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Vero Sterotactic Body Radiotherapy

New System targets tumors more precisely

Upstate is one of three institutions in the United States to offer the Vero, a 9-ton ring of sophisticated cancer weaponry that allows radiation oncologists to pinpoint tumors and deliver radiation with unprecedented precision.

Vero provides high accuracy for treatment delivery, even with moving targets. Core features, such as sophisticated and versatile image-guidance, verification tools and the first-of-its-kind gimbaled irradiation head with tilt functions deliver targeting confidence.

Vero "integrates several state-of-the-art capabilities and technologies into one machine and is designed to locate tumors and direct radiation precisely where it is needed," said Jeffrey Bogart, MD, who leads the Department of Radiation Oncology.

Bogart said Vero will allow for a more tightly focused beam of radiation, which is essential when aiming at a tumor that is located near critical structures such as the spinal cord. The system's advanced imaging capabilities allow providers to locate and track tumors, confirm the location at any point in the treatment process and account for even slight anatomical movements that occur each time a patient takes a breath. Also, once patients are settled into place, they will not have to be moved because Vero allows for beam delivery from almost any angle.

"Upstate physicians already have extensive experience with stereotactic radiotherapy for complex tumors in both the body and the brain, and VERO adds to our armamentarium of advanced technologies to help successfully battle cancer," Bogart says.

How It Works

The patient lies on the treatment "couch." After he or she is positioned, the Vero moves freely around the patient. With its unique pivoting head, the machine moves as necessary to provide unrestricted access to the tumor from nearly any angle. The advanced imaging technology built into the Vero shows a 3D view of tumors and organs. The technology allows tumors "even those that move or shrink" to be located, targeted and then treated in real time.

The Vero can be used for many types of tumors and may be used on tumors that have spread and for those that are hard to reach surgically. Once the tumor is identified, the Vero's very precise delivery of radiation is achieved through several beams at different angles and intensities — all directed at the tumor. This means that radiation is concentrated on the tumor and less so on surrounding healthy cells and tissues. The customized treatment provides hope for greater cure rates and fewer side effects.


  • Unprecedented integration of imaging and treatment delivery
  • Developed through a partnership between Brainlab AG (Germany) and Mitsubishi Heavy Industries Ltd (Japan)
  • Vero delivers targeted, individualized treatment while continuously tracking and incorporating anatomical changes and breathing cycles for precision dose delivery
  • Treatment options include Image—guided Stereotactic Body Radiation Therapy (SBRT), Intensity Modulated Radiation therapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), and Real-time Tumor Tracking
  • SBRT is a noninvasive procedure where radiation beams are delivered to a tumor in a concentrated, precise manner, minimizing damage to healthy tissues and reducing the number of treatment sessions for patients
  • Vero is particularly advantageous in destroying tumors throughout the body that often cannot be addressed by conventional surgery, especially for lung, liver, prostate, spine, head and neck, and many other extra-cranial indications
Vero sterotactic body radiotherapy

Vero's unique features include

  • High mechanical accuracy
    • Tighter isocenter than the competitors, ± 0.1 mm vs. 0.75 mm
    • Superior isocentric accuracy means a more tightly focused beam
    • Unmatched flexibility of beam design and delivery
    • Vero offers the only gimbaled multileaf collimator (MLC) linac on the market
    • Allows the linear accelerator to swivel in multiple directions
    • ± 60° rotation about Vero's vertical axis enabling beam delivery from almost any angle
  • Innovative imaging provides dynamic tumor tracking
    • Dual-diagnostic x-ray for simultaneous radiographic and fluoroscopic stereo imaging
    • Allows the machine to "chase" a tumor through the full extent of its motion
    • Ability to image the target at any gantry angle and at any point in the treatment process provides unmatched confirmation of treatment accuracy
    • Real-time, six dimensional exact patient positioning