Oncology and Neuroscience Blog from Elekta

Elekta Korea

The Asia Pacific region continues to demonstrate strong growth, fueling demand for healthcare services and technology in the region’s populous countries. South Korea, the world’s 15th largest economy, is among the leaders in Asia Pacific and the site of Elekta’s newest international office located in Bundang, an hour drive from the capital of South Korea, Seoul.

Elekta has a strong foothold in radiosurgery in South Korea, with an installed base of 16 Leksell Gamma Knife®. With increased local presence, Elekta expects to build on its leading position in radiosurgery and strengthen its share of the radiotherapy market, thereby making cancer care available for more people in the country.

“South Korean clinics and medical centers are addressing an increasing demand for healthcare in general, and cancer management in particular,” says Ian Alexander, Executive Vice

Ian Alexander, Executive Vice President of Elekta’s Asia Pacific Region

President of Elekta’s Asia Pacific Region. “Cancer incidences are rising in concert with the growth of the 65-years and older population, which represents nearly 10 percent of South Korea’s 49 million residents. This new office provides another much-needed channel through which our South Korean customers can satisfy their requirements for cancer care solutions.”

The Asia Pacific region as a whole is increasing its acquisition of Elekta equipment in response to a surge in cancer cases, he adds. “The countries in this region collectively account for an increasingly large percentage of Elekta’s global business.”

The South Korea office is in the process of reinforcing a strong organizational foundation. “These positions will be key in providing the best service and support to existing customers as well as reinforce the growth Elekta is experiencing in Korea,” adds Alexander. Elekta also has Asia Pacific offices in Singapore, India, Hong Kong, Tokyo, Shanghai, Beijing and Australia.

Don’t miss the fall issue of Wavelength, Elekta’s magazine focusing on news and advances in radiation therapy, information management and neuroscience from our customer partners worldwide. This issue discusses the use of SBRT for inoperable lung tumors; the first sites to implement our new digital control system; IGRT innovations that manage respiratory motion; the frontline role Monaco® with VMAT plays at a cancer center in China; the value of Gamma Knife® surgery for optical pathway tumors—and that’s not all.

On page two, don’t miss an article highlighting the University of Pittsburgh Medical Center’s (UPMC) stereotactic radiosurgery program where clinicians—including spine SRS pioneer Peter C. Gerszten, M.D., M.P.H., Associate Professor of Neurological Surgery and Radiation Oncology—have had remarkable success using Elekta Synergy® S to treat spine and paraspinal lesions. Speaking of top physicians, you may recognize the name of Robert Timmerman, M.D., Professor of Radiation Oncology and Neurosurgery at University of Texas Southwestern Medical Center (page six), a customer who uses Elekta solutions with confidence in Gamma Knife surgery and lung SBRT.

On page 12, it also is our privilege to welcome Macquarie University Hospital (MUH) to the global Gamma Knife community! The first and only center in Australia capable of providing dedicated intracranial radiosurgery, MUH recently treated their first patient, a 33-year-old male with multiple brain tumors, with Leksell Gamma Knife® Perfexion™.

Enjoy this issue of Wavelength!

Dr. Patrick Cobb stood in amazement as hundreds of patients, friends and supporters flowed through the front doors

Elekta Synergy of the Frontier Cancer Center and Blood Institute Sunday afternoon.

Each who passed by were welcomed with a hug or handshake before roaming around the new $23 million cancer center where Cobb is a managing partner.

Crowds wandered through the radiology waiting room, passed the phlebotomy area and through various exam rooms.

The tour continued upstairs to the chemotherapy area and the outside deck area.

Formerly known as the Hematology Oncology Center of the Northern Rockies, which was located on North 30th Street, the new center has been three years in the making.

read more here – http://billingsgazette.com/news/local/article_d34298d2-b3f8-11df-b128-001cc4c002e0.html

The Frontier Cancer Center is equipped with MOSAIQ™ – Elekta’s Medical and Radiation Oncology Software and an Elekta Synergy Linac

ROCKS AGAINST CANCER from Grace Huang on Vimeo.

Elekta VMAT (Volumetric Modulated Arc Therapy) is Elekta’s next generation arc therapy technique that establishes new standards for radiation therapy treatment speed and dose reduction to the patient. With Elekta VMAT, single or multiple radiation beams sweep in uninterrupted arc(s) around the patient, dramatically speeding treatment delivery. Doctors can use Elekta VMAT with complete or partial arc(s) to reduce treatment times from the eight to twelve minutes required for “conventional” radiation therapy to as few as two minutes.

read more at http://www.elekta.com/VMAT

Fairmont Hotel

USAir from Philadelphia to Chicago for a Medical Oncology Advisory Board meeting and our Annual Medical Oncology Summit.   The meeting was held at the Fairmont, a beautiful hotel near the Navy Pier.   As usual, the slowest part of the trip was the leg between O’Hare and the city.   Once there, Chicago is one of my favorites.

The Advisory Board Meeting was Wednesday, beginning bright and early and lasting through the day.  Our Advisers are a terrific mix if professionals – Nurses, Pharmacists, Physicians, Administrators…. representing the spectrum of our US Medical Oncology user base.   What an amazing day!    Lots of great discussion with “Meaningful Use” and HITECH/ARRA the lead topic.    As we prepare for the behemoth of this program, it is so clear to me how critically important this Advisory Board is to our success.   It’s not just preparing MOSAIQ for certification, but also our customer base for what they’ll need to do to qualify.   Spreading the word in every which way, including through this board, will be critical to success.

Lots of other topics were discussed, including QOPI support, our ever improving UI, some improvements in chemotherapy dose adjusting, and one of my favorite new MOSAIQ features – the availability of ALL MOSAIQ Assessment data elements as eScribe document merge fields.   The MD’s will love this – it’s going to make their lives so much easier.  The icing on the cake will be the ability to import, export and therefore share the assessment views and the eScribe templates.   Both will be available in MOSAIQ 2.3, though Assessment import/export is available now.  I don’t mean to sound too promotional here, but this one is really a biggie.

Through the course of the meeting, one statement in particular, made by Rajinder Dhada who has taken an interest in these meetings, is worth repeating here.   “It’s the ultimate in adaptive therapy”, he said, with reference to a discussion on how on-the-fly changes to chemotherapy administration orders should be managed.  That says it all.

The day was capped by dinner with our advisers in a hotel restaurant – dare I say – called “Aria”.

Our Advisers

A nice respite to end a long day’s work, even if the name wasn’t so fitting.

Next day began the Medical Oncology Summit meeting.    I have to confess I was only able to stick my head in a few times over the day because of conflicting meetings, but what I saw was a real surprise.   For the opening session, not only was it a bigger room than I had expected, but it was completely filled to near capacity – standing room only.  Wow! I’m told it is our largest attendance thus far,

standing room only

and having been to most of these Annual Summits, I must say we’ve come a long way.  No surprise that “Meaningful Use”, HITECH/ARRA were at the top of the list of interest.  Yes, there are dollars at stake, but there are also important implications related to work flow, effects on patient chart access, physician order entry, decision support and many other issues.    For the MOSAIQ product development group, it’s been the single highest priority.

Of course, there were lots of other interesting sessions including ones touching on survivorship, data visualization, clinical trial eligibility determination, billing… and the like.   A great meeting with a great outcome, and I only hope we’ve not raised the bar too high.

I’m on vacation next week, but will sticking around the area.  I will be visiting the White House during the week and bowling there (courtesy of some DC connections), so maybe will have a few words about that in my next blog.

Joel

Gamma Knife Center of Pacific, the Aloha State’s only dedicated intracranial radiosurgery facility, installs latest Gamma Knife model

Surrounded by thousands of square miles of ocean, Gamma Knife Center of the Pacific is the only Gamma Knife® center in Hawaii. Since 1998, Gamma Knife Center of the Pacific has treated more than 1,300 patients, offering residents a convenient treatment option and tourists a way to combine needed therapy with the pleasures of a paradise.

In August, the radiosurgery center will retire its first Leksell Gamma Knife system and begin operating Elekta’s latest generation radiosurgery system, Leksell Gamma Knife® Perfexion™. Gamma Knife radiosurgery is a gentler alternative to traditional brain surgery for illnesses such as metastatic disease, which is cancer that has travelled to the brain from elsewhere in the body. With pinpoint accuracy, the system delivers up to thousands of low-intensity radiation beams to one or more targets in a single session.Perfexion provides even greater speed and ease of use than previous models.

“Perfexion is a much faster, more efficient machine to treat multiple metastases in a single visit,” says Maurice Nicholson, M.D., neurosurgeon and the center’s medical director. “This is important because the pendulum is swinging toward treating with stereotactic radiosurgery [SRS] rather than whole brain radiation therapy [WBRT]. Studies have shown that there is decreased mental function at four months in a higher percentage of WBRT patients. Perfexion will be good for the patients and good for physicians.”

Read more here

Off to Wurzburg, Germany to visit Matthias Guckenberger and the University Radiation Oncology (Klinik und Poliklinik für Strahlentherapie) Department there.  Took USAir from Philadelphia to Frankfurt (always a treat, especially in economy class), followed by a real train from Frankfurt to Wurzburg.  The Europeans do training right!  I arrived at my hotel after a short walk from the Wurzburg Bahnhof on Sunday morning, and did a little touring of Wurzburg during the day.

When I visit Germany, it’s especially fun for me because I get to brush up on my very limited high-school German language skills.

Wurzurg, Germany

I arrived bright and early Monday morning at the Wurzburg Department, and was greeted by Matthias at their Physics division which is located in temporary office space turned permanent in Building B3 [photo].  It was a short walk from my hotel, but I took a wrong turn and spent an extra 10 minutes backtracking.

We spent most of the day going over their Elekta Symmetry work-flow, discussing a paper Matthias wrote, and some ideas he had concerning a super-secret Symmetry-related enhancement.   We also spent a couple hours looking through some patient records for ELRG data, and discussing ways to make MOSAIQ work more effectively for Wurzburg.   Among many things, I learned that in Germany, the Department Chair (in this case Professor Michael Flentje) has to sign off on each and every radiation prescription, letter and note since they are legally responsible.  So, they need a real good way to provide a high level summary of the patient’s care on one page, and to get there without lots of clicks.  I love a challenge!

During the day, I also had lunch with Matthias and Dr. Reinhart Sweeney who treats the pediatric cases at Wurzburg.  So, we had lots to talk about.  We topped of the visit with dinner at a beautiful restaurant in the hills surrounding Wurzburg.  I walked there, but got lost and ended up taking a taxi.   Can someone tell me why German taxi drivers speak better English than the ones in Philadelphia?

At the restaurant, I was greeted by Matthias and Reinhart  and was surprised to meet two Elekta colleagues – Annika Chill and Selma Setin – who joined us and happened to be in town working on the Wurzburg Hexapod couch.  The five of us had a great dinner and nice discussions, among other things over protons, the evolving role of the radiation oncologist in an increasingly connected and technological world, and Elekta’s role in making that happen.  Sounds boring, but it really wasn’t.   Maybe that was the German Reisling talking? [photo]

I returned to the department the next day where I finished my work and also got a nice tour of an amazing facility [photos], which is distributed widely over a number of locations on the University Campus.  They’re using beautiful Synergy-S to treat their SBRT lung cases, so a spent an extra few minutes looking at that portion of the department. [photo]

On my way out, Matthias asked me whether I had visited the Wurzburg Wilhelm Roentgen museum.  Holy cow, I had forgotten that Wurzburg was where Roengten discovered the X-ray.  On my way to the train station, I made a quick stop, convinced the guard at the door to show me it, and snapped a few priceless photos.  It was not easy to find the building which is under construction, but well worth the search.

All in all, it was a fantastic and productive visit.   I made tentative plans to return, and may even join Reinhart for an upcoming trip that he is planning to an Elekta site near Sibera.  Now that will really be interesting!

Next week, off to the Med Onc summit in Chicago.  See you there.

Just came back from a great meeting held by the American Board of Radiology Foundation in Bethesda, Maryland called “Improving Patient Care through e-Communication in Imaging”. I took the Amtrak Acela via Washington, DC to get there, and got to bypass most, but not all of the usual security and inconvenience of Air travel. We still don’t hold a candle to the rest of the world when it comes to train travel.

The meeting was attended primarily by leadership in diagnostic radiology and radiation oncology. Bill Hendee and Paul Wallner invited me, and I gave a keynote address on the future of the radiation oncology electronic health record.

I got to hear the perspective on e-communication from all sides, including some young residents in Radiation Oncology. Seems pretty clear to me that our electronic health record systems will be a primary vehicle of communication not only to other providers but also to our patients and their families. We won’t be Twittering from them, but we’ll sure be connected to them. After hearing the talks, including one from Bill Crounse who is my counterpart at Microsoft, I maintain my position regarding our own EHR product – MOSAIQ. It remains the most sophisticated EHR system out there. It’s doing more things in a more complicated environment than any other system – and doing it darned well. We’re still the only field with a nearly 100% EHR penetration, but we’ve also got a ways to go to get all our customers using the system to its fullest.

While there, I had a nice chat with my old friend Bruce Haffty, the Chair at Robert Wood Johnson in NJ, and was delighted to hear they just bought a Perfexion. Paul Wallner and his wife Susan had had lunch with me one day, and gave me a list of area restaurants to try on an upcoming visit to DC where we’ll be bowling at the White House. More on that later. Also had nice chats with Ron Arenson, an old friend who’s been chair of Diagnostic Radiology at UCSF since the early 90′s, Walter Bosch from MD Anderson, and Dr. Alfredo Siochi from the University of Iowa. They are using Lantis there, but about to make the switch to MOSAIQ. All in all, it was a good trip close to home, and fruitful. Looking forward to next year’s summit.

iViewC, Elekta’s new digital imaging system for use with Compact (our cost-effective linear accelerator for radiation therapy) has achieved CE marking. Utilizing CCD (charge couple device) technology, iViewC affords high quality, real-time images that verify the patient is in the correct position at the time of treatment. This helps to ensure patient safety and reduces margins during therapy delivery.

The digital architecture of iViewC ensures rapid patient set up and positioning, faster patient throughput and valuable workflow efficiencies compared to X-ray film, such as digital image storage and no waiting time between image acquisition and analysis. Based on the world-renowned iViewGT™ image evaluation software, iViewC harnesses advanced CCD camera technology to provide high quality, real-time images for accurate patient position verification at a cost-effective price.

The first iViewC for Elekta Compact was shipped to the Jose R. Reyes Memorial Medical Center in the Philippines. “The cost effective image-guidance capabilities offered by iViewC will enable workflow efficiency, higher patient throughput and cost savings,” says Erwin Q. Vito Cruz, Chairman, Department of Radiation Therapy, Jose R. Reyes Memorial Medical Center. “This is ideal for high-workload government institutions such as ours.”

*iViewC™ and Elekta Compact™ are not available for sale or distribution in all regions.

iViewC Patient Position Verification Solution Designed to Optimize Treatment Accuracy for Elekta Compact Radiation Therapy System