AK IMRT Würzburg - UKE · S. Tarte, J. McClelland, J. Blackall, D. Landau and D. Hawkes. A Non...

Roland Kramer AK IMRT Würzburg 26./27.03.2009

AK IMRT Würzburg

26./27.03.2009

Roland Kramer, Conmedica GmbH, Schriesheim


AK IMRT Würzburg

26./27.03.2009

Roland Kramer, Conmedica GmbH, Schriesheim

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OVERVIEW

Company Background

AlignRT®

GateCT® and GateRT®

International Collaboration

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COMPANY BACKROUND

Vision RT Ltd

Founded in 2001 (UK based)

Highly innovative R&D team

Key focus: Radiation Therapy

Clinical/Development Collaborations

Leading International Institutions

GateCT®, GateRT®

Products newly released

AlignRT® CE marked

September 2005

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THE NEED FOR 3D PATIENT TRACKING

Influence of anatomy on tumour shape

Arm position and breast

Patient Breathing

Adjacent critical organs at risk

Patient Setup

Unnecessary Irradiation in certain anatomical sites

Breast

Interdependence of adjacent targets

Head, Neck and shoulders

Patient Movement

Introduction of systematic error – geographic miss

Surface shape change

Critical with proton treatment - overshoots and undershoots

Treatment Delivery

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PRODUCT OVERVIEW 6


STATE OF THE ART IN3D PATIENT TRACKING

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PRODUCT OVERVIEW 8


PRODUCT OVERVIEW 9


PRODUCT OVERVIEW

Patient Setup

Surveillance

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0


PATIENT SETUP

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SURVEILLANCE

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PATIENT SETUP: CLINICAL WORKFLOW 13


SURVEILLANCE : CLINICAL RATIONALE

Where is the patient?

During Imaging

During Treatment Delivery

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SURVEILLANCE : COLOUR MAPPING 15


DECOUPLING BREATHING AND MOVEMT16


17BREAST TREATMENT


18BREAST TREATMENT

C. Bert et al. Clinical experience with a 3D surface patient setup system for alignment of partial-breast irradiation patients. International J. of Radiation Oncology Biology Physics: 64(4), pp. 1265-1274, March


19BREAST TREATMENT



20BREAST TREATMENT



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MARKERLESS SURFACE TRACKING

THE POTENTIAL

3D surface provides reference for repositioning;

Multiple points or a region of surface may be tracked

Points/region for tracking may be selected remotely, and repeatedly

from fraction to fraction

Multiple parameters may be derived from real time surface data from

which phase and amplitude may be extracted

Provides the potential for more precise modelling of internal motion

Works in progress.

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CLINICAL WORKFLOW

PATIENT SETUP

SURVEILLANCERESPIRATORY

GATING

PATIENT MOVES

4D PLANNING

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INTERNATIONAL COLLABORATION

Royal Marsden

Hospital

Fulham Road

London, UK

Institute Curie

Paris, France

DKFZ

Heidelberg,

Germany

Norrlands

University

Hospital

Umeå, Sweden

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INTERNATIONAL COLLABORATION

Massachusetts

General

Hospital,

Boston, MA, US

Mallinckrodt

Institute of

Radiology

St Louis, MO, US

University of

Florida

Gainesville and

Jacksonville,

FL, US

UC Davis

Hospital

Sacramento,

CA, US

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SCIENTIFIC PUBLICATIONS

D.P. Gierga, J.C. Turcotte, M. Riboldi, G.C. Sharp, S.B. Jiang, G.T.Y. Chen. Comparison

of Target Registration Errors for Multiple Modalities in Image-Guided Partial Breast

Irradiation. International Journal of Radiation Oncology Biology Physics: 66(3): S103-4.

November 2006.

S. Tarte, J. McClelland, J. Blackall, D. Landau and D. Hawkes. A Non Contact Method

for the Acquisition of Breathing Signals that Enable Distinction Between Abdominal

and Thoracic Breathing. Radiotherapy and Oncology: 81(1): S209, October 2006.

P. Schoeffel, W. Harms and C.P. Karger. Evaluation of Repositioning Accuracy of

Patients with Breast Cancer Using a 3D Surface Imaging System. Radiotherapy and

Oncology: 81(1):S195, October 2006.

C. Bert, K.G. Metheany, K.P. Doppke, A.G. Taghian, S.N. Powell, G.T.Y. Chen. Clinical

experience with a 3D surface patient setup system for alignment of partial-breast

irradiation patients. International Journal of Radiation Oncology Biology Physics: 64(4),

pp. 1265-1274, March 2006.

Christoph Bert, Katherine G. Metheany, Karen Doppke, George T. Y. Chen. A phantom

evaluation of a stereo-vision surface imaging system for radiotherapy patient setup.

Med. Phys. 32(9), pp. 2753-2762, Sep 2005.

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SUMMARY

TECHNICAL ADVANTAGES

Markerless and non-invasive

Can be used online and remotely

Images entire 3D surface

Analysis of multiple regions of interest

Auto patient correction

No ionizing radiation

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Enables 4D CT reconstruction

SUMMARY

CLINICAL ADVANTAGES

Allows interactive correction of non rigid anatomy

Real time surveillance

Respiratory gated imaging and delivery

Real time surface tracking

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Vielen Dank für Ihre Aufmerksamkeit.

AK IMRT Würzburg - UKE · S. Tarte, J. McClelland, J. Blackall, D. Landau and D. Hawkes. A Non...

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