Stereotactic Body Radiation Enhancements Minimize Treatment Area Restrictions

New stereotactic body radiation therapy (SBRT) innovations are being used to tackle the most challenging SBRT and extracranial radiosurgery cases, including lung, head, and neck indications.

BrainLab (Munich, Germany), a global leader in stereotactic radiosurgery (SRS) and image-guided medical technology, reported that its technology for highly precise, targeted treatment planning and delivery for stereotactic body radiation therapy (SBRT) was presented during the ASTRO (American Society for Therapeutic Radiology and Oncology) 2008 annual meeting, in September 2008, in Boston, MA, USA.

IPlan Monte Carlo, iPlan Head & Neck Automatic Atlas Segmentation, ExacTrac Adaptive Gating, and ExacTrac Snap Verification are designed to expand treatment possibilities for SBRT and increase treatment options for clinicians. IPlan Monte Carlo and iPlan Head & Neck Automatic Atlas Segmentation treatment planning systems minimize treatment area restrictions, including time, system, modality, and software integration limitations.

IPlan Monte Carlo photon dose calculation provides highly accurate dose calculations for SBRT within seconds for highly precise treatment delivery to inhomogeneous regions such as the lung. The powerful speed and intuitive interface enables a broader treatment spectrum and use with every patient. Seamless integration allows for use with all major linear accelerators and multi-leaf collimator (MLC) types.

IPlan Head & Neck Automatic Atlas Segmentation provides fast, automatic contouring for more than 40 head and neck organs at risk. Consistent segmentation outcomes lead to more accurate treatment planning and eliminate the time-consuming process and inconsistent results of manual- or threshold-based segmentation. Head & Neck Automatic Atlas Segmentation generates results within two minutes, supporting frequent plan updates for adaptive RT.

ExacTrac is a leading image-guided radiation therapy (IGRT) choice among clinicians for tumor motion management. The room-based design of ExacTrac allows Snap Verification images to be taken at anytime whether the treatment beam is on or off and for any gantry and couch position. ExacTrac Snap Verification detects and compensates for random patient and internal tumor movement in real time. Snap Verification enables flexible intrafraction IGRT verification, including detection of mechanical inaccuracies from couch rotation for safe delivery of advanced SBRT protocols and frameless radiosurgery treatment. ExacTrac Adaptive Gating is a linac-based IGRT system that allows detecting and compensating breathing baseline shifts that occur with the patient's breathing pattern. ExacTrac Adaptive Gating and Snap Verification allow clinicians to confidently deliver highly precise, targeted treatment for SBRT.

"The intrafraction patient imaging and verification provided by ExacTrac Snap Verification allows us to track possible target motion throughout treatment and realign targeting during the treatment fraction if intrafraction tumor displacement is detected. We can now be certain that treatment is delivered precisely to the target throughout the entire fraction--giving us the confidence to escalate our doses and further reduce safety margins,” said Donna McCorkle, Chief Therapist, B.S.R.T.(T.), Hollywood Radiation Oncology (Hollywood, FL, USA).

BrainLab develops, manufactures, and markets software-driven medical technology that enables procedures that are more precise, less invasive, and less expensive than traditional treatments. Among the core products are image-guided systems that provide highly accurate real-time information used for navigation during surgical procedures. This utility has been further expanded to serve as a computer terminal for physicians to more effectively access and interpret diagnostic scans and other digital medical information for better informed decisions. BrainLab systems allow expansion from a single system to operating suites to digitally integrated hospitals covering all subspecialties

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