Welcome to the February 2010 e-Lectron e-news from RadPro.
This month’s feature is called “Advances in Brachytherapy with and update on Prostate cancer treatment”.

The contents of this edition are;

What’s new…the feature list for future e-Lectron editions is now online
Featured website…the Prostate cancer charity
Advances in Brachytherapy and Prostate cancer feature:
(1) Nucletron…
Southend first to use comfort catheters for breast cancer HDR brachytherapy
Isodose control and Nucletron to work together
Targeted Radiotherapy article
(2) Varian…
Bristol team pioneers HDR Brachytherapy treatment that enables Prostate cancer patients to avoid overnight hospital stay
(3) SeeDos…
Transperineal solutions for the modern practitioner
(4) University of Sussex…
TexRad mapping software used in Prostate cancer treatment
(5) Oncology Data Systems…
MU Check for Brachytherapy, independent dose calculation software

Radiotherapy hot news…
International news from Varian
News from Sheffield Hallam University on RIP5

Radiotherapy jobs…
Centre manager for CPUK Elstree plus many others

New e-Lectron feature lists…
A full listing of all upcoming features and subjects

The list of e-Lectron e-news features up to September 2010 has been published on the home page, please contact admin@RadPro.eu to suggest further feature subjects or co-features.  

www.prostatecancermatters.org.uk

1.SOUTHEND UNIVERSITY HOSPITAL THE FIRST IN THE UK TO USE NUCLETRON’S COMFORT CATHETER SYSTEM FOR HIGH DOSE-RATE BRACHYTHERAPY IN THE TREATMENT OF BREAST CANCER

Southend University Hospital is the first in the UK to use Nucletron’s COMFORT^TM Catheter Applicator System in combination with its high dose-rate remote brachytherapy afterloader, the microSelectron™ on a young, 53-year old breast cancer patient. Benefiting from this new procedure, the patient completed her treatment (including staging and grading of disease and lumpectomy) in less than six weeks. The brachytherapy element of her treatment was given over five days, which differs remarkably in duration to external beam irradiation that would have taken 15-25 days.

This new technique in combination with the applicator system, known as accelerated partial breast irradiation (APBI), offers a number of patient benefits, including highly improved cosmesis over the external beam irradiation technique, by retaining breast shape and avoiding collateral damage to underlying structures such as ribs, heart or lung. In addition, overall treatment time is greatly reduced.

Nucletron’s innovative and patient-friendly COMFORT Catheter system for interstitial High Dose Rate (HDR) and Pulsed Dose Rate (PDR) brachytherapy cancer treatments offers benefits to both the patient and the clinician. Patients are more comfortable during the course of treatment since the smooth rounded catheter buttons and unique flexible catheter design enable them to be treated on an outpatient basis, wear normal clothing and able to resume normal activities with minimal or no interference.

For the clinician, the system has minimal impact on costly resources and frees up time on linear accelerators; however, more importantly it facilitates this type of advanced treatment technique.

For the brachytherapy radiographers, channel numbers are marked on the catheter buttons and treatment needle assemblies, for quick, accurate and easy connection in each fraction. The innovative design facilitates the removal of the source introduction catheter in between fractions, reducing the chance of catheter kinking and providing a closed-end transport channel for the treatment source as well as minimising risk in patient set-up and time.

The patient recently treated was part of a feasibility study. The hospital has now treated three patients overall, with many others actively seeking the procedure due to recent publicity. Dr. Anne Robinson, Consultant Clinical Oncologist said,“The first patient has done so well and had the whole of her treatment in less than six weeks, although, of course, she will need to return for regular checks. We are delighted with how well it went.”

The COMFORT catheter system was developed by Nucletron in close co-operation with Dr. Luis Linares of New Orleans Cancer Institute, Memorial Medical Center, New Orleans, USA and Dr. Vratislav Strnad of the University of Erlangen-Nuremberg, Germany.

Alex Kypriotis, Sales Manager, Nucletron UK, comments,“The COMFORT Catheter system and close co-operation with clinical partners demonstrates Nucletron’s focus on improving patient care and maintains Nucletron’s position as an innovative world leader in brachytherapy”

Photo – shown here (left), Consultant Breast Surgeon Mr. Neil Rothnie, Consultant Clinical Oncologist, (centre) Dr. Anne Robinson with the patient (right)

2. Nucletron exclusive distributor of Isodose Control products 

Isodose Control and Nucletron join forces to drive innovation of high-precision cancer treatment, or brachytherapy. In this global partnership Nucletron leads all marketing, sales and service related activities, worldwide for both companies. Isodose Control will focus purely on development of innovative solutions.

“This combination makes us the undisputed global leader in brachytherapy, which offers safe and effective radiation treatment for the most frequently occurring kinds of cancer,’’ said Jos Lamers, CEO of Nucletron BV.

Providing meaningful solutions and options in treating cancer, so that patients may achieve longer and fuller lives, is a key challenge for all involved in cancer care. The two companies sign up to the challenge.

Eric van’t Hooft, founder of both Isodose Control BV and Nucletron BV is looking forward to speeding up market introductions: ” We want healthcare institutions and their patients to benefit from our  ideas as quickly as possible. We can now focus on bringing our innovative products to market even faster.”

All questions related to the Nucletron or Isodose Control solutions, such as product or price information, maintenance or user-related questions should now be addressed to the Nucletron staff. They are dedicated to support you with any question you may have. Please contact your nearest Nucletron representative for more information.

About Nucletron
Nucletron is a global leader in Radiation Oncology, working with clinical teams to realize innovative solutions that improve patient care. Nucletron strives to offer the best possible choice of radiation modalities through integrated products, software and services. Critical to the Nucletron philosophy is the establishment of close working relationships with individual clinical teams – reconfiguring traditional boundaries between customer and solution provider. Many Nucletron employees have clinical experience delivering oncology care, providing an in-depth understanding of the complex needs of clinicians.

To read more click to download this PDF file (300k)

Nucletron contact details:

Office - 01829 77111 DDI - 01829 773944

Fax - 01829 770979

Email - kathryn.edwards@uk.nucletron.com

Web www.nucletron.com

Bristol Team Pioneers HDR Brachytherapy Treatment That Enables Prostate Cancer Patients to Avoid Overnight Hospital Stay

A leading provincial cancer hospital is one of the first in Europe to deliver two high dose rate (HDR) prostate brachytherapy radiotherapy treatments in the same day. The procedure at Bristol Oncology Centre using Varian’s GammaMed® HDR afterloader and BrachyVision™ planning software often avoids the need for an uncomfortable overnight hospital stay for patients.

HDR brachytherapy involves using needles or catheters to place a radiation source directly within the tumor. These needles are positioned within the tumor using images, treatment planning software, and a computer-controlled device called an afterloader. To maximize accuracy, the needles generally remain in position until all treatment sessions are completed.

Dr Amit Bahl, senior oncologist at Bristol Oncology Centre, said, “When we first introduced brachytherapy treatments we used the standard procedure of delivering the first treatment on the first day and the second treatment a day later. This meant the patient would have to spend the night in hospital with the needles in place. By doing iton a single day, it is beneficial for patient comfort, it enables us to treat more patients and it is helping the NHS by freeing up bed space.

“As well as making it much more comfortable for the patient, there is less chance for needle motion and it reduces the potential for the prostate becoming swollen, as tends to happen 24 hours after the needles have been inserted.”

Dr Bahl said this innovative process has only been made possible thanks to the agreement and dedication of the entire clinical team. “It requires a lot of commitment from the entire team of oncologists, physicists, dosimetrists and radiotherapy nurses,” he says. “We are lucky here at Bristol because all our people strongly believe in this approach.

“It works like clockwork and the team feels very happy. It is extremely fulfilling to complete the treatment by the end of the day, take the needles out and ensure that the patient has a much better night’s sleep. If the patient lives nearby, he can go home that same day.”

HDR brachytherapy patients require at least six hours between treatment sessions to enable the body to recover. The team at Bristol treat two patients every other Monday using this process. Patients are normally suffering from locally advanced prostate cancer and they receive brachytherapy as a boost prior to receiving a full course of external beam radiotherapy.

Pic: Brachyvision 3D view of isodoses

Bristol Oncology Centre, which serves 2.4 million people in the Avon, Somerset and Wiltshire region, has been treating clinically using a Varian GammaMedafterloader since 2005. The device is used in combination with BrachyVision treatment planning software, which enables clinicians to plan treatments by combining and using MRI, CT and 3-D scans for the best possible images of the tumor and surrounding organs.

Contact Neil.Madle@Varian.com for more information

Transperineal solutions for the modern practitioner

Brachytherapy | Focal Therapy | Cryotherapy | Perineal Access | Biopsy

Complete Solutions from SeeDOS Ltd, 3D Prostate Mapping

Three-dimensional mapping has evolved so physicians are now routinely obtaining between20-80 biopsies, depending on the size of the prostate. These biopsies are obtainedtransperinealy, between the scrotum and rectum, using the same approach used inbrachytherapy and cryoablation. Information from these biopsies can be used to create avirtual 3D map of the prostate identifying the location and extent of the cancer. While this procedure was initially intended to help with the diagnosis of prostate cancer, 3D mappinghas recently extended to include patients in all stages of diagnosis and treatment.

The purpose of 3D Mapping:To provide a means for comprehensive biopsy of the entire prostate using a systematic and reproducible technique that advances the diagnosis and treatment of prostate cancer. Thebenefitof this approach to prostate biopsy is that it is a safe and effective technique for detecting prostate cancer in high-risk patients whose cancer has been missed or is not detectable by standard transrectal methods.

The latest SeeDOS AccuCARE 3D Mapping solution simplifies the 3DPM process by providing sterile specimen placemats and matching labels for pathology jars. This provides operating room personnel with a systematic manner of cataloguing biopsy cores as they are taken. The map has each prostate section divided into three zones. Due to the larger number of cores drawn, seven placemats are provided in this case.

Features:

• Increases organization and efficiency for 3D Prostate Mapping ( 3DPM ) procedures

• Placemats are made with Tyvek

3D Mapping Template

SeeDOS offers an array of steppers / stabilizers / templates to meet your requirements in LDR brachytherapy, HDR brachytherapy, other therapies and prostate biopsy. Stabilizers provide a base foryour Stepper and have versatile mounting configurations to help you achieve your goals.

Freehand Manipulation : SeeDOS AccuCARE stabilizers are fixation devices which allow physicians to manipulate the ultrasound transducer and lock instantly in any desirable position.

Independent Micro-Adjustment :SeeDOSAccuCARE stabilizers allow for precise and independent micro-adjustment in every plane and every axis to attain an ideal orientation and starting position.

Versatility and Flexibility : SeeDOSAccuCARE stabilizers will adapt toany perineal procedure requiring ultrasound guidance.

Micro-Touch®(Dual-Sided Table Mount)

The Micro-Touch features stable single-arm fixation with a single-point locking mechanism to instantly fix the stabilizer in the desired position. An adjustable weight-assist feature allows users to achieve a “zero gravity” feel to the entire system.

Features
• Rapid fixation and locking with single knob turn
• Zero gravity feel with unique weight compensator
• Precise, in vivo probe adjustment of pitch, yaw, and roll
• Intuitive design suggests a short learning curve for the clinician and staff
• Unique roller stand for transport included

Micro-Touch® LP(Single-Sided Table Mount)

The Micro-Touch LP (Low Profile) is specifically designed for use on cystoscopy tables with a fixed fluoroscopy/x-ray gantry. The Micro-Touch LP attaches to tables, opposite the gantry, and allows users to perform simultaneous fluoroscopy/x-ray and seed implantation while retaining the remarkable versatility of the Micro-Touch ultrasound platform and needle guidance system.

Features:
• Rapid fixation and locking with single knob turn
• Zero gravity feel with unique weight compensator
• Precise, in vivo probe adjustment of pitch, yaw, and roll
• Intuitive design suggests a short learning curve for the clinician and staff
• Quick-connect mounting system
• Unique roller stand for transport included
• Also ideal for cryotherapy

Multi-Purpose Workstation™

For Use During 3D Mapping, Fiducial Marker Placement, Transvaginal, Transrectal and Transperineal Procedures.

The Multi-Purpose Workstation is ideally suited for genitourinary procedures where a stable platform is required. The Workstation features a single-point locking mechanism to rapidly and easily lock the stabilizer position without transducer migration. The Workstation’s wheels and adjustable height provide easy transportation, set-up, and storage.

Features:
• Floor stand offers versatility for any clinical setting
• Flexibility and precise positioning guaranteed with single-point locking mechanism
• Fine height adjustment with convenient

Multi-Purpose Workstation™LP

For Use During 3D Mapping, Fiducial Marker Placement, Transvaginal, Transrectal and Transperineal Procedures.

The Multi-Purpose Workstation LP is designed for use in hospital, outpatient, and urology clinic settings. The Workstation attaches to table rails on the right side and allows users to perform diagnostic and therapeutic genitourinary procedures.

Features:

SeeDOS AccuCARE EXII Stepper®

The EXII Stepper features a top-loading cradle and an adjustable stepper positioning reference scale. The EXII Stepper has a digital backlit monitor with an easy-to-read display which tracks the position of the transducer during the procedure. It features a serial data output port for connecting to the planning and treatment software. This stepper is ideal for use in LDR or HDR prostate brachytherapy.

Features:
• Incremental X and Y fine adjustment of grid to achieve precise needle path control and verification
• Allows user to set the visualized zero retraction plane at zero on a reference scale
• Selection of continuous or 5mm step positions
• Works with Varian’s Variseed planning and treatment software

Classic Stepper

The Classic Stepper is a lightweight precision stepping device. The Stepper’s modular design is adaptable to a variety of transrectal transducers. The Classic Stepper features a secure centreline detent featuring 45 degree clockwise and counter-clockwise rotation with easy-to-read marking scales from either side.This stepper is ideal for use in prostate biopsy mapping.

Features:
• Precise needle path control and verification using fine adjustment feature
• Transducer rotation out of the Stepper without loss of orientation
• Grid independently moves from a convenient backside location

A range of disposables including template grids, drapes and adjustable stand-offs are provided as part of the product range.

Disposable Template Grids

Disposable template grids are for use during prostate brachytherapy, fiducial placement and 3D Pathologic mapping of the prostate. Template grids consist of rows and columns of holes spaced 5mm apart, providing accurate placement of radioactive seeds or biopsy needles in predefined areas of the prostate. The single-use grid is sterile and is a cost-effective solution in an infection controlled environment.

Features:
• Sterile, single-use grid eliminates the cumbersome cleaning and reprocessing of reusable grids
• Easy identification and insertion of 17 or 18 GA instruments
• Bold, “low light” graphics and precision hole alignment
• Exclusive adaptors allow a retrofit to any manufacturer’s stabilizer

Latex-free Endocavity Balloon

The Endocavity Balloon provides a unique, adjustable interface control for the ultrasound probe. It allows a raising or lowering of the prostate to achieve the optimal image within the visual field and ensures the entire prostate is accessible within the grid. Also, it fills the anterior rectal space without distorting the prostate contour.

Features:
• Small insertion profile for snug fit to endocavity transducers, minimizing patient discomfort
• Adjustable inflation control to maximize user control over prostate position
• Assures gland positioning within the grid and at an optimal focal length to enhance ultrasound image

Sterile Drape

The drape provides a protective barrier for AccuCARE™ products, including Stabilizers and Positioners, during implant procedures.

Features:
• Sterile, single-use disposable drape
• Latex-free, transparent material
• Cost-effective, protective barrier offers expanded sterile field

More details about these solutions are available from SeeDOS Ltd or contact enquiries@seedos.com

To review other SeeDOS product areas please go to the SeeDOS website at www.seedos.com

Colin S Walters, Director, SeeDOS Ltd, Tel: +44 (0) 1525 850670 Fax: +44 (0) 1525 850685

New software set to transform cancer prognosis from medical images and used in Prostate cancer treatment

Researchers from the University of Sussex, UK, have developed groundbreaking new software that can produce prognostic information from diagnostic body images of cancer patients.

Now, the hunt is on for commercial backers and advanced clinical trial funders for TexRAD.  The new imaging software provides clinicians with vital additional information from scans, including biomarkers for risk stratification to more accurately predict the patient’s treatment outcome. Large-scale clinical trials will help bring to market a major new tool in the radiologist’s armory.

TexRAD is being developed by the Brighton and Sussex Medical School and in collaboration with clinicians at other locations including Dr Vicky Goh, Consultant Radiologist at Mount Vernon Hospital, Northwood, UK, said: "TexRAD provides unique tumor information, which in addition to standard morphological assessment, could improve therapeutic assessment in renal cancer treated with tyrosine kinase inhibitors. The preliminary results are encouraging for its use as a predictive biomarker in this clinical context."

Dr Olga Strukowska, Consultant Radiologist of the Western Sussex Hospitals

Trust, Worthing said: "The preliminary TexRAD results were impressive: I was able to identify an invasive breast cancer focus within larger area of pre-operative, non-invasive disease. This information, used in addition to standard morphological assessment, could assist clinicians in treatment planning and optimal selection for sentinel node biopsy, and potentially minimize the number of two-step breast surgery, which is undertaken whenever an invasive disease is established, not before final histology.

TexRAD is an important development because it derives ‘textures’ from routine diagnostic images and highlights anomalies not apparent to the human eye.  From these anomalies the software generates a risk stratification report and can even be used retrospectively on old scan data.  TexRAD currently analyses CT images of colorectal, lung, renal and prostate cancers as well as Mammography for breast cancer.

TexRAD’s creator, Dr Balaji Ganeshan of the University of Sussex, highlighted the cost benefits of the technology, saying: “TexRAD can be integrated easily within existing hospital imaging systems without the need for any hardware modifications.”

The software can extract and quantify ‘hidden’ information from existing scans (CT, MRI, etc.) thereby increasing considerably the depth of information given by radiological images.  Professor Ken Miles of BSMS, consultant radiologist and TexRAD clinical advisor, said: “TexRAD assists clinical decision-making by predicting the risk of disease and assessing the prognosis for cancer patients.”

To find out more about TexRAD contact Dr. Ian Carter, Director of Research and Enterprise at University of Sussex, on i.carter@sussex.ac.uk 

University of Sussex Press Office, m. 07740099325e. Danielle.treanor@sussex.ac.uk

MU Check from Oncology Data Systems can provide an independent dose calculation program for Brachytherapy along with IMRT, Cyberknife, GammaKnife and many other Radiotherapy treatments. Click on www.Mucheck.com for more information or contact Vince@mucheck.com

Varian International news

1. Cancer Patients Gain Greater Access to Intensity Modulated Proton Therapy Treatments at Leading German Clinic

Varian Medical Systems Commissions Additional Treatment Gantry at Rinecker Proton Therapy Center  

Munich, Germany, January 19^th 2010 –The Rinecker Proton Therapy Center (RPTC) in Munich has doubled its capacity with the successful commissioning of a second treatment room that will enable it to deliver intensity modulated proton therapy using pencil-beam scanning technology from Varian Medical Systems (NYSE: VAR) of Palo Alto, Calif.

To read more click here ... (ms word document)

2. UK Cancer Network Implements Varian’s ARIA™ for Electronic Prescribing and Comprehensive Electronic Patient Records

Oxford, England, January 12^th 2010 --A chemotherapy software solution that enables patients to become more involved in managing their own care has been successfully rolled out across a network of hospitals in the UK. The Thames Valley Cancer Network has implemented Aria for Medical Oncology™ from Varian Medical Systems (NYSE: VAR) and already has more than 850 clinical staff routinely using the system.  

To read more click here ...(ms word document)

3. Varian Medical Systems Accredits Royal North Shore Hospital as Australia’s First Image-Guided Radiotherapy School

Leading Sydney Cancer Hospital to Host Events Teaching Advanced Radiotherapy Techniques to Increase Precision

Sydney, Australia, January 21^st 2010 --The Radiation Oncology Department at Royal North Shore Hospital in Sydney has become the first in Australia to be formally accredited by Varian Medical Systems (NYSE: VAR), the world leader in radiotherapy, as a teaching facility for image-guided radiotherapy (IGRT). The hospital will hold four IGRT courses in 2010 and there are plans to extend this accreditation to other advanced techniques such as intensity-modulated radiotherapy (IMRT) and RapidArc® in the future. 

To read more click here ...(ms word document)

Sheffield Hallam News…

Sheffield Hallam University has announced and now published details for this years

Radiotherapy conference to be held on the 9^th and 10^th of October 2010 called

”Radiotherapy in Practice 5/Advanced Practice 2 - joint conference”

Click for Details or contact d.eddy@shu.ac.uk directly.

CancerPartnersUK at Elstree

Affiliated with BUSHEY SPIRE, HERTFORDSHIRE

LEAD POSTS – Centre Manager, Lead Physicist, Lead Dosimetrist

Radiographers (senior + junior), Radiotherapy Nurse and Administration Staff

Click on this link for more information or to download a job application form

http://www.radpro.org.uk/employment.php

www.CompareRad.com allows you to find out about Radiology and Radiotherapy equipment at a convenient, one-stop shop. Our partner companies will reply to your request for product information within 24 hours.

For International Radiology Jobs, click here to enter the International Radiology Job Pages.

weblink: http://www.radpro.org.uk/jobs_radiology.html

March 2010. What will the Linear Accelerator look like in the future? A major feature edition! Please don’t miss this one! There will also be a second feature on how all other radiotherapy equipment keeps up with the advances in treatment delivery systems

April 2010 International Recruitment in Radiotherapy, a major feature edition

May 2010 Radiotherapy company international website review! We publish your website details and a weblink to some important “news or special feature items” on it and our readers simply click to be taken there…simple but very effective!

June 2010 Immobilisation in Radiotherapy, featuring advances in thermoplastics, frames, carbon fibre systems and other treatment accessories

July 2010 Radiation protection, shielding and QA in Radiotherapy special feature

August 2010 ESTRO 29 Barcelona, 12th to 16th September 2010. A manufacturers exhibition and congress special preview edition

September 2010 Your choice of feature subject, just email us with your suggestions!

Please send you editorial, corporate or clinical, suggestions and any questions to admin@RadPro.eu

Duncan Hynd, February 2010

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