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
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."