Elekta VMAT. Choose freedom

Transcription

1 Elekta VMAT Choose freedom

2 Freedom... Elekta VMAT is an advanced radiotherapy solution which has been developed to combine dramatically reduced treatment times with a removal of traditional restrictions to treatment delivery, while delivering the lowest possible integral dose to the patient. Using a unique multileaf collimator (MLC) and control system design with highly flexible treatment parameters, you now have the freedom to treat patients the way you have always wanted to. As an Elekta innovation, you know it will maximize efficiency without sacrificing choice, a concept we call Personalized Efficiency. Choose Elekta VMAT for { } Full 4cm x 4cm uninterrupted fieldsize Dynamic movement of MLC leaves Active leakage reduction Variable gantry rotation speed Dose (MU/min) Dose (MU/degree) Continuous collimator angle optimization Single or multiple superimposing arcs Coplanar or noncoplanar arcs

3 Elekta VMAT treatment plan using ERGO++ Efficiency Improved patient compliance due to reduced treatment time Improved patient throughput to maximize asset utilization Personalized Enhanced dose conformance to match each patient s anatomy and pathology All delivery parameters variable to maximize treatment flexibility Shorter treatment times allow better quality treatment to more patients using existing resources Ultra-low dose 3D volumetric imaging gives the confidence to minimize treatment margins without compromising patient safety Flexibility of vendor choice for treatment planning supports existing workflows and practices Available as an upgrade option rather than a separate treatment machine, thereby reducing capital outlay Template driven solutions developed with clinical partners maximize workflow efficiencies Faster treatment times reduce the complexity of managing intrafractional and respiratory motion Native integration with EMR-based oncology information system to maximize efficiency and support evidence based practice. Choice of single or multiple arcs to deal with both routine and complex cases.

4 ...to deliver No two patients are the same, so why should their treatment be? For many years AKH has been practicing a technique called IMRT. The new Elekta VMAT technique adds the possibility of modulating the radiation intensity during an arc treatment. The advantage is an even better sparing of healthy organs and a more effective and better targeted irradiation of the tumor. At the same time the total treatment time is significantly reduced which is of highest importance for patients with serious diseases Prof. Dr. Richard Pötter, Chief Medical Doctor, Allgemeines Krankenhaus/Medical University of Vienna Minutes Conventional IMRT Helical IMRT Typical treatment time in minutes Elekta VMAT Speed Elekta VMAT speed of delivery means that for the first time, complex image guided IMRT treatment techniques are possible within a typical 1 minute treatment session. The increased throughput expands daily capacity and may open up many more treatment slots per day from using existing equipment. Given this new freedom, in a busy clinic you could choose to offer the helicallike conformity and dose distribution of Elekta VMAT to a larger proportion of your patients without compromising efficiency. With control Elekta VMAT enables you to address the key objectives of providing advanced radiation therapy: maximize dose to tumor increase tumor control probability (tcp) avoid adjacent critical structures and healthy tissue reduce normal tissue complication probability (ntcp) deliver safe, efficient, high quality treatment. Only Elekta VMAT offers the use of either single arcs, or where clinically indicated, multiple arcs (sequential and superimposing) to optimize target dose delivery for all different patients and pathologies.

5 ...to be confident As with any advanced treatment, the accurate delivery of the dose depends on accurate target localization. Elekta VMAT will deliver the best results when used in conjunction with VolumeView 3D IGRT to ensure: accurate patient set-up size, shape and position of target compared to plan size, shape and position of oars compared to plan. Elekta VolumeView imaging provides the confidence to treat both aggressively and safely. Elekta VMAT, with its inherent dose optimization characteristics offers the freedom to escalate dose or hypofractionate with an equivalent ntcp to obtain better tcp, however, with all such strategies the reassurance of pretreatment 3D IGRT is essential. No compromise to safety A suite of VMAT delivery quality assurance tools embedded in the control system software, constantly monitors: dose rate gantry angle and speed leaf motion MU per degree collimator angle and speed. This ensures that the treatment will immediately be interrupted should any parameters fall outside of tolerance. Treatment can then begin from the point at which it was interrupted with the system automatically recalculating and implementing adjustments to deliver the treatment as originally prescribed. Clinical partnership All Elekta solutions are developed in collaboration with our clinical partners. A VMAT Consortium has been formed from the leading institutions in this field to offer our customers: a template-driven solution with efficient workflows developed during pilot clinical practice the confidence that the solution has been tried and tested in a real-world environment a body of clinical data training at centers of excellence by leading practitioners experienced with Elekta VMAT techniques using an open-systems approach.

6 ...to treat 1 8 Single arc 3D CRT Volume (%) Dose (% prescribed dose) VMAT Single Arc 3D CRT PTV Bladder Tissue Small Intestine Elekta VMAT single arc Comparison of conventional 3D RT treatment for Anal Ca with single arc Elekta VMAT planned using ERGO++ Minimizing dose Elekta VMAT delivery requires significantly fewer monitor units than conventional IMRT, reducing the total MU delivery by up to 5%. Elekta MLC technology emits low interleaf leakage and, through the use of a dynamic back-up diaphragm, reduces integral dose to minimize the risk of inducing secondary tumors. The efficiency and flexibility of this technique is impressive and we hope to be able to expand the use of this advanced new treatment method to become routine practice in the future. We anticipate that when used in conjunction with our Elekta Synergy image guidance systems and employing non-coplanar angles of delivery, Elekta VMAT will be a significantly improved treatment modality for the Royal Marsden s radiotherapy patients Jim Warrington, Head of Radiotherapy Physics, Royal Marsden Hospital UK Combined with 3D IGRT protocols, delivering doses in the region of.9mgy CTDI, Elekta VMAT represents the ultimate choice for patient safety.

7 Elekta VMAT superimposing arcs Multiple arcs 1 8 Volume (%) IMRT Comparison of conventional IMRT treatment for Anal Ca with two arc Elekta VMAT planned using Ergo Dose (% prescribed dose) VMAT Multiple Arcs IMRT Corvus PTV Bladder Tissue Small Intestine Maximizing conformance Anal Ca case study from Universitätsklinikum Mannheim Technique Treatment time MU 3D - RT 3:4 213 IMRT 9: Elekta VMAT 1 arc 1:3 293 Elekta VMAT 2 arc 2: 287 We like the freedom, whenever is necessary, to over impose more arcs to better modulate the dose from different angles, without the constraint of one single arc, where the improvement on speed doesn t counterbalance the advantage of getting exactly the dose wanted by adding 1 or 2 arcs more. Keiichi Nakagawa M.D., Associate Professor, Department of Radiology, University of Tokyo Elekta VMAT delivery retains the dosimetric accuracy of segmental IMRT delivery through the 3rd Generation digital control system while offering the freedom to simultaneously vary: dose rate gantry angle and speed dynamic MLC leaves collimator angle and speed MU per degree. Elekta VMAT is the only solution to offer real-time control of all of these variables.

8 In this complex head-and-neck case, CMS Monaco based optimization has been used. Monaco IMRT features innovative biological cost functions with multi-criterial optimization, powerful leaf sequencing, and an accurate robust Monte Carlo dose calculation. Sensitivity analysis tools quantify differences between target prescription with organ at risk dose limits and eliminate the trial and error of traditional IMRT planning. Elekta is commited to offering an upgrade path to VMAT planning for all users of Elekta treatment planning systems. The VMAT sequencer for CMS Monaco is work-in-progress and not available for sale or distribution. Please contact your local Elekta representative or authorised distributor. Corporate Head Office: Elekta AB (publ) Box 7593, SE Stockholm, Sweden Tel Fax info@elekta.com North America Atlanta, USA Tel Fax info.america@elekta.com Elekta VMAT on your current TPS 7-field IMRT Single arc VMAT Elekta is committed to an open systems policy allowing you the freedom to choose the planning system that best suits your clinic. In this case, Martha Matuszak, from William Beaumont Hospital, has used a pilot version of Philips Pinnacle treatment planning system to produce an Elekta VMAT delivery which resulted in lower MU, dramatically shorter delivery time, comparable target coverage, and improved sparing of the bladder, rectum, and femoral heads. VMAT functionality within Philips Pinnacle3 is work-in-progress and not available for sale or distribution. Please contact your local Elekta representative or authorised distributor. Regional Sales, Marketing and Service: Europe, Latin America, Africa, Middle East & India Tel Fax info.europe@elekta.com Asia Pacific Hong Kong, China Tel Fax info.asia@elekta.com Human Care Makes the Future Possible Document No :8 28 Elekta Ltd. All mentioned trademarks and registered trademarks are the property of the Elekta Group. All rights reserved. No part of this document may be reproduced in any form without written permission from the copyright holder. Specifications subject to change without notice.