At that time, he says, many cancer centers used ultrasound to determine a patient's internal anatomy prior to radiation. Dr. Wong remembers that he and Dr. Uematsu persuaded Siemens to make a system that provided precise imaging by joking, "Look at a neonatal ultrasound. Sometimes you can't even tell if its a boy or a girl."

He asked Siemens' decision-makers to make a machine that hooked up a diagnostic CT scanner to a linear accelerator.


Leaving Cornell Medical Center

In 1997, Dr. Wong was an oncologist at the prestigious New York Hospital, Cornell Medical Center. Cornell didn't have a large enough room for the machine. When Morristown Memorial Hospital told Dr. Wong they would build him the facilities he needed, he left Cornell for a community-based hospital in Morristown, which he says unlike Cornell, is not a teaching hospital.

Left to Right Shifts Are Significantly Greater in the Obese

Incidentally, he says that in 2006, a paper was published from M.D. Anderson concluding that obese people are more likely to fail external beam radiation for some "intrinsic" reason. But Dr. Wong knew differently.

"The Anderson article prompted our team to review all their patients' histories, to prove that obese men may not be receiving adequate prostate cancer treatment," he says. "We found that the percentage of moderately to severely obese patients with a left to right shift of greater than 10 millimeters was 21.2 percent compared to a 1.3 percent shift for slimmer men.

His paper was published in the September 1 issue of the International Journal of Radiation Oncology, Biology, Physics, ASTRO's official journal.

"The implications of our findings apply to various types of cancer," Dr. Wong concludes. "If patients are obese, skin localization is not good and image-guided radiation therapy is highly recommended."

Sources: ASTRO, DOTmed.com News

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