Health Imaging & IT - October 2007 - (Page 32) special section: Oncology Imaging the technology for the greatest impact on patient care. “These new technologies consume a lot of resources. We can show people how to bring IGRT into their clinic and use it in a resource-efficient manner,” Mehta says. He and his team have a long track record of bringing doctors in from across the country who want to learn in a practical, hands-on approach. “People hear about promise but they really want to talk to someone who’s used it, find out whether it will work in their situation and what we have learned to make it an effective solution.” understanding daily changes William Russell, MD, medical director of the Baton Rouge General Radiation Oncology Center in Baton Rouge, La., has been using IGRT with ultrasound technology for five years. “We have progressed to using IGRT with megavoltage cone beam technology” from Siemens Medical Solutions, he says. “The ‘holy grail’ of radiation oncology is to destroy cancer without any destruction of normal tissue. For structures with very defined borders, IMRT really added a lot,” Russell says. “IMRT allowed us to treat unusually shaped objects. Instead of treating a tennis ball, we could treat just the shell of a tennis ball. It gave us opportunities to sculpt and shape dose. That’s the real appeal of IMRT.” The ability to target and understand daily changes with cone beam technology has greatly moved radiation oncology forward, says Russell. “It has changed our ability to apply this technology.” However, there starts to become other issues such as not interfraction, but intrafraction. “If you take a long time to go through the process of targeted treatment delivery, you’ve still lost your advantage. Between the time when you started and ended, you may have lost your target.” Russell says that plenty of researchers The team at Swedish Cancer Institute in Seattle uses the Elekta Synergy for IG-IMRT and shares its three years of experience with a variety of visitors who come to learn how to use the technology more efficiently and effectively. have demonstrated that targets deform with normal organ function and breathing. The challenge that came along with IG-IMRT is to deliver treatment very quickly. “I’m very pleased with megavoltage cone beam technology. We can accomplish fairly complicated treatments in less than 10 minutes. Time becomes more and more important in sophisticated delivery mechanisms.” Now, in a matter of minutes, Russell can acquire a complete 3D structure. “This is very elegant software to match the planned target with the perceived target at the time of treatment. It’s IMRT on steroids, but it’s a very simple system to use. We really can achieve a lot of patient comfort and accuracy and minimal target motion during treatment itself.” in the future… IG-IMRT is still the future for 90 percent of the clinics out there, says Mehta. Next up is learning how to track changes and predict changes before they happen to a tumor, and then adapt the radiotherapy plan to be even more precise. Mundt, who works with Varian on developing new technologies, says that Varian is going to announce major new features at the American Society for Therapeutic Radiology and Oncology’s Annual Meeting in Los Angeles late this month. The changes, including imaging and delivery features, will be “really revolutionary,” he says. “This is really going to change a lot in how we treat patients. It’s really exciting.” Meanwhile, as physicians become comfortable with this and see the power of this technology, they will use it more and more often, says Russell. Broadband capability is going to allow much more seamless integration of multiclinic sites, he says. “I think that as the application of these technologies becomes more userfriendly that it is going to disseminate very rapidly through radiation oncology facilities in this country.” 32 O C T O B E R 2 0 07 | Health Imaging & IT HealthImaging.com http://HealthImaging.com
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