Radiation Oncology & Radiation Therapy

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RSNA President David H. Hussey, MD, discussed the need for more collaboration between diagnostic radiologists and radiation oncologists during his opening address - and some exhibitors were already heeding that call. Hussey said that greater collaboration would lead to an end result of strengthening both fields and improving patient care, and radiation oncology vendors were ready to show how their products can improve diagnosis and treatment. Here are a variety of technology solutions from the exhibit show floor.

GE Healthcare's Evolution for Bone is a new suite of reconstruction tools for GE's Infinia with Xeleris functional imaging workstation for SPECT/CT bone imaging. Bone scintigraphy is one of the most frequently performed procedures in nuclear medicine to detect bone lesions. The importance of SPECT bone scintigraphy in improving lesion detection and specificity is well-established.

GE also showcased at RSNA its revolutionary Advantage 4D and Advantage SIM technology, fusing the capability of 4D imaging and planning to deliver the highest levels of precision and speed for radiotherapy. AdvantageSIM MD is the latest generation of industry-leading simulation and localization technology that takes motion management to the next level by seamlessly integrating 4D data into the planning process, and providing multi-modality/multi-phase simulation for the optimal use of state-of the art treatment methods, like IMRT and IGRT. The exclusive AdvantageSim MD multi-dimensional display presents a real-time view of the anatomy in motion giving radiation oncologists the ability to see the true shape of the tumor and critical structures, evaluate its full dynamic range of motion, and select a segment of the respiratory cycle for treatment that will offer the optimal benefit to the patient. Radiation oncologists can then export the selected phase to the treatment planning system.

By using multi-modality/multi-phase contouring tools, the AdvantageSim MD allows for simultaneous contouring of multiple data sets, including MR and PET, increasing the precision and speed of contour localization by eliminating the need for multiple contouring sessions. In addition, contours can be imported and superimposed over cine images in multiple planes-simultaneously, making it easier to confirm tumor motion and deformation relative to the Planning Target Volume. The auto-segmentation function automatically delineates critical organs and structures in 3D, improving the speed and accuracy of organ segmentation, for conventional treatment methods as well as newer 4D techniques.

Siemens Medical Solutions at RSNA displayed its PRIMATOM System, a multifunctional configuration consisting of a Siemens PRIMUS Linear Accelerator and a SOMATOM CT Scanner with Sliding Gantry. This technology brings image guidance to radiation treatment delivery, providing accurate, near real-time target localization within the treatment room. Access to a CT scanner within the therapy delivery room offers the oncologist the ability to obtain current information on the size, shape and location of the target volume and nearby critical organs. Since the patient is in a ready-for-treatment position during CT acquisition, the information can be applied immediately for improved treatment accuracy. The system allows for fast, 3D tumor localization prior to any treatment fraction, providing an opportunity to escalate dose, reduce complications, and evaluate therapeutic effectiveness of treatment, the company says. CT functionality in the treatment room provides diagnostic quality images with the patient in the actual treatment position, ensuring routine visualization of the tumor in order to check for anatomical movement. Having the CT scanner under the control of the therapy department can help to manage the scheduling and acquisition of patients' CT image data for simulation, planning and treatment purposes.

The BEAMVIEW TI Electronic Portal Imaging Device (BEAMVIEW TI EPID) is used to improve the quality of patient treatments by assuring accurate placement of the radiation beam, field alignment on the patient and any beam shaping devices. Digital images of the treatment port are captured and displayed throughout each fraction. Patient positioning errors made evident by the BEAMVIEW TI System may be corrected before continuing the treatment. BEAMVIEW TI adds Image Guided Radiation Therapy (IGRT) workflow benefits such as the ability to check accuracy of field placement