Norton Cancer Institute is among the first in Kentucky to offer ExacTrac Dynamic, an advanced radiation therapy technology that improves precision, safety and patient comfort.

Published: May 7, 2026

A new radiation technology is helping make treatments faster, more comfortable and safer for patients at Norton Cancer Institute. ExacTrac Dynamic, developed by Brainlab, is a motion-tracking and patient positioning system that improves accuracy during radiation therapy, supporting stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) across a range of cancer types.

How ExacTrac Dynamic works

ExacTrac Dynamic combines thermal-surface imaging, stereoscopic 3D surface tracking and low-dose X-ray imaging into a single integrated system. A 4D thermal camera generates a hybrid image by correlating the patient’s heat signature with their reconstructed 3D surface anatomy. Room-based X-ray components provide internal anatomy-based positioning independent of treatment couch position, with synchronized stereoscopic imaging at low dose.

Throughout treatment, the system monitors patient position continuously. When positional changes are detected, an automatic beam hold is triggered, allowing the care team to reposition the patient before treatment resumes. Corrections can be made in 6 degrees of freedom (6DoF), and X-ray verification can be triggered automatically or manually based on protocol or patient needs.

Clinical applications

ExacTrac Dynamic is often used for highly precise treatments involving:

• Brain cancer and spinal tumors: precise intracranial targeting for SRS
• Lung cancer: accurate SBRT delivery with real-time respiratory motion management
• Prostate cancer, genitourinary and gynecological cancers: tighter targeting of pelvic lesions
• Breast cancer: including left-sided, improved cardiac and pulmonary sparing during treatment

“ExacTrac Dynamic allows us to treat with submillimeter accuracy while better protecting surrounding healthy tissue, and because positioning is faster and more reliable, we’re able to see more patients without compromising the quality of care they receive,” said Aaron C. Spalding, M.D., Ph.D., radiation oncologist and executive medical director of Norton Cancer Institute.

Robust radiation oncology technology at Norton Cancer Institute

ExacTrac Dynamic is the latest leading-edge radiation oncology technology added at Norton Cancer Institute. Others offered are:

• Identify, a surface-guided radiation therapy solution that uses skin-surface tracking for treatment accuracy
• TrueBeam with Hypersight, advanced linear accelerator delivering precise radiation therapy equipped with HyperSight, an epic advancement in image quality, precision and speed
• GammaTile, a surgically implanted radioactive tile that delivers targeted radiation directly to brain tumor sites following resection
• Additional radiation-based therapies across multiple Norton Cancer Institute Radiation Center locations throughout the Louisville and Southern Indiana region.

Patient referrals

Norton Cancer Institute is a nationally recognized cancer program offering comprehensive, multidisciplinary care, and is recognized as a GammaTile Center of Excellence for advanced radiation therapy. As one of the first programs in Kentucky to offer ExacTrac Dynamic, Norton Cancer Institute welcomes patients referred both within and outside the Norton Healthcare system.