IMRT
AAPM Elekta Events
New to the Elekta booth is Clarity™, which provides non-invasive soft tissue visualization to support radiation therapy workflows. Clarity compares 3D structures—not images—to provide accurate guidance non-invasively, without additional dose or any compromise to throughput. Demonstrations of the new version of ABAS 2.0 software, which includes the STAPLE algorithm to increase segmentation accuracy, will also be available. ABAS deforms atlases of anatomy previously defined on a reference image onto a new patient image, creating a new structure set fit to the patient anatomy and enhancing planning efficiency.
Representing the latest advance in 4D image guidance, Elekta’s XVI offers intelligent motion management and guidance. Symmetry™ motion management provides imaging tools to manage shifts in the relative positions of the tumor and organs-at-risk during the respiratory cycle. Intuity™ provides critical structure avoidance by accounting more accurately for both the position of the tumor and the healthy critical structures. Symmetry and Intuity demos will be available, and may be scheduled at the reception desk of booth #101. Demos of MOSAIQ® oncology information system, as well as other treatment planning software will also be available.
Before you leave for Philly, don’t forget to register for our complimentary customer events. All Elekta, Elekta Impac Software and Elekta CMS Software users are welcome to attend. To learn more, visit www.elekta.com/aapmevents.
See you in Philadelphia!
'Images courtesy of OCA Hospital, Monterrey, Mexico'
A 64-year-old female patient with mediastinal metastasis recently became the first in Latin America to receive Elekta VMAT radiotherapy treatment enhanced with Monaco® planning software. The patient completed her five Elekta VMAT treatment sessions at OCA Hospital, each of which lasted less than five minutes. The largest private medical center in Mexico, OCA Hospital is the fifth center in the world to utilize the combined radiation therapy planning and delivery solution.
“The speed of Elekta VMAT is reinforced with sophisticated Monaco planning, which helps us effectively plan around targets and organs-at-risk,” says Genaro Levinson, president and CEO of OCA Hospital. “Also, the Monte Carlo dose algorithm enhances the predictability of the dose, so we can confidently deliver the highest therapeutic dose.”
In addition to its Elekta VMAT/Monaco first, OCA Hospital was the first medical center in Latin America to install Elekta Synergy®, a treatment system equipped with advanced imaging technology to visualize the tumor and critical structures with the patient in the treatment position at the time of treatment.
'Images courtesy of OCA Hospital, Monterrey, Mexico'
“OCA leadership and senior management determined to upgrade our oncology department with state-of-the-art technology, including how we could improve Elekta Synergy,” Levinson says. “We wanted to be one step ahead of Intensity Modulated Radiation Therapy [IMRT]with static segments, which we had been doing successfully for years. We envisioned VMAT as an excellent alternative for dynamic IMRT using rapid volumetric arcs.”
Read more at: http://www.elekta.com/healthcare_international_press_release_20071055.php.
Linac Demonstration
SINGAPORE : More cancer patients will now be able to receive faster and more precise radiation treatments as one of Singapore’s two national cancer centres beefs up its facilities.
The National University Cancer Institute, Singapore’s (NCIS) Radiation Therapy Centre is adding another Linear Accelerator machine to its existing two. New features will also be added.
The investment costs S$11.5 million.
In anticipation of a surge in the number of people seeking radiation therapy, the centre is now equipped with one of the few and latest arc-based techniques called the Volumetric Modulated Arc Therapy (VMAT).
It allows beams to be delivered around the patient instead of just one direction.
The centre said it’s the first in Singapore to have it.
“VMAT is one type of arc therapy which uses a 360 degree of radiation and it gives continuous delivery of radiation during the whole course of the treatment – it’s called the arc therapy. VMAT is a type of Intensity Modulated Therapy but it provides a much shorter time for treatment,” explained Associate Professor Jiade Lu, head of Radiation Oncology Department, at National University Cancer Institute, Singapore.
With VMAT, treatment time can be reduced from 12 minutes to two minutes.
The upgrade also means the machines, which are enabled with Intensity Modulated Radiation Therapy (IMRT), can provide 3-D images.
Read more here:
http://www.channelnewsasia.com/stories/singaporelocalnews/view/1056362/1/.html
Gordon Brown and the Elekta Synergy
The Prime Minister Gordon Brown praised The Christie for “leading the way in health care” with its new radiotherapy centre in Oldham when he visited today, Thursday 18th March 2010.
He met staff and patients at the £17 million centre, which is the first facility of its kind in the UK.
During the hour long visit, Gordon Brown described the centre as a great advance in the health service. He said; “This is an amazing facility offering the best of care and the best of technology. It will make a huge difference to patients and will ensure people can get the best service close to home.”
Click here for more on Elekta Synergy
Generation V – Capable of reducing treatment times and enhancing conformality, the next-of-breed IMRT known as VMAT has radiation oncologists beaming.
Imagine a newly diagnosed prostate cancer patient lying on a table in a darkened room, about to undergo intensity-modulated radiation therapy (IMRT). Besides eyeing the linear accelerator anxiously and pondering the side effects radiation might induce (secondary tumors?), he’s also feeling intense pressure to urinate. You made him fill his bladder to lift his reproductive organs out of the way of the beam’s target area-his prostate. But he must ignore that pressure and lie perfectly still. Moving a few millimeters too much could make or break his cure.
Elekta VMAT
In conventional static-field IMRT, that patient must lie prone for five, eight, 10 minutes as you maneuver the linac around him. You deliver a treatment dose; stop and reposition the machine; deliver another dose; stop and reposition the machine; deliver another dose, and so on.
Imagine achieving the same effect in just two or three minutes via the push of a button as your linac rotates around the patient in one or more arcs with the radiation continuously on. As it rotates, the system automatically varies the multileaf collimator (MLC) aperture shape, dose rate, gantry rotation speed and MLC orientation to deliver maximum doses while sparing normal tissue. That’s the promise of volumetric modulated arc therapy (VMAT)-essentially, moving IMRT.
“Instead of covering something from seven angles, you have an infinite number of angles,” says William Bodner, MD, a radiation oncologist at Montefiore Medical Center who has used VMAT since March. “Ten to 15 years ago, we were thinking in terms of static fields and large lead blocks. Now we track these tumors as the machine rotates around, adjusting the shape of the beam. It’s beyond comprehension.”
View the entire article @ http://imaging-radiation-oncology.advanceweb.com/Archives/Article-Archives/Generation-V.aspx
More information can also be found @ http://www.elekta.com/vmat
If you’re looking to find out more on the latest radiotherapy technologies and novel work-in-progress projects, the show floor of the ASTRO Annual Meeting is always a good place to start. This year was no exception, with Swedish equipment vendor Elekta disclosing its latest endeavour to the public for the first time.
To read this article, please continue to :
http://medicalphysicsweb.org/cws/article/research/40925
(sign-in required)
Elekta's 160 leaf MLC - more leaves, less leakage
Ken Penfold was The first patient to experience the new IMR treatment
Revolutionary new technology in cancer care was launched at Royal Berkshire Hospital this week offering improved radiotherapy treatment.
The kit places the Reading hospital among an elite group in the country.
State-of-the-art three dimensional radiation waves will be the new thing for patients to help focus the lasers on the tumour and save any harm to surrounding organs.
And a new movement-sensored laser that works around the natural movement of the organs also means less risk on the area of the body surrounding the tumour.
Christine Lord, radiotherapy physicist at the hospital, has been working on implementing the intensity modulated radiotherapy (IMR) for 12 months and said she is delighted it has finally happened.
She said: “We are actually a very small cancer centre with no research team so to be able to be in the top half of hospitals in the country really is a fantastic achievement.
“Previously radiotherapy was more two dimensional but now we can get around the tumour which means we can either offer the same level of radiation with less side effects, or a higher level of radiation with the same side effects.”
The first patient to experience the new IMR was Ken Penfold, 63, who was diagnosed with prostate cancer last Christmas.
The improved radiation treatment has reduced his programme from seven weeks to just over four weeks.
The father-of-two from Bracknell said: “When I was offered the new treatment I was more than happy to be one of the first patients to try it.
“To live near one of the best cancer centres in the country is a massive benefit and I obviously am prepared to do whatever it takes to try and beat this cancer.
“When I was first told about it, it was somewhat of a shock as I had no symptoms. It was picked up in a routine blood test so to be able to treat the tumour at a higher dosage without damaging my body and causing fewer side effects is a huge bonus and hopefully will pay off.
“I am trying to live my life as normally as possible. I am still going to work and playing golf and watching football. I just have to make sure I am not too far away from a toilet because having prostate cancer does have some side effects.”
The new cancer treatment came about following a Royal Berkshire Hospital research partnership with The University of Pittsburgh Medical Centre.
Dr Richard Brown, consultant oncologist, said: “Patients have been very excited about this new treatment because it offers a much stronger chance of beating the cancer the first time around.”
A new cancer centre opening in Bracknell next year announced this week it will also be offering IMR.
Spotlight on Success
Elekta is a medical technology company specializing in radiation therapy and neurosurgery solutions for treatment of cancer and brain disorders. Headquartered in Stockholm, Sweden, Elekta maintains offices in several other countries, including a significant presence in the United States. Elekta supports its products with training programs for the medical and scientific professionals who comprise their customer base. This month’s Spotlight on Success describes how an Elekta writing team applied the Information Mapping® method to help customers learn to make quick, easy corrections to cancer treatment plans.
Meet Diane Norris
Diane Norris
Diane told us that she finds the Method extremely valuable and makes use of it in all aspects of her work. She has also successfully applied the Method to develop her 80-page doctoral proposal at Georgia Tech, where she is pursuing a PhD in nuclear engineering.
Writing training for users of radiation therapy equipment and software products
George Andl
Diane is a member of an internationally based technical writing group that creates documentation and training materials for Elekta’s radiation therapy equipment and software products. A notable example of the team’s work is a Quick Start reference guide intended for use by clinicians on radiation oncology teams. These clinicians deploy Elekta’s PrecisePLAN software to design treatment plans for cancer patients using Intensity Modulated Radiation Therapy (IMRT) technologies. We recently interviewed Diane and medical physicist George Andl, who worked closely with her and another team member to develop the Quick Start reference guide.
Targeting radiation to tumors, not healthy tissue
George, who acted as the primary subject matter expert for this project, explained that the PrecisePLAN software simplifies development of IMRT treatment plans by enabling clinicians to simulate the effects of different intensities of radiation on tumors and surrounding tissues. The objective is to maximize the dosage of radiation to a tumor, which may be large or irregularly shaped, while minimizing the dosage to surrounding critical organs. Clinicians can use the PrecisePLAN tool to model different scenarios, evaluate their treatment plans, and correct problems before submitting the plans to oncologists for implementation.
“The basic concept is to make the high dosage of radiation target the shape of the tumor,” George said. “We want to drive the number of complications down by reducing damage to healthy tissue. This software enables simulation before treatment.”
Quick Start reference guide
The Quick Start reference guide is an excellent illustration of how Information Mapping principles can be applied to enable quick scanning and optimize learning. The reference guide is an 11 X 17 inch poster entitled Procedures to Correct IMRT Plans. It provides customers with “at a glance” instructions for dealing with specific problems that arise as they develop their IMRT treatment plans. Enhancing her application of the Information Mapping method with her own expertise regarding use of color, Diane has created a reference guide that is intuitive to use and supports performance by making it remarkably easy for clinicians to find the information they need to troubleshoot their treatment plans and take corrective action.
Procedures to Correct IMRT Plan Poster
“Our customers wallpaper their workspace with this poster”
“I used the basic principles of the Method, like chunking and relevance, to help me organize the information on this poster,” said Diane. “There was a lot of information to include, but being able to think ‘in Information Mapping’ was tremendously helpful. It’s really the way you think about the information that makes the difference.”
George added, “What we needed to do was to capture the relationships among the different problems and their solutions. I feel that we succeeded. I spend some of my time working with our Customer Support staff, and I know that our customers wallpaper their workspace with this poster. They probably don’t have to rely on it after they’ve gained skills, but early on while they’re learning the different procedures, it’s quite valuable to them.”
The Quick Start reference guide has been in use for over a year and a half, and it is working so well that Diane anticipates the need to develop similar guides for other Elekta products. Needless to say, she plans to apply her Information Mapping skills to ensure that they’re as effective as this one.
For more information, view the original article on InfoMap.com
Visit Elekta/IMRT
Application of 3D Elekta VolumeViewTM image guided radiation therapy (IGRT) in treatment of locally advanced nasopharyngeal carcinoma – Tuen Mun Hospital, Hong Kong
Isodose Distribution
Patient history
A 34-year-old man was diagnosed to have a stage IVA (T4 N2 M0) NPC (nasopharyngeal carcinoma). Medical imaging showed a large tumor mass in the nasopharyngeal region with extensive involvement of neighboring structures including base of skull, sphenoid sinus, ethmoid sinuses and pituitary fossa. Multiple enlarged lymph nodes in both cervical regions were also reported.
Planned treatment
Depatrment of Clinical Oncology TMH
Read the remainder of this case study here
MRI showing massive tumor with extensive involvement - CT scan showing skull base destruction
Read more about VolumeView here
Read more Oncology and Neuroscience Case Studies here
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