Diagnostic imaging  

Milan clinic first in Italy to offer image-guided radiotherapy

16 January 2006

Milan, Italy.  The Humanitas Clinic in Milan has become the first clinic in Italy to offer state-of-the-art image-guided radiotherapy treatments to patients with the installation of the country's first robotic On-Board Imager device from Varian Medical Systems.

The Clinic will use the new device for image-guided radiotherapy treatments for a range of cancers, including head/neck, prostate, upper abdominal and lung tumours. Dr Marta Scorsetti, chief physician at the private clinic, said, "The On-Board Imager device will enable us to lower margins around the tumour, spare more healthy tissue from exposure and increase the dose and therefore the effectiveness of the treatment."

The On Board Imager device is a new accessory that is designed to improve the precision and effectiveness of cancer treatments by giving doctors the ability to track and adjust for changes in tumour positions more accurately at the moment of treatment. Up to now, doctors have had to account for tumour motion by using broader beams that expose a significant margin of healthy tissue in the treatment area.

Using the On-Board Imager, doctors can generate X-ray images of the patient's tumour and compare them with CT scans and DRR (digitally reconstructed radiograph) images from the treatment plan to ensure that the patient's tumour is aligned with the beam immediately prior to treatment. This enables radiographers to verify the tumour location while the patient is in the treatment position, and automatically move the treatment couch to the correct position before delivering the daily treatment. The fully automated Varian system makes it possible for clinical staff to complete the advanced IGRT treatments within the normal patient schedule.

"The On-Board Imager is extremely helpful because it allows us to precisely and quickly check and correct the accuracy of our treatments and repeatedly verify and re-plan based on what we're seeing," said Dr Scorsetti.

As well as enabling treatments using IGRT, the On-Board Imager device will also provide the impetus for doctors at Humanitas will introduce IMRT (intensity-modulated radiotherapy) treatments in February. IMRT is a breakthrough radiotherapy process that enables clinicians to precisely target the radiation dose at the cancerous tumour while protecting surrounding healthy tissue, as well as automatically varying the dose strength to kill the tumour more effectively.

On-Board Imager and IGRT

Varian's On-Board Imager device is a digital imaging system mounted on the treatment machine via robotically controlled arms that operate along three axes of motion so that they can be positioned optimally for the best possible view of the tumour. This device produces high-resolution images of the area to be treated. In addition, it can track tumour motion to provide doctors with a clear indication of exactly how a tumour will move during treatment due to respiration or other repeatable physiological cycles.

"By using our robotically-controlled On-Board Imager device and control software to image and position the patient, doctors are treating cancer with the best of two critical technologies for IGRT," said Dow Wilson, president of Varian's Oncology Systems business. "We have combined two important technologies on one platform: low-dose, high-resolution, kilovoltage X-ray imaging and integrated software control of all treatment parameters. This enables improved, fast, cost-effective, automated treatments that are conducive to patient comfort."

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