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Nominee 2022

(In)visible tumors on the move

(In)visible tumors on the move – New perspectives for radiotherapy thanks to precise tumor tracking

Stefan Vilsmeier (Spokesperson)
Prof. Dr. med. Cordula Petersen*
Dipl.-Inf. Claus Promberger
Brainlab AG, München
*Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg

(f.l.t.r.) Prof. Dr. med. Cordula Petersen, Stefan Vilsmeier, Dipl.-Inf. Claus Promberger

Cancer is one of the most common chronic diseases worldwide – and is often terminal. Yet with new therapy methods it can be treated and, in many cases, cured. One treatment is radiotherapy during which tumor tissue is destroyed in a targeted manner by high-energy radiation. Decisive in this scenario is that the tumor is precisely detected, and treatment is not affected by the patient’s movement. In treating lung cancer, an added difficulty is the tumor moving as the patient breathes. This reduces the chances of success and carries the risk of damaging side effects. How can this problem be solved?

Stefan Vilsmeier, Claus Promberger and Prof. Dr. Cordula Petersen are working on a solution. It is based on a novel technology to detect patient position during radiotherapy precisely and to compensate for changes by tracking the area targeted by radiation. This ensures that the tumor cells targeted are attacked accurately and that as little healthy tissue as possible is damaged. The result is very effective treatment which eliminates the tumor, in some cases in a single treatment session.

The radiosurgery system the nominees are currently developing aims to improve the prospects of cancer patients, particularly those with lung cancer. Stefan Vilsmeier is Founder and CEO of Brainlab, Claus Promberger is head of Radiotherapy Research and Development at Brainlab. Cordula Petersen is Director of the Clinic for Radiotherapy and Radiation Oncology at the University Medical Center Hamburg-Eppendorf as well as President of the German Society of Radiation Oncology.

To date the irregular motion of lung tumors due to a patient’s breathing made radiotherapy treatment difficult. To ensure that diseased tissue is destroyed despite its constant change in position, doctors defined a safety zone around the tumor, calling it the motion envelope. It includes the entire area through which the tumor moves during respiratory movement.

During conventional treatment, healthy tissue is inevitably also destroyed in addition to tumor cells – in some cases to an extent greater than the size of the tumor itself. To keep these side effects to a minimum, the maximum dose of radiation is limited which is why numerous sessions are usually needed to complete treatment. Another factor is that radiotherapy was not even feasible for many tumors in the past due to their position or small size.

The new system for highly precise positioning during treatment lays the foundation for much more precise directing of the beam than conventional equipment can provide. The safety area around the tumor is thus much smaller. Moreover, with the next version, even small tumors that are virtually invisible on normal x-rays can be detected and destroyed.

The newest generation of the “ExacTrac Dynamic” system developed by the nominated team combines multiple sensors with different functions. Both the exact position of the surface area of the patient’s body as well as the patient’s internal anatomy can be verified. The data measured is continuously compared to a previously calculated model that describes the patient position and any change in position during treatment, and the model is adjusted as needed. The so-called correlation model uses surface tracking and tracks the motion of internal structures as well as, in future, unusual parts of nearby body tissue.

The key component of the sensor system is a combination of a tracking camera, two x-ray systems and a control computer including dedicated software. The tracking camera is a combination of a surface camera with a thermal sensor. This lets the system track the patient motion during radiotherapy. The two x-ray tubes placed diagonally to each other as well as the corresponding detectors for measuring the x-ray light diffracted in the tissue look inside the body and can determine the tumor’s exact position. All information is taken into consideration in calculating the correlation model used to adjust the radiation. This makes it possible to control the patient’s position to ensure that the tumor is detected with the utmost precision.

The entire treatment is pain-free and aims to eliminate as many side effects as possible. In contrast to the technologies used up to now, the radiation does not harm virtually any healthy tissue. To develop the innovative system that is gentle on patients, the team at Brainlab worked closely with doctors and medical engineers at the University Medical Center Hamburg-Eppendorf. Their expertise in the medical application of radiotherapy and radiosurgery in daily clinical practice has contributed to the design and function of the marketable product.

ExacTrac Dynamic has been approved for use in the USA and in Europe since 2020. In future, it will considerably expand the possible uses of radiotherapy – and presumably bring a surge in sales for the Munich company, specializing in software-supported medical technology. A first generation of the system is already being used to treat brain tumors – and is installed for this purpose in around 1000 leading cancer centers worldwide. The next generation of the positioning system will primarily support radiation treatment of lung tumors.

It is expected that the technology will subsequently be used for the precise detection of liver tumors – even when and if they have already metastasized. The system has benefits not just for people with cancer for whom it may be lifesaving. In developing the system, the nominated team also made a point of emphasizing the importance of environmental compatibility and the sustainable use of resources. To use the technology, clinics do not need to replace existing radiation equipment. Instead, ExacTrac Dynamic can be combined with existing systems to expand their range of application in cancer treatment.

The right to nominate outstanding achievements for the Deutscher Zukunftspreis is incumbent on leading German institutions in science and industry as well as foundations.
 The project "(In)visible tumors on the move – New perspectives for radiotherapy thanks to precise tumor tracking” was submitted by Deutschen Patent und Markenamt.

Federal President Frank Walter Steinmeier will present the Deutscher Zukunftspreis to one of the three nominated teams on October 26, 2022.

More Details


Stefan Vilsmeier

Born in Munich
Publication of the book “3D-Konstruktion mit GIGA-CAD Plus auf dem C64/C128” on 3D- Graphics
High school diploma from the Franz-Marc-Gymnasium in Markt Schwaben
Matriculation at the Technical University of Munich, major in Information Systems and minor in Theoretical Medicine
Foundation of Brainlab
Opening of the first Brainlab subsidiary in USA
Head of strategic business planning for the oncology division
Management board responsibility for the oncology product line
Appointment as member of the Innovation Dialogue of Chancellor Angela Merkel


Named as inventor of 81 patent families

Honors and Awards

Award of the Bavarian Order of Merit, the highest honor of the state Bavaria
“Entrepreneur of the Year 2001” award from Ernst & Young
“World Entrepreneur of the Year 2002” award from Ernst & Young
Honor by the World Economic Forum (WEF) as “Global Leader for Tomorrow”
„International Steven Hoogendijk Award“ for lifetime achievements in pioneering medical technology


Digital Life Design (DLD), Bits and Pretzels, Digital Health 2020 – EU on the Move, Süddeutsche Zeitung Economic Summit, Digital Summit of the Federal Government, German Israeli Health Forum for Artificial Intelligence (GIHF-AI), a. o.


Frankfurter Allgemeine Zeitung, “Deutschlands Daten-Paranoia“ Süddeutsche Zeitung, “Spielend in den Körper“
Handelsblatt, Disrupt Podcast, “Der OP-Saal muss digitalisiert werden“

Claus Promberger

Born in Pfaffenhofen a. d. Ilm
High school diploma from the Schyren-Gymnasium in Pfaffenhofen a. d. Ilm
Completion of degree in Information Systems at the Technical University of Munich with a minor in Space Engineering
Career start at Brainlab as software engineer for BrainSCAN radiosurgery planning software 1998 Lead engineer of the first prototype of the positioning system, ExacTrac
Lead engineer of the first implementation of IMRT in BrainSCAN
Project leader and lead engineer for the universal planning software, iPlan RT
Lead engineer for the first implementation of planning software for tumor tracking and 4Pi in iPlan RT for Vero
Appointment as Director Portfolio Management Oncology
Appointment as Vice President R&D and therefore responsible for all R&D activities of the oncology branch at Brainlab


Named as inventor of 5 patent families in the field of radiosurgery planning, procedure and motion management


Multiple publications and presentations at conventions and symposia

Prof. Dr. med. Cordula Petersen

Born in Hamburg
High school diploma from the Gymnasium Hohenzollernring in Hamburg
Medical school at the University Hamburg
Completion of doctorate degree Dr. med. (magna cum laude) at the University Hamburg
1995 - 1996
Department of Radiotherapy at the University Medical Center Hamburg–Eppendorf (UKE)
1996 - 2006
Clinic and Polyclinic for Radiotherapy
University Hospital Carl Gustav Carus Dresden
Research residency at the Department of Experimental Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA
Approval as medical specialist for radiotherapy
2006 - 2009
Medical practice for Radiation Oncology, Radiological Alliance Hamburg
Appointment as W3 Professor of Radiotherapy and Radiation Oncology
Appointment as Clinic Director of the Clinic for Radiotherapy and Radiation Oncology at the University Medical Center Hamburg-Eppendorf
2010 - Present
Member of the board of the UCCH at UKE (University Cancer Center Hamburg) Sponsored center of excellence by the German Cancer Aid (DKH)
2017 - Present
Member of the review board of the German Research Foundation (DFG)
Since 06/2021
President of the German Society of Radiation Oncology (DEGRO)

Honors and Awards

Hanns-Langendorff poster prize for radiation biology at the 4th DEGRO Congress
“Herrmann-Holthusen-Preis” award from DEGRO
”ESTRO-Varian Research Award” award from ESTRO (European Society for Therapeutic Radiology and Oncology)


Multiple publications, research fellowships, clinical study activities and memberships in expert associations



Thomas Martin
Management Associate to the CTO
Brainlab AG
Olof-Palme-Str. 9
81829 München
Phone: +49 (0) 89 / 99 15 68 21 68


Bernadette Erwig
Communication & PR Manager
Brainlab AG
Olof-Palme-Str. 9
81829 München
Phone: +49 (0) 89 / 99 15 68 22 29


Stefan Vilsmeier
Vorstandsvorsitzender und CEO der Brainlab AG
Brainlab AG
Olof-Palme-Str. 9
81829 München
Phone: +49 (0) 89 / 99 15 680

A description provided by the institutes and companies regarding their nominated projects

(In)visible tumors on the move – New perspectives for radiotherapy thanks to precise tumor tracking

One in every two people will develop cancer during the course of their lifetime. Today, radiotherapy already plays an important role in cancer treatment. As this type of treatment continues to advance and develop, radiotherapy has the potential to become the procedure of choice and even be used curatively and as a standalone therapy. When it comes to radiotherapy, precision is the key to successfully targeting and destroying tumor cells while sparing healthy tissue. However, small tumors and tumors that move due to respiration make it challenging to maintain precision during dose delivery.

To address challenges in radiotherapy precision, ExacTrac Dynamic® was developed by the interdisciplinary team composed of Stefan Vilsmeier, Founder and CEO of Brainlab, Claus Promberger, Head of Radiotherapy Development at Brainlab and Professor Dr. med. Cordula Petersen, Clinic Director of the Clinic for Radiotherapy and Radiation Oncology at the University Medical Center Hamburg-Eppendorf (UKE) and President of the German Society of Radiation Oncology (DEGRO). ExacTrac Dynamic® enables medical professionals to achieve submillimetric radiotherapy positioning and to target various types of tumors with high precision. As a result of the precise positioning, it is possible to effectively destroy tumor tissue while sparing healthy tissue. This technology’s potential is considerable as it allows for more cancer patients to be treated quickly and with few subsequent side effects. This, in turn, supports better quality of life during and after treatment.

The Challenges of Precise Radiotherapy
Lung cancer is the leading cause of cancer death worldwide, claiming around 45,000 lives per year in Germany alone. Oftentimes, lung cancer is not diagnosed until the disease has reached a more advanced stage because lung cancer symptoms can take longer to manifest and detect.

Patients move during treatment and, due to respiration, the tumor can also move irregularly. Until now, a safety area around the tumor — referred to as the motion envelope — has been irradiated along with the tumor. The motion envelope encompasses the entire space in which the tumor moves during respiration. However, this approach can result in the destruction of healthy lung tissue, which ultimately can impair function and quality of life.

In addition, 2D X-Rays may not always be able to detect small and often treatable tumors. If these small lung tumors could be detected and treated in an early stage of disease progression, the patient’s chances of survival may increase.

ExacTrac Dynamic® – Intelligent Combination of State-of-the-Art Tracking Technologies
ExacTrac Dynamic® is advanced technology that can be installed on linear accelerators or other external beam radiation therapy devices. It was developed by Brainlab in close collaboration with Professor Petersen from UKE. The product consists of a tracking camera, two X-Ray systems and software run on a control computer. The tracking camera combines a surface camera with a thermal camera to continuously track the movements of the patient’s body surface during radiotherapy. Meanwhile, the X-Ray system provides a visual of the patient’s anatomy. With all this data the software verifies the position of the tumor in real-time. The system enables the treatment beam to be controlled according to the position of the tumor, thereby preventing damage to the surrounding healthy tissue. As a result, higher radiation doses can be administered in fewer radiation sessions.

This new concept is mainly used for treatment of tumors of the brain, spine, breast and prostate. With ExacTrac Dynamic®, patients can be quickly and efficiently positioned for high precision treatment, and can be checked and adjusted at any time during treatment.

Currently under development is the integration of movement-during-respiration into the correlation model. This feature makes it possible to treat patients within a certain breathing window, which must be reached and maintained in a controlled manner during radiation dose delivery. This window of time requirement presented a technical challenge, meeting critical speed requirements with simultaneous timestamping and data correlation from all sources. The next major step in development will be the upgrade to a completely dynamic system. This means that patients will be able to breathe freely while the system analyzes all parameters in real time. The focus will be on internal recording by the X-Ray system. With this system, it will be possible to record multiple images in quick succession, search through the images for a target region and use it as a basis for positioning. The target region can be the tumor itself, but also areas visible in the X-Ray image, such as the bronchi, which move simultaneously with the tumor.

During the development of ExacTrac Dynamic®, Stefan Vilsmeier and Claus Promberger were in constant contact with medical professionals that used radiotherapy in their everyday clinical practices. Professor Petersen and her team provide regular feedback and, based on their considerable experience with stereotactic radiosurgery and radiotherapy, advance the practical implementation of ExacTrac Dynamic®, especially in novel treatment areas. From her work with the German Society of Radiation Oncology (DEGRO), Professor Petersen was also able to gather valuable insights that were further incorporated into the development of the product. As a clinical expert, Professor Petersen trains radiation oncologists and medical physicists in the field of radiotherapy as part of the Brainlab Academy training program.

Vision for a Stronger, Long-term Role for Non-invasive Radiosurgery
Stefan Vilsmeier and Claus Promberger have been instrumental for decades in shaping the development of non-invasive patient positioning for radiotherapy. In the past, physicians often used radiotherapy for palliative care, primarily to alleviate symptoms. In comparison, modern, high-precision radiation techniques—for example, those used to treat brain tumors—are increasingly being used as standard of care. Currently, radiosurgery is considered state of the art treatment for more than 50% of benign brain tumors cases. Moreover, almost 1,000 of the world’s leading cancer centers use ExacTrac technology to treat brain tumors. As part of her work in the field of radiation oncology, Professor Petersen is also committed to further establishing non-invasive radiosurgery as standard of care.

High-precision radiotherapy also has the potential to effectively encourage high-risk patients, such as smokers, to undergo lung screenings. To date, many high-risk patients have refrained from getting lung screenings to avoid lengthy treatments in the event of a cancer diagnosis. As the primary technology in a completely painless, non-invasive treatment and with one or few sessions, ExacTrac Dynamic® could potentially increase the willingness of high-risk patients to undergo screening and thus help save more lives.

The importance of adequate lung function has also been brought to widespread public attention by the COVID-19 pandemic and how the virus impacts lung health. Patients with COVID-19 may already have reduced lung function, while all other patients want to maintain their maximum lung capacity.

In addition to benefitting patients and physicians, the Brainlab team is also focused on developing sustainable products that easily integrate into the circular economy. Based on this goal, we’ve engineered ExacTrac Dynamic® to be compatible with all common external beam radiation therapy systems on the market thereby eliminating the need for cost-intensive replacement of complete systems. Healthcare is a particularly CO2-intensive industry; therefore, it is critical to develop and produce carbon effective products like ExacTrac Dynamic® that can contribute to a sustainable future.

Cancer remains one of the most diagnosed diseases in the world. As such, ongoing development and advancement of technologies like ExacTrac Dynamic® are important to ensure patient access to gentle, precise and safe treatments. This technology has the potential to benefit physicians, patients, their families and society.

About Brainlab
Brainlab creates software-driven medical solutions that digitize, automate and optimize clinical workflows. The company sets new standards in medical technology to improve the quality of life of patients worldwide and support physicians, healthcare professionals and their patients in more than 6,000 hospitals in 121 countries. Brainlab employs more than 2,000 people in 25 locations around the globe.

For further information, please visit

About UKE
We are one of Europe’s most modern clinics. Here specialists from all fields of medicine are brought together under one roof. State-of-the-art medical technology, innovative information technology, and architecture created with the provision of medical care at the forefront, all with the aim of optimally supporting doctors, nursing staff, and therapists. The ideal conditions for the interlinkage between modern medicine, research, and teaching are found at the UKE. About 14,400 employees work around the clock with the singular aim of providing the best medical care to our patients.

For further information, please visit

The right to nominate outstanding achievements for the Deutscher Zukunftspreis is incumbent on leading German institutions in science and industry as well as foundations.
 The project "(In)visible tumors on the move – New perspectives for radiotherapy thanks to precise tumor tracking” was submitted by Deutschen Patent und Markenamt.

Federal President Frank Walter Steinmeier will present the Deutscher Zukunftspreis to one of the three nominated teams on October 26, 2022.