Welcome to the November 2009 e-Lectron e-news from RadPro. This month’s feature is on Laser technology in Radiotherapy…a brand new feature subject! There is also a mini second feature on “Daily QA” and lastly a news section on the upcoming ASTRO 2009 meeting in Chicago.
Please click on the links provided for more detailed information and please use the email contacts shown.
The 51st ASTRO
Annual Meeting will be held from November 1-5, 2009, at McCormick Place West in
Chicago. There is a news section about ASTRO from our partner companies in
the features section below. For more information on the final program click on http://www.astro.org/meetings/annualmeetings/finalprogram/index.asp
ASTRO news…
Elekta Astro news
ASTRO booth: 2501
At ASTRO, Elekta is showcasing new tools that demonstrate the IGRT-pioneer’s continued leadership in advanced oncology imaging. Intuity™*, which builds upon Elekta XVI imaging technology, offers new image-registration and workflow tools. Symmetry™*, which represents the future of motion management, allows clinicians to visualize respiratory-induced target movement and its relation to organs at risk. With Symmetry, clinicians will be able to make decisions about baseline shifts between treatments and determine corrections using anatomically correlated image guidance.
Elekta demonstrates continued leadership in image guidance
Image-guidance using daily cone beam CT has become a clinical requirement in many progressive cancer programs. Elekta’s imaging solutions combine the most powerful imaging tools available with advanced workflow management and storage solutions. New tools enable clinicians to see and use even greater volumes of imaging data to guide the treatment process. Daily imaging at ultra-low doses offers clear benefits to patients, and oncology imaging solutions from Elekta are designed to extend those benefits to more cancer patients without increasing the burden of complex imaging workflows on therapists and oncologists. At ASTRO, Elekta will showcase new tools that demonstrate the IGRT-pioneer’s continued leadership in advanced oncology imaging, including:
Intuity™* will allow clinicians to understand continuous changes in the positional relationships of both tumor and healthy tissues during the course of a patient’s treatment. This understanding will allow clinicians to manage changes and optimize dose placement.
Symmetry™* will be the next generation of image guidance, creating new opportunities in motion management. This powerful innovation will allow clinicians to visualize respiratory induced target movement and its relation to organs at risk. With Symmetry, clinicians will have the ability to make decisions about baseline shifts between treatments and determine corrections using anatomically correlated image guidance.
*Intuity™ and Symmetry™ are feature sets of XVI 4.5 and a works-in-progress that require 510(k) review
Elekta’s radiation oncology solution streamlined by MOSAIQ
Elekta’s radiation oncology solution is streamlined by MOSAIQ®, the market’s leading oncology-specific EMR and practice management solution from Elekta Impac Software.
MOSAIQ Radiation Oncology EMR provides an image-enabled electronic medical record for radiation oncology. MOSAIQ is a complete practice management solution, overseeing everything from scheduling to patient flow to clinical information to patient financial account management. The solution also offers a comprehensive distributed review of both treatment plans and images, and an unwavering commitment to open systems support of the technology in your clinic.
Complete with new connectivity, functions and database enhancements, MOSAIQ supports the entire cancer team by uniting diverse systems and devices.
For additional information, visit www.elekta.com/impac or www.impac.com/mosaiq.
Set yourself apart with linear accelerator solutions from Elekta
Distinguish yourself with Elekta Infinity, the next-generation digital linear accelerator that is optimized for Volumetric Modulated Arc Therapy (VMAT). Infinity delivers unmatched dose conformance, treatment speed and ultra-low dose safeguards. It is the only fully integrated treatment system available that allows customers to personalize imaging and treatment workflows.
Elekta Synergy® is an advanced digital linear accelerator that integrates a suite of imaging tools to enable high-quality imaging at the time of treatment for every patient, every day. Synergy inspires confidence in IGRT by adding valuable 2D, 3D and 4D* imaging information at the time of treatment.
Elekta Axesse™ is a fully integrated stereotactic system that combines three-dimensional (3D) image guidance at the time of treatment with highly conformal beam shaping and robotic 6D sub-millimeter patient positioning to deliver fast, efficient and accurate treatment.
Digital linear accelerators from Elekta offer Volumetric Modulated Arc Therapy (VMAT), which delivers helical-like dose conformance and reduced treatment times in one or multiple arcs while dynamically changing gantry speed, MLC leaves, dose rate and collimator angle.
*works in progress
Elekta to feature demos of Monaco radiation treatment planning system
Monaco is a next-generation VMAT and IMRT treatment planning system from Elekta CMS Software that uses Monte Carlo dose calculations and offers constrained optimization with multiple physical and radiobiological objective functions. Monaco provides improved dose distributions compared to traditional DVH point methods, and includes smart sequencing, segment weight and leaf position optimization.
For more
information, visit www.elekta.com/cms or www.cmsrtp.com.
We are proud to show the CE certified RayPilot® system for real-time electromagnetic prostate positioning and real-time dosimetry*. RayPilot® is an add-on system to existing radiotherapy equipment featuring:
- Continuous
prostate positioning
- In-vivo dosimetry*
- Automatic patient identification*
* Work in progress
Welcome to visit us and learn more in our booth #3031.
www.micropos.se info@micropos.se
A complete solution for patient monitoring integrated in the workflow of the radiotherapy clinic
C-RAD Sentinel™ is a new advanced system for surface contour localization and monitoring of the patient in the radiotherapy treatment process. As the development of treatment techniques has enabled higher levels of accuracy in the treatment with higher doses there is also an increasing demand for better accuracy in monitoring the patient position and movements. The C-RAD Sentinel basic platform is based on advanced laser technology with multipurpose software modules covering different tasks in the treatment procedure. The different software modules are seamlessly integrated with other systems in the clinic.
C-RAD Sentinel is designed to provide a high level of ease of use combined with improved accuracy.
The Sentinel system does not require any markers to be placed on the patient or the couch, and doesn´t subject the patient to any additional radiation. This also means that the personnel can stay in the treatment room during the whole set up procedure. C-RAD Sentinel offers solutions for fast patient positioning with a high level of accuracy, motion detection during the treatment delivery procedure, respiratory gating functionality and furthermore advanced applications like image fusion and adaptive radiation therapy.
C-RA D Sentinel provides
• C onnectivity Seamless integration with other systems in the RT clinic
• A ccuracy H igh level of accuracy based on state-of-the-art laser technology
• E ase of use N o need for manual marking or maneuvering of the patient – enables timesaving in the patient positioning procedure
• C onfidence The system confirms correct positioning and monitors movement.
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| Diagnostics | Treatment planning | Simulation | Treatment delivery |
Precision throughout the whole process
By seamlessly integrating with the systems and workflows already in place, C-RAD Sentinel makes it possible to ensure precision throughout the whole radiation therapy process, while at the same time minimizing the amount of work necessary to operate the system.
DIAGNOSTICS
High quality diagnostic imaging is the foundation of the radiation therapy process, and its importance is growing even more with the adoption of advanced treatment delivery methods such as 3D-CRT (3D-Conformal Radiation Therapy), IMRT (Intensity Modulated Radiation Therapy) and ART (Adaptive Radiation Therapy).
In many cases, one imaging modality is not enough to get the complete picture. The solution is image fusion, a process in which the volumetric images from multiple imaging modalities such as CT, MR, PET and SPECT are co-registered to a common coordinate system. The final result is a combined data set that will give the maximum information possible to assist the oncologist in the critical decision on which form of therapy should be chosen for subsequent treatment.
To further increase the image quality, respiratory gating can also be used at this stage for prospective or retrospective gating of the data acquisition procedure, which will minimize any breathing motion artifacts and, in the case of retrospective gating, facilitate reconstruction of a complete 4D data set.
TREATMENT PLANING
Once the treatment planning has been performed, the resulting plan can be transferred to the Sentinel system through import from the industry-standard DICOM format. If the external patient outline was traced by the treatment planning system, this data can also be imported and used as reference data for performing patient positioning at each fraction.
The Sentinel system can also, depending on the capabilities of the treatment planning system, provide the information needed for adaptive radiation therapy – by aggregating the systematic and stochastic errors in patient position for the already delivered fractions.
SIMULATION
In the case of conventional simulation, the Sentinel system can be used for initial patient positioning based on the reference data coming from the treatment planning system, while motion detection helps ensure that the patient doesn’t move during the simulation session. When the correct patient position has been verified, reference data can be acquired for patient positioning during the upcoming fractions.
For patients to receive gated treatment, respiratory gating during the simulation session is used to ensure that the gating parameters established earlier are still valid.
TREATMENT DELIVERY
In the treatment room, synchronization with the LINAC or R & V (Record and Verify) system ensures that the correct reference data is called up automatically when the patient is selected for treatment, and also eliminates the need for any manual selection of the patient in the Sentinel system.
Patient positioning before the actual treatment begins, together with subsequent motion detection, ensures that the patient’s position is correct both before and during the whole treatment delivery.
If respiratory gating is used, the treatment will be synchronized to the patient’s respiratory cycle so that more dose can be delivered to the tumor, while the surrounding healthy tissue is spared. C-RAD Sentinel uses no physical markers for gating, and eliminates the need for cumbersome extra equipment in the treatment room.
ADAPTIVE RADIATION THERAPY
In adaptive radiation therapy, the information gathered by C-RAD Sentinel is fed back to the dose planning system, so this can produce accurate modified plans. The system collects and aggregates the information on the actual positioning of the patient during the performed fractions, allowing the dose planning system to compensate for any possible previous errors.
Pic: C-RAD Sentinel is an advanced laser/camera-based system, which can be used for patient positioning as well as for motion detection, respiratory gating, image fusion and adaptive radiation therapy functionality.
Laser scanner
The hardware consists of a single scanner unit containing the laser and camera, mounted in the ceiling in front of the gantry. The scanner is connected to the PC running the c4D software.
During patient surface acquisition, a laser line is swept along the patient while the camera records a number of images. From the data acquired, a complete 3D surface of the patient can be reconstructed using laser line triangulation. For patient positioning, the acquired surface is captured in a few seconds and can contain several hundred contours. For motion detection and respiratory gating the number of contours are typically lowered so that the desired frame rate is achieved. The system is capable of acquiring more than 50 contours per second.
c4D software
The c4D multi-application software supports all modes of operation in one integrated package. Great efforts have been made to make the software as user friendly as possible, requiring a minimum of user interaction in the daily clinical workflow, while providing the advanced user with sophisticated data management, analysis and reporting functionalities.
The software is designed to integrate seamlessly with existing systems at the clinic, such as CT, MR and PE T equipment, as well as with treatment planning systems, linacs and R&V systems, and with motorized couch tops.
cPosition
By advanced surface registration algorithms the actual patient position is compared to a predefined reference position/image. With a click of a button the results are obtained and the need for manual markings on the patient
and for manual handling to bring the patient into the defined position is eliminated. With interface to major
accelerator vendors the suggested patient position is transferred to the respective couch control system and
fast and accurate alignment is achieved.
cMotion
During the treatment delivery phase it is critical that the patient does not change position and that the treatment is delivered in accordance with the plan. cMotion monitors the movement of th epatient during treatment delivery and automatically warns if the patient moves outside the allowed tolerances. This eliminates the need for visual monitoring by the staff, adding convenience as well as safety.
cRespiration
In some treatment procedures the location of the tumor is moving as a result of normal respiration. In order to adjust for this the treatment planning can choose to use a larger target volume, with the side effect that healthy tissue is also affected, or choose treatment based on respiratory gating. With respiratory gating the treatment delivery is synchronized with the patient’s respiration phase. cRespiration allows respiratory gating without markers and any cumbersome extra equipment in the treatment room.
cAdaptive
Collects and prepares information on the actual positioning of the patient during the performed fractions, allowing the dose planning system to compensate for any possible previous errors when preparing plans for adaptive radiation therapy.
cFusion
Radiotherapy treatments today include a number of different imaging modalities such as CT, MR , PE T and SPECT. The use of these systems often varies between clinics. With cFusion C-RAD will offer a unique solution for image fusion by combining information from these various imaging modalities
THE COMPLETE SOLUTION FOR4D PATIENT MONITORING
For details contact Imaging Equipment Ltd
07879261713
Laser Systems for virtual simulation in radiotherapy from Physics Instruments
In virtual CT simulation, A2J Laser Systems' HORUS range facilitates accurate marking of the patient's skin relative to the isocentre of the anatomy to be treated. It is designed for use in conjunction with a 3D imaging system and a treatment planning system having the option of virtual simulation interfaced with moving lasers. (Among the systems supported are the CMS FocalSIm and XiO Treatment Planning systems )
Configurations are available with up to 6 moving lasers and are delivered with a computer incuding the SimAxe software, a test phantom and user manual.
Pic: A2J CT simulation patient marking moving laser system.
Contact: admin@physicsinstruments.co.uk for more information
RadPro directory of other laser based products in Radiotherapy
DHA
Profa system for 3D laser based patient contouring and 3D shape change evaluation
http://www.dha.co.uk/laser_contouring.html
Prima Facie system hand held laser scanner for virtual immobilization mask making and 3D contouring
http://www.dha.co.uk/primafacie.html
Qados
IBA Emerald and Ruby positioning lasers
http://www.qados.co.uk/patient_positioning_lasers.htm
Gammex RMI laser positioning products
http://www.qados.co.uk/gammexrmi.htm
Oncology Imaging Systems
LAP Dorado CT simulation laser marking systems
http://www.oncologyimaging.com/movinglasersystems.asp
LAP Apollo and Astor positioning lasers
http://www.oncologyimaging.com/Lap_Astor.asp
Physics Instruments
A2J Laser star fixed and Laser star motorized systems
HORUS system from A2J for CT Simulation based patient marking
Daily, Monthly and Annual Testing needs to be part of a robust QA and
Dosimetry Programme
The
physics goal of routine QA is to minimize the burden yet maximise the data and
analyse options. Using the Daily QA 3 device this goal is achieved by
offering a daily device with 25 detectors that performs five unique tests in a
single measurement.
Daily QA 3 raises the bar for routine QA of linear accelerators. Data
collection is automated and the Daily QA 3 user routine is guaranteed to
be the easiest, most user-friendly system available. Accepted data is
automatically written to a trend analysis database in real-time where it is
available for review and analysis. With a simple two step operation and quick
analysis. It uses a total of 25 specifically designed detectors, both ion
chamber and diode, to obtain the best possible results in real-time.
This
goal is then carried a significant step further with the ATLAS option,
which centralises all routine QA and Dosimetry test data in one location,
offering new opportunities in reporting, analysis and efficiency.
ATLAS = Organization
Statistics and Reporting
The Daily QA 3 uses the same connectivity as all other Sun Nuclear instruments, therefore users with existing cabling can just plug and play. There is also a wireless version, this makes the task of going from to room so easy.
Daily QA3 measures and reports axial and transverse flatness and symmetry , photon and Electron energy, field size and light field / radiation coincidence and constancy. All of these measurements are taken and reported in one beam exposure.
Electrons can be measured without adding extra build up to the device and by using the optional IMF
(Isocentric mounting fixture) measurements can be taken at all gantry angles.
The Sun Nuclear Daily QA 3 offers excellent dosimetry at affordable prices and when coupled with the ATLAS QA management system provides an unrivaled safe and fuly auditable system.
Contact phil@imagingequipment.co.uk for more information
PTW Solutions - Minimum time in linac QA - day after day
Through Linacheck and Quickcheck Webline, PTW delivers the complete solution for daily linac QA
LINACHECK Dosimetric Test Device
Linacheck is a measuring device for the simultaneous and automatic measurement of the dose, dose rate and irradiation time on a linear accelerator. It is used for constancy checks of the monitor calibration as required by national and international regulations.
With light weight and battery operation, the device is easily and quickly set on the treatment table and the rest is done by Linacheck. The measurement is automatically started with irradiation and automatically stops as radiation is switched off. Air density correction is not required due to the built in sealed ionization chamber, further saving time.
When the measurements are finished, data can be evaluated. The bright and large display serves for easy reading from a distance. Furthermore, Linacheck stores up to 99 measurements allowing users to quickly check their linacs one after the other using different photon and electron energies. Optional, easy to use software downloads the logged data to MS Excel for storage and later evaluation of the measuring results. Finally, rechargeable batteries and a dedicated charger keep the Linacheck ready for immediate use.
QUICKCHECK webline Constancy Test Device
The
QUICKCHECK webline is a highly reliable and very easy to use QC measurement
device especially designed to make daily routine measurements for LINAC
constancy tests as convenient as possible. With 13 vented ionization chambers,
integrated in a housing that also contains the complete electronics, the
QUICKCHECK webline combines very high accuracy with the highest level of usability.
Air density corrections of the open ionization chambers are performed
automatically.
QUICKCHECK webline features all the measuring tasks for daily constancy tests
of the relevant LINAC parameters as symmetry, flatness, central beam dose,
energy, irradiation time or wedge filtering for both dynamic and static wedges.
All these tasks can be performed with this single portable wireless device
which optionally can be gantry mounted. Settings and readings can be done
directly at the device as a bright full-colour display is built in. Autostart,
autostop, autopower-off and autocalendar functions allow hassle-free
measurements.
While not used for measurements, the device can be stored in an optional
docking station. A comprehensive software package enables the user to set up
worklists and to read out and analyze measured data.
Quickcheck Webline - completely automatic and convenient
Task lists are defined once and in advance
Measurement procedures are trigger controlled
Immediate display of measurement results provided
Measurement values can be stored for several months
Quickcheck Webline – Versatile and Transparent
Individually configurable evaluation logs
Flexibly adjustable time intervals for trend analysis
Convenient filter function via selection menu
Suitable for data export in Excel format
Safe password protection
Linacheck and Quickcheck Webline, PTW solutions providing minimum time in linac QA, day after day
PTW-UK Ltd
Springfield House
Springfield Business Park
Grantham NG31 7BG
Enquiries for Ireland and U.K. :
+44 (0)1476 577503
Eastern Europe’s First Novalis Tx™ Radiosurgery Platform Begins Radiotherapy Treatments in Latvia using RapidArc® Technology
Region’s first stereotactic radiosurgery treatments due to begin by end of October
Riga, Latvia, October 14th 2009 – Doctors in Latvia have begun treatments using the region’s first Novalis Tx™ radiosurgery platform from Varian Medical Systems (NYSE: VAR) and BrainLAB. Two prostate cancer patients have been treated using Varian’s RapidArc® radiotherapy technology at the Riga Eastern Clinical University Hospital.
Pioneering Cancer Center in India Will Expand its RapidArc® Radiotherapy Program
Hyderabad, India, October 19th 2009 – A hospital that is using RapidArc radiotherapy to treat cancers of the head & neck and cervix is announcing it will be expanding its use for treatment of other cancers. Yashoda Cancer Institute in Hyderabad has found it can deliver image-guided, intensity modulated radiotherapy (IMRT) faster and more precisely using the RapidArc technology from Varian Medical Systems
Latest International Radiotherapy Jobs
http://www.radpro.org.uk/employment.php
For International Radiology Jobs, click here to enter the International Radiology Job Pages.
Weblink: http://www.radpro.org.uk/jobs_radiology.html
December 2009. Logistics in Radiotherapy and Radiology and a
Proton Therapy update
January 2010. What will the Linear Accelerator look like in the future! A major feature edition.
February 2010 Advances in Brachytherapy with a review of Prostate Cancer treatment.
March 2010 Radiotherapy Company international website review!
April 2010 Your feature of choice, please let us know.
Please send you editorial, corporate or clinical, job vacancies, suggestions and any questions to admin@RadPro.eu
Duncan Hynd November 2009
