Is Patient Positioning Falling Behind in Radiotherapy Innovation?
After working in patient positioning—fixation, immobilization, and beyond—for quite some time, I’ve come to realize that innovation in this field has stagnated compared to other areas of radiotherapy. We’ve seen major advancements in Proton and Carbon-Ion therapy, IGRT, MRI-guided RT, AI-driven planning, surface guidance, and robotic positioning, which are evolving beyond their early hype into real-world applications. It’s clear that radiotherapy technologies are accelerating and improving treatment outcomes on an unprecedented scale.
So why aren’t patient positioning manufacturers keeping pace?
This sector is growing—companies are merging, being acquired, and responding to an aging population and earlier cancer detection rates. The demand for faster, more precise treatment has never been greater. Every radiotherapy treatment relies on patient positioning in some form or another, meaning every new advancement in radiotherapy inherently requires progress in how we position patients. Yet, many companies are still releasing the same products that were released 30, even 40 years ago.
Why?
Is there too little competition to drive meaningful change?
Are companies more focused on market share than patient outcomes?
Or is it simply a matter of outdated business models unable to adapt?
There are certainly challenges in innovating patient positioning. Regulatory approvals are lengthy, and research in this area is often underfunded compared to other aspects of radiotherapy. But these are not insurmountable barriers. Other sectors within radiotherapy have found ways to push forward, so why hasn’t patient positioning kept up?
Technologies like surface guidance, 4D imaging, and robotics provide new levels of precision, but they do not replace patient positioning itself. In fact, they rely on accurate, stable, and reproducible positioning to function correctly. Without consistent and effective immobilization, these innovations are far less effective.
Perhaps it’s time for manufacturers to rethink their priorities. We can’t afford for patient positioning to be an afterthought when it plays such a crucial role in treatment precision, patient comfort, and clinical outcomes.
Innovation in patient positioning isn’t just about making incremental improvements—it’s about rethinking what’s possible. As the rest of radiotherapy evolves, patient positioning must evolve with it.
—Bas
