Mary Bird Perkins Cancer Center
Radiation oncologists and medical physicists expect their treatment systems to do a lot these days and VMAT is a perfect example. In a single technique, radiation therapy moved from static to fully dynamic – with the gantry, MLC and collimator all moving simultaneously, and on-the-fly gantry speed and dose rate modulation throughout the VMAT arc. VMAT ushered in the kind of complexity that demands a robust control system. Clinicians at Mary Bird Perkins Cancer Center (MBPCC, Baton Rouge, La., USA) recognized the challenges and opportunities that sophisticated methods present and decided to upgrade their Elekta Infinity™ linac with the Integrity™ control system.
“Mary Bird Perkins’ medical physics expertise lends itself perfectly to this type of early product implementation and testing with Elekta. We are pleased to be able to contribute to the evaluation of the Integrity control system which will ultimately benefit patient care,” says Todd Stevens, President and CEO, MBPCC.
Enhanced safety
Having used Integrity for seven months, MBPCC medical physicist Jonas Fontenot, Ph.D., reports on features of the new control system that enhance safety, the potential of MLC interdigitation and smoother, faster VMAT.
Integrity employs three tiers of safety. The first tier records and verifies the prescription received from MOSAIQ® OIS and checks that all linac parameters are set correctly. The second tier checks and controls MLC leaves, gantry, collimator and dose delivery every 40 milliseconds, ensuring that all parameters are in the correct position and the right dose is being delivered. Guardian, the third tier, supervises the proper operation of the other two tiers– verifying in real-time that the field currently being delivered matches the prescribed treatment parameters. If a discrepancy occurs, Guardian will stop the treatment.
“I like that it’s not just one set of measures being deployed to ensure correct treatment delivery,” Dr. Fontenot says. “Another noteworthy feature of the Integrity functionality within the MOSAIQ environment is that during VMAT, Integrity constantly captures delivery parameters and sends them back to MOSAIQ. These data then become part of the permanent electronic treatment record. We use an in-house utility to extract delivery data from the MOSAIQ database, analyze it and notify our technical staff of any anomalous treatment behavior. It’s a good example of the flexibility and transparency of Integrity, which enabled us to construct custom safety features.”
Read more in the August 2011 issue of Elekta’s Wavelength customer magazine: www.elekta.com/wavelength.
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