Adaptive Radiation Therapy Accelerator Provides Multiple Imaging Modalities Protocols

A new radiotherapy system is a linear accelerator engineered specifically for adaptive radiation therapy (ART). Unique in design, the system is an integrated imaging and workflow solution that provides a comprehensive range of image-guided and advanced treatment delivery protocols, including in-room computed tomography (CT) imaging capabilities, and a new multileaf collimator, 160 MLC.

Siemens Healthcare (Erlangen, Germany) presented its latest technologies at the 50th annual meeting of the American Association of Physicists in Medicine (AAPM) in Houston, TX, USA, July 27-31, 2008. The system, called Artiste, offers clinicians multiple imaging modalities. From megavoltage (MV) to gold standard, in-room CT imaging, clinicians can select the optimal imaging application for their treatment approach. Siemens MVision Cone Beam Imaging Package provides remarkable soft-tissue contrast, especially in challenging cases, such as imaging prostheses and with large patients. The CTVision CT-on-rails System provides in-room, diagnostic quality imaging; thus opening up opportunities to implement benchmark concepts, such as daily re-planning.

"Artiste's design incorporates an array of proven components that reinforces clinicians' confidence in adapting protocols for each patient,” said Holger Schmidt, chief executive officer, Oncology Care Systems, Siemens Medical Solutions USA, Inc. "With Artiste, IMRT can be delivered within five minutes in most cases.”

For precise patient positioning, the 550 TxT treatment table meets the growing demand for accuracy and stability, while providing the mechanical strength to accommodate a patient weight capacity of up to 250 kg. Recently, Artiste has gone clinical in four of the most prominent cancer centers around the world: MAASTRO Clinic in the Netherlands; German Cancer Research Center (DKFZ; Heidelberg, Germany); St. Vincent's Private Hospital (Sydney, Australia); and Baton Rouge General's Pennington Cancer Center (LA, USA).

Also being demonstrated at the Siemens booth is syngo VSim, a virtual simulation of radiotherapy treatment planning. syngo VSim supports target and critical structure delineation with isocenter localization; accurately models all structures, radiation beams and linear accelerator parameters; and produces high-quality digital reconstructed radiographs (DRRs), multiplanar reconstructions (MPRs), MIPs (million instructions per second), and shaded surface displays to optimize the clinical process.

With a flexible implementation, syngo VSim software can be accessed at the CT acquisition console or at post-processing workstations. The simulation tool also provides motion management solutions, such as multiple triggering device support and four-dimensional (4D) contouring tools. All these advanced applications support the state-of-the-art Sensation Open platform, Siemens leading edge offering for CT simulation.

Syngo TrueD, a Siemens-exclusive multimodality software solution accelerates the cancer management workflow and offers high-quality biological therapy response assessment. Syngo TrueD also enables physicians to efficiently compare patient scans from up to three different time points (e.g., pre- and post-therapy). By automatically registering and displaying positron emission tomography (PET)/CT, single photon emission computed tomography (SPECT)/CT, CT, or magnetic resonance (MR) images from studies acquired at different times, this advanced application assists physicians in making better informed therapy and follow-up decisions.

Further enhancing ease of use for Artiste is Siemens' comprehensive software solution, syngo Suite for Oncology; a workflow platform, providing scalable workspaces that enable clinical team members to access data, patient information, and images as needed. The suite also includes: (1) syngo MultiModality Workplace, which provides multi-modality imaging solutions in one workplace and uses treatment response evaluation application. (2) Syngo RT Oncologist, which provides tailored physician tool sets and integrates cutting-edge 2D/3D IGRT treatment review tools. (The Coherence range of Oncology workspaces are currently being rebranded to syngo Suite for Oncology. Syngo RT Oncologist may be purchased under the Coherence brand name.) (3) Syngo RT Therapist, which employs MVision technology for 3D image-guided automated patient positioning, and adaptive targeting for IGRT operations for image registration and offset calculation.

Morever, exclusively distributed by Siemens will be the ImageGrid Archive Appliance, which supports ever-increasing storage needs for Digital Imaging and Communications in Medicine (DICOM) RT objects and is ideal for storing treatment plans, contours, treatment reports or any other RT specific objects.

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