An accelerator with artificial intelligence allows you to update the treatment plan even a few minutes before the session. Here’s how adaptive radiotherapy works and why it changes the precision of treatment.
The human body does not remain still even during a therapy. One organ fills, another moves, the tumor itself can change size over the weeks. The adaptive radiotherapy: a treatment that can also be updated immediately before the session. The structure is the first in Italy to put an accelerator of this type into operation. In the indicated cases, the machine allows you to adapt the treatment thanks to CBCT, cone beam computed tomography. To understand the news we need to start from how it normally works oncology radiation therapy: The plan is built on a centering CT performed before the start of the cycle, a photograph of the anatomy at that time. But patients’ anatomy changes between dose planning and delivery and then over the course of therapy. Adaptive radiotherapy was created to target accurately even in the presence of these changes, using the images as a control circuit to correct the plan. In Brescia, specialists observe the patient’s anatomy a moment before irradiating, thanks to three-dimensional images. Thus they identify any variations in the position of the tumor and nearby organs compared to the initial plan. When it is necessary to modify it, the medical physicist recalculates and checks the distribution of the dose together with the team, before dispensing. The goal is to hit the target with greater precision and protect healthy organs.
Artificial intelligence in radiotherapy: it helps, but doctors decide
THE’artificial intelligence it is already integrated in some phases of the process. It supports the preliminary definition of organs on centering CT images and helps improve the quality of CBCT images. The point, however, is who controls. The results are verified by the doctor and medical physicist. Clinical decisions and plan validation remain entrusted to professionals. THE’ accelerator with high definition imaging is powered by artificial intelligencecapable of delivering offline and online adaptive radiotherapy. The dedicated software automates the entire workflow, from organ contouring to plan adaptation to quality checks. It must be said that the field is in full evolution. A 2025 German study analyzed 155 sessions of eight prostate cancer patients retrospectively with a system from another manufacturer. The researchers observed that the anatomy may change even during the adaptation phase, but that the actual delivered dose remained more advantageous to the target than that of the non-adapted plan. The sample is small, and for this reason the research continues.
MORE than ten million to innovate: accelerators, gamma knives and philanthropy
The Centre’s project is valid overall 10.8 million euros. It includes two new Elekta linear accelerators, a new bunker and the redevelopment of care spaces. The reception area has also been renovated gamma knife radiosurgeryused to treat specific intracranial lesions without traditional surgery. A dedicated day hospital, reference nursing staff and more comfortable environments have been provided. «The renovation of the Center combines new equipment, professional skills and a review of the routes. Technology offers more possibilities, but its value depends on the way in which it is integrated into the team’s work and the person’s care” he said Marcellino Valerio, general director of the Poliavventura Foundation.
The renewal strengthens the collaboration with Guido Berlucchi Foundationengaged in oncology research for over 25 years. The relationship began with the birth of the Center and the purchase of the first linear accelerators, continued in 2022 with the optical positioning systems and today with the support for modernization.
«Innovation in the fight against cancer is moving fast, which is why the real challenge is to ensure that its progress becomes concrete treatment opportunities for patients. Bring it to Brescia adaptive radiotherapy supported by artificial intelligence it means taking an important step in this direction. This is where philanthropy can make the difference: supporting investments capable of bringing scientific discoveries closer to clinical practice and making increasingly advanced tools available. This is the vision that Guido Berlucchi left us and which continues to guide the choices of our Foundation” he explained Giambattista Bruni Conter, president of the Guido Berlucchi Foundation.
Mario Taccolini, president of the Poliavventura Foundation, closes: «The Center bears the name of Guido Berlucchi and its history is linked to the Foundation which preserves his memory. The support of the Foundation accompanied its birth and development, up to today’s renewal, with concrete consequences for patients and the territory. As he remembers Pope Leo XIV in the Magnifica Humanitas, “technique should not be considered, in itself, as an antagonistic force towards the person” even in medicine, progress has value when it is oriented towards the person and their good”.
