From the October 2012 issue of HealthCare Business News magazine


One way SBRT does this is through real-time imaging. “Image-guidance adds immeasurably to the ability to give high dose and preserve normal tissue, especially in areas like the lung where we can’t use radiation to its full benefit now,” says Dr. Stephen Schimpff, former CEO of the University of Maryland Medical Center and author of a new book called The Future of Medicine: Megatrends in Healthcare. The lung tends to be one of the more difficult areas to treat with conventional radiation therapy, because the target is constantly moving from breathing.


“Image guidance is core enabling technology,” says Cal Huntzinger, senior director of Varian Medical Systems surgical science, which announced a global partnership in the spring with Siemens Healthcare to collaborate on radiation therapy solutions. “Talk about bi-plane imaging, effectively, that’s what is happening now in radiotherapy.”

According to Huntzinger, fluoroscopic, stereoscopic, and cone beam CT image guidance are major advances that have just been available in the past few years. This has typically been in the form of intensity-modulated radiation therapy (IMRT), but more recently, according to Huntzinger, volumetric radiotherapy has moved into the arena.



“You get very conformal dose [from 3-D images of the tumor] that reduce side effects in combination with high quality image guidance, and those are the two enabling technologies that allow SBRT to be as conformal and as efficient as it is,” says Huntzinger.

Robotic-guidance, based on motion detection, can add another dimension to precision. Accuray’s CyberKnife delivers SBRT via a robot with a linear accelerator that generates a high-energy source of radiation and sits on the end of the robot.

“It assesses in 3-D continually where the tumor is and how the tumor moves and automatically adjusts and corrects the radiation beam throughout the treatment, and that’s critical when delivering these really high doses,” says Dawood.

He adds that this robot—in contrast to others like the da Vinci Surgical System—doesn’t involve cutting or manual control by a surgeon.

“Once you feed him the information about where the tumor is and what you want to deliver, the robot takes over. And the CyberKnife robot doesn’t have a bad day and doesn’t get tired,” says Dawood.

October 2012 Magazine

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