

Monitor system Start/Stop

Latencies in the delivery system

Beam hold for anomalous conditions

Beam hold if target exceeds threshold

Correctness of coordinate system

End-to-end dosimetry effect

Streamlined Workflow

HexaMotion together with the Phantom+

The system is placed on the treatment table, where it measures the same geometric points throughout the entire delivery. It only takes one measurement and the complete delivery sequence is acquired—becoming immediately available for analysis. The measured dose is then compared to the calculated data from the Treatment Planning System. With customizable acceptance criteria and an instant display of results, it’s easy to see whether the verification of the delivery has passed or failed.

Next, the motion pattern from the patient is imported into the HexaMotion software. The motion pattern can come from 4D-CT, ExacTrac or similar. The HexaMotion then mimics the movement of the actual target.

Phantom+ measures the 3D dose distribution during the delivery of the plan, and shows exactly where the dose ends up.


What can you gain from tumor tracking/gating?

You can assess whether or not motion management is of clinical benefit to a patient by looking at the results from usage with and without motion compensation. At the same time, you can see if the plan has passed.

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Using HexaMotion together with Phantom+ yields an ideal solution for the end-to-end quality assurance of tracking functions.

Delta4 and Accuray

HexaMotion together with Radixact and Synchrony

The Delta4 HexaMotion is used together with the Delta4 Phantom+ to provide a full analysis of the dosimetric effect of tumor respiratory motion in the Radixact®. Delta4 HexaMotion recreates the movement of a tumor in 6 dimensions whereas the Delta4 Phantom+ measures the 4D dose distribution and shows exactly where the dose ends up.

An easily identifiable target can be created for tumor tracking by placing a custom phantom-quarter in the Delta4 Phantom+ to house the Accuray Ball Cube II.

The Independent Motion Platform (IMP) for HexaMotion is developed in close collaboration with Accuray and mimics the breathing of the patient, independent from the motion of the tumor. The Delta4 software allows you to run the HexaMotion movement and the IMP movement with a phase shift in order to properly simulate the actual patient situation.

The result is a realistic pre-treatment verification of the delivered treatment for Accuray Radixact® with Synchrony®.


Check out our latest webinars


This presentation covers:

  • Equipment configuration and capabilities
  • Device setup and user workflows
  • Measuring IMRT QA with motion and the Radixact


Motion management with Delta4 HexaMotion:

  • Reducing the margin
  • Precision 6D motion platform
  • Advantages


Delta4 HexaMotion

Delta4 HexaMotion

Allows for motion ±40 mm in the X,Y & Z directions
Roll ±10° at origin
Pitch/Tilt ±3° at origin
Refresh rate 50 Hz
Positional accuracy > 0.5 mm
Trolley Provides easy and ergonomic handling of the system, eliminating heavy lifting

Independent Motion Platform

Positioning accuracy Better than 0.5 mm
Movement range Z: +/- 40 mm, vertical movement only
Total weight 3 kg


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Alexander Rossbach

Alexander Rossbach

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Updates from Delta4

Rouen Mathilde Pannier and David Gensanne