Imaging Technology News 9/08

> > special report SBRT continued from page 28 research. As the technology is so new, the field lacks critical information on dose fraction schemes that will optimize tumor control while maintaining morbidity at acceptable levels. Rigorous institutional study can address both the technological and clinical challenges inherent in SBRT, and determine the best specialized training for physicists, physicians and technicians. “It’s not rational for every hospital in a major metropolitan area to do liver transplants, for example,” said Solberg. “But with new radiotherapy technologies, centers can feel pressured into adopting new procedures, to jump on board as soon as possible to remain competitive and financially secure. The radiation oncology community must approach new modalities like SBRT slowly and rationally. Use of SBRT should start in centers of excellence who do the initial work and train future practitioners.” With research and establishment of best practices in SBRT in process, including several studies at Solberg’s facility, areas of possible use for the system are adding up. Oncologists are eying SBRT as a potential boon for tumors, metastases, sarcomas and more in areas like the spine, lung, pancreas, liver, prostate and the musculoskeletal system. SBRT tools SBRT technology is so far led by a partnership between two key companies, Varian Medical Systems, a manufacturer of oncological radiotherapy options, and BrainLAB, a producer of medical technology and image-guided systems. The result of the partnership is the NovalisTX. The NovalisTX’s beams are designed for delivering doses over 60 percent faster than conventional tools. Radiation delivery is guided by an advanced set of imaging options, including stereo X-ray 6D targeting, cone-beam CT and fluoroscopy. Proper patient positioning is achieved through adaptive gating and a robotic couch correction. Radiation is delivered through a high-definition multileaf collimator to shape treatment to specific tumors and placement. The NovalisTX promises flexibility, enhanced functionality, improved patient care and increased numbers of treated patients. “In terms of our technological platform, Novalis offers no compromises,” said Huntzinger. The array of tools the system offers a medical team includes localization, treatment planning and dose sculpting. SBRT may also impart economic benefits, as fewer treatment sessions, more effective and less damaging dose delivery and faster patient recovery translate into decreased overall cost. With careful study and testing, and the advent of highly advanced tools like the NovalisTX, the future looks bright for SBRT. “In the short term, caution with SBRT is key, and use should start with specialized centers, with rigorous programs for training new practitioners," said Solberg. "SBRT represents a profound paradigm shift for radiation oncology, with broader implications over the entire healthcare continuum, so in the long term, there will be widespread adoption of SBRT throughout the oncology community.” < multidisciplinary team to care for the cancer patient, which is beneficial.” A dedicated ambulance team transports hospital inpatients to the center, which is located next to a hotel that can serve as a convenient stop for out-of-town patients and their families and friends. BCCC ROC clearly grasps a fundamental understanding of patient satisfaction and customer service. “It takes a team, individually and collectively, that is committed to providing customer-focused care,” McGraner emphasized. “Committed is the key word. It takes a team of individuals to excel at patient satisfaction – from the secretary at the front desk who smiles and greets the patient, to the therapists and nurses who daily provide warm and compassionate care to the patients, to the physicians who take the time to address the patients’ needs, and to all those working behind the scenes to make sure all systems are working. “Our team members meet one on one with the patients to welcome them to our care setting and provide the appropriate education,” she continued. “It is our goal that we understand their expectations and take the time to listen. Our team members understand the patients’ expectations, and, anticipate them. Every staff member is accountable for providing the necessary education, allowing time to reinforce any issues that the patient may feel remains unresolved.” Staff provide educational and support programs, and personally provide flowers, cards, treats and gifts for a variety of special programs and holidays; music and art therapy also are offered; and blankets are kept warm to wrap around or lay over a patient. When a patient completes a therapy course, the staff award him or her with a “congratulations certificate” signed by all. “Simply put, patient satisfaction occurs when everyone merely remembers the golden rule, educates the patients, keeps the patient informed and follows through on every step,” McGraner said. “It truly makes one proud when you watch your team celebrate patient birthdays, or help patients with their wigs or dress – just because they care. [At the time of the interview] All of our teams were excited as the wife of a young male patient of ours gave birth. He kept in touch with our team during labor and after delivery – not to communicate his appointment time, but because our staff was celebrating with him and his family!” McGraner emphasized the ROC Jea Lee, M.D., Karen McGraner, director, BCCC team’s dedication to provide a patient-centered environment, serving patients “each and every day straight from their hearts – just like the Tin Man in the Wizard of Oz,” she said. “They practice the appropriate distance from our patients, necessary to provide accurate care, but know how to touch their spirit and emotions to help them with the Nursing team (left to right): Carolyn Carter, R.N., Cathy Wright, R.N., Rita challenges of their diseases.” Furthermore, she noted how Chenault, head nurse empowered the team became during the last year. “They were not only a part of every decision during all of our transitions this past year, but they were the solution,” she said. “Because of shared values within the complete team a new sense of trust, caring and respect among all staff empowered everyone. As we built our ARIA EMR, as we anticipated planning methods for new techniques, as we practiced new techniques with dry runs, our staff themselves grew in their individual roles/professions. We had champions within our team, working to complete and fit all of the pieces of the new puzzle together. For example, Medical Physicist Kevin Bronson clearly was integral to the process, working with the software to verify accuracy, while also working with the staff to implement the new techniques. Several members of our therapy team and office teams worked to complete a database conversion. “We have evidenced decreased wait times, decreased treatment times, decreased planning times and increased efficiencies, increased employee satisfaction, and a new sense of renewed self-worth and contribution at every step of our processes as a result of our team’s direct engagement,” she continued. Accountability helps to drive the process, according to McGraner. “We continue to analyze strategic objectives and evaluate the needs of our patients, our technology, new services to adopt, the environment and our competition on an ongoing basis,” she said. “Our organization holds all employees to be good stewards of its resources – patients, staff, operations, processes, productivity and supplies. Standards are set to plan and monitor our investment, ongoing expenses and ROI. During all meetings, for management or staff, we all follow the strategy to communicate new issues, but patient volumes, productivity, quality improvement and patient satisfaction are always addressed – all key to financial well-being.” special report > 31 http://new.reillycomm.com/imaging/special-report-b.php

Table of Contents Feed for the Digital Edition of Imaging Technology News 9/08

Imaging Technology News 9/08 Contents IGRT How IGRT Targets the Prostate ASTRO Oncology Information Management Systems (OIMS) Imaging Leading the Intense Race Against Cancer SBRT - The New Treatment of Choice Top IMRT/IGRT Centers to Watch Molecular Imaging: Ready for the Limelight CR or DR in the ER? Have You Hit the Glass Ceiling?

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