ACRF Image X Institute

the Artis Pheno - CT scanner

The ACRF Image X Institute is a world-leading centre for basic and translational medical innovation. Our work focuses on radiation oncology imaging and targeted radiotherapy systems.

The ACRF Image X Institute provides a site and forum where academia, medicine, industry and government can advance the science and clinical practice of cancer treatment.

We welcome researchers from around the world to visit our institute. Come to present your work, collaborate or participate in training and development. To find out about how you can get involved, visit our Opportunities page.

ACRF Image X Institute Group


Real-time image-guided adaptive radiation therapy on a standard linear accelerator

29 March 2018

Tumours move during radiotherapy treatment, reducing the geometric and dosmetric accuracy of the treatment. Typically, imaging is performed before the treatment for planning purposes, but the motion of the tumour is not monitored during treatment delivery. We developed a method that reconstructs the images obtained by onboard imaging systems found in most linear accelerators to monitor the position of the tumour during treatment - Kilovoltage Intrafraction Monitoring (KIM). We recently reported that prostate motion estimated with KIM correlates well with the true motion. KIM is used in the TROG 15.01 SPARK trial to monitor target motion in prostate cancer patients so treatment delivery can be suspended if motion exceeds a threshold, and the patient can be repositioned. The LARK trial is about to commence using KIM to monitor liver tumour motion.

Another technology we developed has also recently been tested in a clinical trial of prostate cancer radiotherapy treatment. The multileaf collimator (MLC) is found on most linear accelerators and shapes the radiation beam. We developed software to control the MLC during treatment delivery and adapt the beam to the motion of the prostate. This improved the accuracy of the radiotherapy treatment. In this trial, tumour motion was monitored using the Calypso System - an electromagnetic-based monitoring system that is not available for the majority of radiotherapy patients.

To adapt the radiation beam to track the target on a standard radiotherapy system, we have combined our technologies, using KIM to monitor motion and beam adaptation via the MLC to adapt the radiation beam to the motion. This enables radiotherapy to be guided by images obtained during treatment with a standard linear accelerator. Our first clinical implementation of real-time image-guided adaptive radiotherapy using a standard linear accelerator has recently been published and is featured in the MedicalPhysicsWeb News. The integration of these technologies with existing radiotherapy systems would allow beam adaptation during treatment to be accessible for the majority of radiotherapy patients. The new technologies potentially enabling real time 3D Image Guided Radiotherapy to become widely accessible are discussed in our recent review article in the International Journal of Radiation Oncology Biology Physics.

Funding Success for the LARK Clinical Trial

10 January 2018

The ACRF Image X Institute is thrilled to announce commencement of the LARK Clinical Trial in 2018, having secured $583,300 in Cancer Australia Funding across three years.

The LARK Trial will take our first-in-world KIM technology, and apply it to liver tumours. KIM guides and monitors radiotherapy treatment to tumours in real-time, improving accuracy of the radiation beam, therefore reducing radiation dosage and side effects. It is a technology which is compatible with standard radiotherapy systems currently in use all over the world, with the potential to improve outcomes for cancer patients globally. In 2017 KIM was successfully applied to prostate cancer, increasing treatment efficacy, as well as reducing side effects and treatment time dramatically for patients. The LARK Trial will strengthen case for the use of KIM worldwide, and lead to trials for lung, kidney and pancreas cancer.

The LARK Trial will be led by ACRF Image X Institute, with the research team spread across Sydney and the world: University of Sydney, Westmead Hospital, Royal North Shore Hospital, Aarhus University Hospital in Denmark, & University of Colorado, USA.

Table showing estimated improvements for liver cancer radiation therapy with LARK.

A comparison of estimated treatment parameters with and without LARK.

NHMRC Funding Success for A/Prof Ricky O'Brien

15 December 2017

Congratulations to A/Prof Ricky O’Brien, who has received $650,650.50 in NHMRC Project Funding.

Each year 11,880 Australian are diagnosed with lung cancer with 40-50% receiving radiotherapy. Four dimensional cone beam computed tomography (4DCBCT) is an imaging modality that forms the standard of care for lung cancer patients. However, 4DCBCT suffers from very high imaging doses, very long scan times (4min) and inconsistent image quality from one patient to the next. Over the past 5 years, we have developed an imaging system to address all of these problems. Specifically, we have improved image quality, reduced scan times from 4min to below 60sec and reduced imaging doses by 85%. We also allow radiotherapists to control the image quality, allowing them to acquire images of a higher quality than can currently be achieved, by collecting only the imaging data that they need; no more, no less.
To date, we have developed a prototype device to modify the behaviour of a radiotherapy machine and tested the prototype with mechanical devices, called phantoms, which mimic a human lung during respiration.

In this project, we will overcome the barriers in transitioning from phantoms to lung cancer patients. We will perform the World's first-in-human implementation of our technology in a 30 patient lung cancer pilot study. For the patient, these improvements not only improve treatment efficacy by improving the accuracy of radiotherapy delivery, they reduce treatment times and reduce discomfort to the patient.

This project is the bench-to-bedside translation of the highest scoring 2011 NHMRC project grant (APP1034060) which has brought together a stellar list of investigators including the World's foremost 4DCBCT imaging expert (CIB Sonke) and the Australian researchers that have invented the technology.

Assoc/Professor Ricky O

Ricky explains the Artis Pheno at the recent ACRF Image X Institute Opening.

New institute to revolutionise cancer imaging and targeted radiotherapy opens at University of Sydney

23 November 2017

The Australian Cancer Research Foundation (ACRF) Image X Institute, a world-leading centre for medical innovation, launches today at its University of Sydney headquarters at an event hosted by journalist and cancer survivor Julie McCrossin.

The work of the Institute will focus on creating new medical devices for cancer imaging and targeted radiotherapy. The Institute will provide a site and forum where academia, medicine, industry and government can advance the science and clinical practice of cancer treatment.

The ACRF Image X Institute will be led by Professors Paul Keall (University of Sydney), Michael Barton (Ingham Institute), and Associate Professor Michael Jackson (Prince of Wales Hospital), with a team of world renowned researchers and collaborators.

The Institute is funded by $2.5 million from the Australian Cancer Research Foundation and a further $25 million in research support.

Please see the media release for more information.


Prof Paul Keall and A/Prof Ricky O'Brien , ACRF Image X Institute

NHMRC Early Career Fellowship awarded to Dr Doan Trang Nguyen

11 October 2017

Dr Doan Trang Nguyen is the recipient of the highly competitive and prestigious NHMRC Early Career Fellowship. Trang has made many contributions to different projects in the group and we are delighted that she will continue to work with us for the next four years. Congratulations Trang!

Dr Doan Trang Nguyen

Dr Doan Trang Nguyen, explaining the KIM technology at the recent ACRF Image X Institute Launch. Photo: Clare Hawley.