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Elekta Aims for More Accurate Radiation Therapy with Unity

A Swedish company is staking its hopes for a larger North American market on a radiation therapy device that can more accurately target tumors than current technology, including real-time imaging.

Eighteen years in development, Elekta’s Unity combines two incompatible devices, a Philips 1.5-Tesla magnetic resonance imaging machine (MRI) with a largely metal linear accelerator, and a highly sensitive linear accelerator or Linac, to produce high-resolution, or high field, images of tumors during cancer treatment. The sharper image allows the radiation therapist to use smaller margins to target the tumor, sparing surrounding healthy tissue from harmful rays.

The MRI-Linac also allows the radiation therapist to detect whether a tumor has moved or changed, and to more accurately focus the beam during each treatment. Elekta’s Unity has demonstrated the dose of radiation within 1% and with 0.3mm accuracy, according to Jan Lagendijk, professor of clinical physics at University Medical Center, Utrecht, the Netherlands. Lagendijk developed the MRI-Linac with Bas Raaymakers, a professor of experimental clinical physics at the same institution.

The radiation oncology market is large, with about half of all cancer patients receiving some type of radiation therapy sometime during the course of their treatment, according to the National Cancer Institute.

Elekta is in the midst of a first-in-human trial at UMC Utrecht to measure the accuracy of Unity in five patients with spinal cord tumors. Radiation inaccurately directed at the spinal cord can cause paralysis, according to Kevin Brown, a physicist and vice president of Research and Innovation at Elekta.

“If you have cervical cancer, that’s moving around all day, quite dramatically,” Brown added. “With today’s technology, we have no way of dealing with that motion . . . This new technology is providing the next level of visualization of what you want to treat at the time you are treating it.”

This heightened precision might enable radiation oncologists to increase the dose at a particular visit and thus reduce the number of treatments, Brown added.

How did the researchers marry two highly incompatible technologies? It modified the MRI machine’s active shielding, introduced passive shielding, and redesigned the linear accelerator. The rest is proprietary information, Brown said.

“It was never possible to combine these two machines,” said Ina Jürgenliemk-Schulz, MD, a UMC Utrecht radiation oncologist and principal investigator of the study. “It was quite a milestone that they did it.”

Startup ViewRay (Oakwood Village, Ohio) patented a similar, but smaller MRI-Linac combo in 2011, a combined 6 MV Linac and 0.35-Tesla MRI machine it calls MRIdian Linac. That machine is considered low-field, but Brown said he’s glad that ViewRay paved the way with regulators. MRIdian Linac has already received CE Mark and 510(k) approval from FDA. Elekta expects to land the CE Mark for Unity by the end of 2017, followed by FDA approval. Elekta is one of the largest makers of radiation oncology devices and has the partnership with Philips on its side as well, Brown noted.

Kristofer Liljeberg, an analyst who follows Elekta for Carnegie, believes Unity could dominate this market segment in a few years.

“We believe the Unity MR Linac will be very important for Elekta to improve sales and order growth that has suffered in recent years,” Liljeberg wrote in an email. “Given the high interest from early adopters, Elekta should have a good chance [of] hitting the target of 75 orders until 2019.”

Original Source: http://www.mddionline.com/article/elekta-aims-more-accurate-radiation-therapy-unity-06-20-17

Original Author: Nancy Crotti

Original Date: June 20 2017

The Average Life Space of Linear Accelerator Parts

As linear accelerators age errors can creep in, but how long is the average lifespan of a medical linear accelerator given that the machines cost of millions of dollars? While it’s reasonable to expect a good 5 to 10 years of use out of a linear, accelerator maintenance also takes its toll on expenses. Most institutions can expect a single linac (Linear Accelerator) machine to cost somewhere in the range of 300,000 dollars every 2 to 3 years.

Facilities can often squeeze more use out of a machine and ensure errors are resolved by keeping the software up to date and replacing or upgrading linear accelerator parts when needed.

It is essential to choose a reputable company to replace your linac’s aging parts as the wrong equipment can end up harming the machine instead of improving it. Most companies who sell linear accelerators and parts will have service contracts available that offer varying levels of support.

Depending on the size of the facility they may be required to choose between keeping the software up to date, operator manuals, or having staff and physicists trained in the use of the accelerator.

You can reasonably expect a for-profit facility to experience some pressure when using this expensive piece of medical equipment. After all, they will need to treat enough patients over time to pay for it.

One of the biggest concerns for facilities using a linac machine is one of liability for injuries to patients. As a litigious society always goes after the institution which gives the best chance of a payout the facility is usually the one bearing the brunt of the lawsuits.

Their expensive insurance creates the illusion that they have large sums of money available for payouts, and this is why it is in the facilities best interests to reduce errors and improve patient confidence. The best way to do this is to ensure the linac gets serviced regularly, software is kept up to date, and all staff is adequately trained.

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.

How we’re making radiotherapy a smarter, kinder treatment for cancer

Radiotherapy is a crucial part of treatment for many cancers. Here at the ICR, we’re developing new ways to use radiotherapy to kill cancer cells with fewer side effects and fewer hospital visits.

Given its 100-year history, you might be forgiven for thinking of radiotherapy as archaic, old-fashioned, out-of-date.

But you couldn’t be further from the truth.

More than 120,000 cancer patients in the UK are treated with radiotherapy each year and the technique continues to cure more people than all existing drugs combined.

Although the principle has remained the same through history – using radiation to damage DNA and kill cancer cells – the mode of delivery has become much more sophisticated over recent decades.

We founded our department of radiotherapy in the early 1940s and have been pioneers in developing the technology, at the forefront of some of the biggest developments that have improved patient care.

Our research into ways to target delivery of radiotherapy precisely to tumours has helped increase the effectiveness of radiation treatments, leading to changes in clinical practice, reduced treatment complications and improved cure rates.

Intensity modulated radiotherapy

Along with our hospital partner The Royal Marsden, we pioneered intensity modulated radiotherapy (IMRT). This high-precision method enables the X-ray beam used in radiotherapy to be adjusted, changing beam shape and intensity as the machine moves around the body, to match the shape of the tumour. This spares the surrounding tissue, and allows higher intensities of radiation to be concentrated on the tumour.

Our researchers have shown that this technique reduces the severity of side-effects in many cancers – such as Professor Kevin Harrington’s research into avoiding dry mouth in patients treated for head and neck cancers, or Professor David Dearnaley’s work to reduce bowel, bladder and sexual side-effects in prostate cancer patients.

We have also shown that the technique is suitable for elderly patients with bladder cancer.

Image-guided radiotherapy

Advances in the imaging of cancer using scanning techniques allowed the ICR and The Royal Marsden to extend the potential of IMRT by combining diagnostics and therapeutics in a new technique, known as image-guided radiotherapy (IGRT).

This allows the radiation beam to be adjusted based on feedback from a scanner that monitors patients in real time.

The technique can accommodate for movement of tumours in the body as a patient moves, protecting surrounding tissue even more effectively.

The MR Linac – a UK-first set to revolutionise radiotherapy

The ‘daddy’ of image-guided radiotherapy, the MR Linac, combines two technologies – an MRI scanner and a linear accelerator.

This means we will be able to precisely locate and dose even moving tumours – such those of the lung, affected by breathing, or a prostate tumour that might move from day-to-day depending on what the person has eaten and how full their bowel is.

The ICR and The Royal Marsden are the first in the UK to receive the multimillion pound machine, which is due to be up and running, and ready to treat patients in 2018.

Reducing side effects of breast cancer radiotherapy

Professor Judith Bliss, Director of the ICR’s Clinical Trials and Statistics Unit, and Professor John Yarnold led a study to reduce side effects from radiotherapy for breast cancer.

The IMPORT LOW trial, involving more than 2,000 women, demonstrated that postoperative radiotherapy focused only around the part of the breast that had contained the tumour has fewer long-term side effects and is just as effective as standard whole-breast radiotherapy.

The researchers hope the study will contribute to a change in clinical practice in the very near future.

Less is more for early breast cancers

Our work hasn’t just focused on precision targeting. We’ve also been looking at refining the doses of radiotherapy needed to kill cancer cells.

The START clinical trial, led by Professors Judith Bliss and John Yarnold, found that three weeks of radiotherapy is as good as five weeks for treating breast cancer – as well as being more convenient and less tiring for patients.

It has also had the added benefit of being cheaper for the health service, saving the NHS around £50 million per year since 2009.

Better for patients, better for the NHS

Professor David Dearnaley led a practice-changing clinical trial that found a shorter course of prostate cancer radiotherapy, involving 17 fewer hospital visits and higher individual doses of radiotherapy, is as effective as the current standard treatment for both survival and quality of life – and could save the NHS tens of millions of pounds per year.

Could gut bacteria dictate how people respond to radiotherapy?

Our researchers have begun the first study to look scientifically at the influence of gut bacteria on how people with cancer respond to radiation treatment.

Professor David Dearnaley and colleagues hope to shed light on whether some patients with a particular make-up of gut bacteria respond differently to radiotherapy, which in turn could affect the amount of radiotherapy they are offered.

The ultimate aims of this work are to reduce the severity of bowel problems after pelvic radiotherapy, and to find out if changing the make-up of the gut flora in individual patients will benefit patients.

Using radiotherapy in combination

Professor Kevin Harrington and his team have been working on combining radiotherapies with chemotherapy, targeted therapies, and even immunotherapies and viral therapies to compliment and boost their cancer-killing abilities.

Many of these combinations have been successful in the lab, and may soon be brought into clinical trial.

Support our work to refine radiotherapy

We are a charitable organisation and rely on support from donors and supporters, as well as grants from major funding organisations.

Find out more about our work to develop kinder, smarter radiotherapy treatments and how you can help us to continue to improve cancer patients’ lives.

Original Source: http://www.icr.ac.uk/blogs/science-talk-the-icr-blog/page-details/how-we-re-making-radiotherapy-a-smarter-kinder-treatment-for-cancer

Original Author: Dr Claire Hastings

Original Date: 11 July, 2017