In May of this year, a research team at the University Medical Center Utrecht performed the first patient treatment using Elekta’s Unity, an MRI-guided radiotherapy system that integrates a diagnostic quality 1.5 T MR scanner with an advanced linear accelerator. Now the team has published details of the first four patient treatments, demonstrating the feasibility and clinical utility of the Unity MRI-linac (Phys. Med. Biol. 62 L41).
The Utrecht team treated four patients with lumbar spinal bone metastases, with a single fraction of 8 Gy prescribed to the target volume while minimizing dose to the spinal cord and the rest of the body. The treatments demonstrated the system’s ability to deliver precisely targeted radiation doses while simultaneously capturing the high-quality MR images that will allow clinicians to visualize tumours at any time, and adapt the treatment accordingly.
The MRI-linac at the University Medical Center Utrecht
The patients were treated with a 3- or 5-beam step-and shoot intensity-modulated radiotherapy (IMRT) plan. Plans were created while the patient was on the treatment table and based on the online 1.5T MR images, with the pre-treatment CT deformably registered to the online MRI to obtain Hounsfield values.
“These study results are very promising and we look forward to further advancing the clinical development of this transformative system, which has the potential to revolutionize the treatment of cancer,” said Bas Raaymakers, professor of experimental physics at UMCU. “These first clinical treatments show an outstanding level of dosimetric and geometric accuracy of the online IMRT planning and the radiation delivery based on the 1.5 T MRI guidance. This approach enables the optimization of dose to the tumour while reducing exposure of healthy tissue. To date, achieving this optimization has been the key challenge in radiation therapy.”
The team chose bone metastases as the first treatment site as these tumours can be clearly visualized on MRI while the surrounding spine bone can be detected on the integrated portal imager. In this way, portal images can be used to independently verify the MRI-based guidance and quantify the precision of radiation delivery.
They validated the geometric accuracy of online MRI guidance by comparing portal images of the IMRT segments with the MRI-based calculated projections. This revealed an average beam alignment of 0.3 mm with the target as defined on the online MRI, demonstrating the stereotactic geometric system accuracy. For each patient, the team performed the same quality assurance procedures for both the pre-treatment plan and the delivered plan, finding a mean difference of 0.4% of the calculated dose.
“These preliminary results are exciting and support the tremendous potential of Elekta’s MR-linac to address some of the historic challenges to improving the safety and efficacy of radiation therapy,” commented Kevin Brown, global vice-president of scientific research at Elekta. “The exceptional dosimetric and geometric accuracy reported in this study support the system as a transformative approach to radiation therapy that may allow more patients to receive optimum cancer care.”
There are several considerations to take into account when you’re servicing linear accelerators and maintaining radiation equipment. Linear accelerators and radiation equipment are critical and essential in any radiation oncology department but they are also quite expensive and complicated.
One of the biggest decisions to take into account is whether to rely on the Original Equipment Manufacturer (OEM) or to work with a servicing company whose main focus is servicing linear accelerators and maintaining radiation equipment.
While it may seem at first that the best cause of action would be to go with the OEM, there are several factors to consider alternative options such as:
Cost
Cost is a major factor to take into account and due to the complexity of servicing linear accelerators and maintaining radiation equipment; OEMs typically tend to charge a higher premium for service and maintenance.
Servicing companies on the other hand are able to offer a bundle of plans for you to choose from which can help to reduce costs, mitigate risk, or eliminate risk and protect your practice from unforeseen costs.
Focus of Service
The main business of OEMs is the manufacture and sale of equipment and equipment parts thus service and maintenance may not be the core of their business. With a servicing company whose main focus is servicing linear accelerators and maintaining radiation equipment, this facilitates greater efficiency and improved uptime.
Response time
The importance of medical equipment which underlies any medical facility is the optimal functioning of the equipment. Unforeseen machine breakdown can paralyze the operations of a practice. The speed at which medical equipment is returned to normal operating capacity is therefore critical.
For servicing companies, response times to servicing linear accelerators and maintaining radiation equipment is typically higher than OEMs since their services are structured to be available 24/7 with quick turnaround time for onsite responses.
Larger scope of operation
Most servicing companies have employed specialists and experts of different types of devices and brands so as to ensure effective servicing linear accelerators and maintaining radiation equipment. The service engineers are typically trained directly by the OEM manufacturers.
In addition, for practices that use different brands of oncology equipment, a servicing company is able to take care of the different requirements and specifications involved with servicing linear accelerators and maintaining radiation equipment in-house without involving different OEMS.
Flexible service contracts
Servicing companies are able to offer flexible service contracts which ensure comprehensive service for your oncology devices while controlling the service costs. Servicing companies are responsible for maintaining optimal uptime of the devices, carrying out scheduled maintenance and emergency repair service during the contract period.
The benefits of these flexible service contracts for servicing linear accelerators and maintaining radiation equipment include no charges for parts, effective cost control, scheduled preventive maintenance, no travel or call out charges, access to 24/7 support and optimal uptime guarantee for qualified devices. These flexible service contracts are therefore customized to meet the unique specifications and financial needs of your practice.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
There are several considerations to take into account when you are purchasing parts for radiation equipment including linear accelerators. Radiation equipment is critical and essential in running an oncology department and it is also quite costly and complicated.
One of the major decisions that you will need to make is whether to buy new or refurbished parts to repair and maintain your radiation department’s equipment. Refurbished linear accelerator parts are suited for both repairs and maintenance. The costs of replacement parts for radiation equipment are lower when purchasing refurbished parts. Refurbished equipment is ideal for medical companies that are starting out, purchasing additional pieces, research companies, veterinarians, and industrial purposes.
Advantages of Refurbished
Some of the reasons for buying refurbished linear accelerators and refurbished parts for radiation equipment include:
To Grow a Practice: Refurbished linear accelerator and refurbished parts free up resources and minimize costs as you upgrade your practice whether that involves opening a new center, a new treatment room, or spare equipment to have on hand.
Manage Expenses: Refurbished linear accelerators and refurbished parts help manage the risk of investing in costly new equipment during turbulent periods and help you stay afloat in times of financial constraints.
Flexibility: Refurbished linear accelerators and refurbished parts provide you the flexibility of having a backup system that you can fall back on when your existing system develops a problem.
What To Think about when Purchasing
There are many factors to consider when buying radiation equipment and parts for linear accelerators, CT scanners and other oncology equipment.
Proper Planning – There are several factors that go into the planning aspect as you make your buying decision. You need to identify and understand what your clinical goals are and what type of technology you will require delivering quality service. Factors to consider include whether you plan on going fully digital to the type of defined treatment field you want to achieve.
Site planning requirements is another factor to consider because installation of linear accelerator parts for radiation equipment requires important considerations such as room dimensions, power, local permits, water supply and future equipment technology.
The timeline for completing your project is critical for planning and executing milestones such as installation dates, equipment acceptance testing dates and going live with the linear accelerator parts. It is important to factor in some level of flexibility in your project timeline so as to account for unforeseen developments and challenges.
Your budget will determine the technology, manufacturer, and age of your equipment acquisition. A limited budget can influence you to go for refurbished linear accelerator parts for your radiation equipment. This also ensures available resources to effectively carry out other essential operations of your practice.
An Experienced Team – The successful implementation of linear accelerator parts requires good cohesion with various experts ranging from the equipment provider to the physics support team to the IT integration team to the clinical implementation team.
Have A Professional Do Install
It is important to ensure that the experts who are handling this implementation are specialists in their own field and have the requisite experience and expertise to execute. Perform due diligence background on the equipment provider for your linear accelerator parts for the radiation equipment to ensure maximum reliability and vendor accountability. Invest in an equipment provider that not only sells you the equipment but also provides post-installation support.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
The building where Linac will be installed K Shijith
KOCHI: Cancer treatment in the city is gaining momentum. With the linear accelerator (Linac) going functional in a couple of months, cancer patients, who are undergoing radiation treatment, can hope for the best. Linac will reduce the duration of the treatment since it is more powerful than the machines like Cobalt which is used now. It delivers high-energy X-rays or electrons right at a tumour and shrinks it.
The thick wall will prevent the X-rays
from going out of the building K Shijith
“More than 70 per cent of cancer patients require radiation therapy. Innovation on this front is very important. When we go for comprehensive cancer care for people, it is important to have the latest technologies in hand,” said K T Thomas Kannampallil, radiation physicist and RSO, General Hospital, Kochi.
The Linac machine, which will be installed in the General Hospital, has provisions that help it to apply radiation according to the size and shape of a tumour. A machine called multileaf collimator (MLC) is used for this purpose.
“After the machine is installed, which will take at least three weeks, we will begin the tests. The machine will be patient-ready after many tests and retests are conducted. These will span over two months. During this period the clinical approval for the treatment process has to be obtained from the Atomic Energy Regulatory Board,” said K T Thomas.A team of radiographers, radiation physicists and radiation oncologists will be operating the Linac.
Patient Benefits
Patients will get minimal exposure to radiation in the areas where they are not afflicted. Almost 70 cancer patients can be treated using the machine every day. The intensity of the radiation is gradually decreased over the period of treatment for the patients. Currently, over 1,300 patients routinely undergo radiation at the General Hospital. Apart from this, the patients looking for pain relief (Palliative) also undergo radiation therapy at the hospital. Once the machine is installed, it will come as a big relief to the patients belonging to the middle and lower middle-class from Central Kerala.
GST Issue
The machine, which is worth Rs 7.4 crore was brought to Kochi a few months back. However, a GST of Rs 1.46 crore was charged and this caused a delay in its installation. The issue has been sorted out with the hospital using its hospital development society’s fund to offload the machine from the Kochi port. The government has promised a reimbursement. The installation process began on Wednesday and all the pending permissions have been acquired. The total expense incurred for the installation of the machine is Rs 16 crore. This includes the cost of the machine, installation, supporting equipment and the building where it is being installed.
Linac lasts longer
The cobalt machine, which is being currently used, is radioactive and degenerates with time. Whereas the Linac machines use X-rays. It emits radiation only when the controller pushes the button. Operated from outside the room, only the patient will be exposed to the X-rays. Cobalt machines were also vulnerable to leakage. Linac doesn’t have those issues. The speed of radiation of the cobalt machine reduces with time.
“The machine will be placed in a building with walls made of concrete that are 2.4 m in thickness. If not the X-rays can penetrate the walls and reach the exterior of the building,” said Sajeesh, radiation physicist, General Hospital. Actually designed for nuclear tests, Linac is now helping cure cancer all over the world. The building has been built near the old RMO quarters in the vicinity of General hospital.
How does the equipment work?
The linear accelerator uses microwave technology (similar to that used for radar) to accelerate electrons in a part of the accelerator called the “wave guide,” then allows these electrons to collide with a heavy metal target to produce high-energy x-rays. These high energy x-rays are shaped as they exit the machine to conform to the shape of the patient’s tumor and the customized beam is directed to the patient’s tumor. The beam is usually shaped by a multileaf collimator that is incorporated into the head of the machine. The patient lies on a moveable treatment couch and lasers are used to make sure the patient is in the proper position. The treatment couch can move in many directions.
Proper maintenance of medical equipment is extremely important if you want to get optimal results. The most important thing to keep in mind is that linear accelerator maintenance and oncology medical equipment maintenance requires a very specialized procedure and you should always consider the most reliable teams to get this done.
Medical Equipment Maintenance
The process of giving maintenance to this kind of equipment is quite complex. This is why you can’t simply give this task to any regular maintenance provider. Choosing one that is qualified and also capable of getting the job done for an affordable cost is going to be important.
If you are looking for a good linear accelerator maintenance provider and oncology medical equipment maintenance services, you need to take the time to search for the best possible results. This is going to require that you take your time and evaluate your options in your area.
The Search for Medical Equipment Service Technicians
A good way to get started with this search is to look at the online information they have available. Not finding a website or social media is always a red flag. Any business that is considered professional in modern times should have a website of their own or at the very least a social media page with all of their information.
Another good way to find out how good they are is to give them a call. Ask about their services and what the procedure is like. You should call at least a couple of different providers in order to get the best possible results. This is going to give you enough information to decide.
Any kind of equipment that is used for medical purposes needs to be handled very carefully. This is going to be the best way for you to maintain the most reliable results when you are looking to get your expensive equipment analyzed and checked for any problems.
Final Thoughts on Maintaining LINAC Systems and CT Scanners
Once you find a good team to give maintenance to your equipment, make sure that you can come up with a good deal that is going to be beneficial to both parties in the long term. This is going to be the best way for you to get maintenance done without having to worry about the hassles of hiring someone new all the time. This is going to be very important to make your equipment last longer.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
External-beam radiotherapy systems that that employ real-time or near real-time MRI guidance show much promise as a new technique to treat cancer. Prototype hybrid MRI-Linac systems are being evaluated as modalities to deliver high precision ablative radiotherapy.
Researchers at Sunnybrook Health Sciences Centre in Toronto are investigating the feasibility of using an MRI-Linac to treat breast cancer patients, using hypofractionated partial breast irradiation (HPBI). Sunnybrook’s Odette Cancer Centre is evaluating a clinical prototype of Elekta’s MRI-Linac. Its clinical staff believe that the system’s online visualization and tumour contouring capabilities, combined with the ability to reduce internal motion margins using multileaf collimator tracking or exception gating from real-time MR images, will be advantageous for treating intact breast tumours.
However, one concern is that treatment with an MRI-Linac can cause elevated radiation doses to the skin. The ever-present magnetic field can create electron return effects (ERE), in which electrons liberated at tissue–air and tissue–lung interfaces curl back on themselves and deposit larger radiation doses in tissue at these interfaces.
Sunnybrook’s Anthony Kim and colleagues
Medical physicist Anthony Kim and colleagues conducted a simulation study to determine the impact of the magnetic field on HPBI dose distributions. After evaluating a tangential beam arrangement (TAN), 5-beam intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT), the researchers confirmed their hypothesis that the magnetic field increases the skin dose. The magnetic field had clinically negligible effects on radiation dose to the heart and the lung (J. Appl. Clin. Med. Phys. doi: 10.1002/acm2.12182).
Impact of the magnetic field
The researchers developed treatment plans for five patients who did not have surgery due to metastatic disease or severe medical comorbidities. They analysed a total of seven tumours close to the skin, with planning target volumes (PTV) of between 37.3 cc and 341.1 cc. For each tumour, treatment plans for the three beam geometries were optimized with and without a 1.5 T magnetic field, using the same PTV isocoverage for all six plans.
The authors used the same patient image data and target contours as used clinically. They evaluated two skin depths, 3 and 5 mm, to determine whether magnetic dose effects were more prevalent closer to the patient’s external surface.
All plans had acceptable PTV coverage. The authors reported that with the magnetic field on, the skin dose was considerably higher for the TAN plan compared with the IMRT plan, which in turn delivered a higher dose to the skin than the VMAT plan.
The skin dose correlated with the number of beam angles used. Specifically, skin dose can be reduced by increasing the number of beam entry angles. Hence, in the presence of a magnetic field, VMAT spared the skin more than IMRT, which in turn spared more than the TAN beam arrangement. Also, the researchers found that the ERE due to the magnetic field was greatest very near the surface of the skin.
The authors explain these phenomena by the fact that the ERE tends to have much less impact at the entry points compared with the beam exit points. Only the beam angles near the tumour created a higher magnetic field dose. The ERE had a much larger impact with TAN radiation delivery compared with IMRT or VMAT delivery when the beam angles were spread far more apart.
Based on their analyses, the authors stated, “The number of beam angles matter, and it is likely that beam arrangement also matters… Skin dose is significantly impacted not only by the magnetic field, but also varies with depth and when increasing the number of beam angles.”
The MRI-Linac is currently being installed at Odette Cancer Centre. “The installation will be completed soon, and in the early part of 2018 we will be conducting basic physics research and volunteer MR imaging, to evolve our understanding of this device ahead of treating patients,” Kim told medicalphysicsweb. “We have been able to do some basic groundwork with respect to how to best optimize these plans without adverse effects. This groundwork has been possible because of our access to the radiation treatment planning system (Elekta’s Monaco) that can simulate the MRI-Linac beam on actual patient data.”
Original Source: medicalphysicsweb.org/cws/article/research/70214
The number of internal injuries and diseases are increasing. People are now concerned about their well-being and to assure that they are healthy they undergo regular checkups. Sometimes they have to get the CT scan done.
There are different machines of CT scan and Linear accelerators available in the hospital. With the help of the internet, patients know everything about the best products and that is why they want to be tested and treated with the latest items. In case you are unable to buy the recently, introduced machinery you can have the replacement parts for Linear Accelerators. Here we have a few reasons that why it will be a beneficial choice.
Durability
Most of the hospitals and laboratories have the old machinery. They might be durable but their life is coming towards an end. It is important that you get all the parts replaced because the new parts will be developed with the best quality material and they will have the features that might be useful for you in the present age.
Improve performance
The overall performance of machines will be improved with the help of replacement parts for CT Scanners. The machine will be as good as new. You will notice that it will take less time to test the patient and generate the result. You will notice that the quality of the results will be enhanced as well.
Cost-effective
One of the biggest benefits that you will get from replacement parts for Linear Accelerators is that it will be an affordable solution. You will not have to change the entire machine and when you will order the parts in bulk you will get special discounts and free installation offers that will provide you the chance to save some extra money.
Energy-efficient parts
With the advancement in technology many unique and innovative features have been introduced in the machinery.
The parts will be operated on less voltage that will help you to save energy
You will be able to save a huge amount on the electricity bills in the long run
You can even get the parts repaired for the best possible effects and results
When the patients will notice that there are replacement parts for CT Scanners available. They will get the idea that you will get the machines refurbished according to the latest technologies. They will have the peace of mind that you will provide the best facilities. In this way, your services will be recommended and most of the patients will visit your clinic or lab for tests.
Bottom line
There are many retailers in the market that are dealing with the replacement parts for Linear Accelerators. Make sure that you select the one who will provide you reliable items and products.
We have been providing our customers with the best products and replacement parts. All you have to do is let us know your requirements and we will assure to deliver the items and our professionals will provide the installation services.
Learn more about Radparts and the variety of services and parts they offer to repair medical equipment including: linear accelerators parts, CT scanners parts, linac parts, and radiation oncology equipment at www.radparts.com. To contact one of our medical equipment repair specialists for parts or service call toll free 877.704.3838 for 24/7/365 support.
CERN, the European nuclear physics research organization, is contemplating the development of a particle accelerator three times larger than the Large Hadron Collider that confirmed the existence of the Higgs boson, a move intended to match growing Chinese ambitions in particle physics.
Fabiola Gianotti, CERN’s director general, said in an interview that the organization has begun design studies for a new circular super-collider that would be between 90 to 100 kilometers long. CERN’s Large Hadron Collider, currently the world’s highest energy particle accelerator, measures 27 kilometers.
The collider is famous for finding the Higgs boson in 2012, considered one of the most important discoveries in particle physics in decades. The particle helps explain how the visible universe holds together.
Chinese scientists would like to build a electron-positron circular collider twice the size of the LHC, which smashes protons together. After building this initial accelerator, China would eventually expand it into an even bigger proton collider. But initial plans to start construction in 2021 suffered a setback when the Chinese government opted not to fund the collider in its 2016 five-year plan. The research team will now to need to wait until 2020 to apply again.
Fabiola Gianotti
Photographer: Fabrice Coffrini/AFP via Getty Images
The effort is controversial. Chinese-born physics Nobel winner Chen Ning Yang, a U.S. citizen, argued last year that China, as a still developing country, could not afford the project, which is expected to cost as much as $6 billion in its initial phase.
Gianotti, who is the first woman to head the European nuclear research agency, said she welcomed the Chinese proposals. “I think it is very good to have competition,” she said. “It is very good to have different regions of the world that are interested in fundamental physics and consider that the outstanding questions today in particle physics are worth building the next generation particle collider.”
But Gianotti said it was unlikely that both CERN and the Chinese would actually complete construction of their massive projects. “I don’t think the world can afford two such colliders,” she said, adding it was important to “optimize” available scientific expertise and financial resources for the sake of advancing science.
“There is no point having two similar accelerators,” she said.
She said that while CERN has begun initial planning for its own massive super-collider, it had not yet produced cost estimates. The growing interest from China could help Gianotti make the case for its 100-kilometer ring or for alternative proposals, such as a high-energy electron and positron accelerator known as the Compact Linear Collider. Gianotti said which project CERN will pursue would be decided in a review of Europe’s particle physics strategy in 2019.
Gianotti described the relationship with China as being collaborative as well competitive. Three CERN scientists sit on the international advisory panel for China’s electron-positron accelerator. Gianotti said discussions had taken place about strengthening CERN’s work with China and that she plans to travel to China next year for further talks.
Higgs Discovery
After discovering the Higgs boson, an elementary particle that the so-called Standard Model of physics postulates is fundamental to giving objects mass, the LHC underwent a two-year retrofit. CERN upgraded the electro-magnets that allow the collider to accelerate particles to velocities approaching the speed of light, as well as the cryogenic refrigerators that keeps those magnets cooled. The new machine, which has been running since April 2015, operates at energy levels about 75 percent greater than the LHC did when it found the Higgs in 2012 and it produces almost triple the number of collisions per second.
Many hoped the upgrade would allow the LHC to move beyond the visible universe and find evidence of dark matter and exotic new particles that are not accounted for by the Standard Model. But so far, Gianotti said, the LHC has not found any conclusive evidence.
“The Higgs boson behaves very much like the Standard Model predicts,” she said, while cautioning that the experimental precision of the LHC is not yet high enough to exclude that Higgs is part of a broader theory beyond the Standard Model.
The LHC is due to undergo another major upgrade starting in 2024. This turbo-boosted collider is known as the High Luminosity LHC.
“At the moment, large uncertainties still exist,” Gianotti said referring to the precision of the LHC results. “We hope that with more data and the advantage of the luminosity upgrade of the LHC, which will extend the full program of the Large Hadron Collider to 2035, by that time we will reduce the uncertainty on several measurements by some large factor.”
Processing all the information the High Luminosity LHC produces will pose a monumental challenge of its own. CERN scientists this week released a paper in which they forecast that by 2026 the computing capacity required for experiments run on the collider will be 50 to 100 times greater than today, with data storage needs running into many exabytes. (By way of comparison, all the words ever spoken by humans are estimated to be about 5 exabytes, according to a 2003 report from the University of California at Berkeley’s School of Information Management and Systems.)
The CERN scientist think improvements in computing technology will be able to meet only 10 to 20 percent of these needs without additional cost. So the physics agency is calling for a major research and development effort to solve the bottleneck with more efficient software coding, changes in data center infrastructure and more use of advance machine learning techniques. CERN works with partners such as Intel Corp., Oracle Corp., Huawei Technologies Co. Ltd., and Siemens AG, on many of these efforts.
CERN, which has a budget of about 1 billion Swiss francs ($1.04 billion) per year, is funding this upgrade to the LHC out of its existing finances, Gianotti said.
“For a researcher like me, perhaps the best reward is a surprise,” she said. “Nature is always more clever, and perhaps also more simple and more elegant, than the human brain. So it may be the all the models that mankind have developed, these are not what Nature has finally chosen.”
CERN has collaboration with U.S. physicists, with American researchers running experiments at CERN’s LHC and CERN scientists working on neutrino and dark matter research at the Stanford Underground Research Facility in South Dakota. Some are concerned this research could be jeopardized by an almost 20 percent funding cut for high energy physics research and nuclear research proposed by President Trump in his 2018 budget.
Gianotti said she was optimistic that this funding would be restored by the U.S. Congress before it passes a final spending bill. “I remain pretty positive things will be okay,” she said.
