Dow R. Wilson,
President & CEO,
Varian Medical Systems (left),
and Dr. Arkadi Stolpner,
From the October 2015 issue of HealthCare Business News magazine
Dr. Arkadi Stolpner founded the International Institute of Biological Systems Diagnostic and Treatment Center, named after Dr. Sergey Berezin, in 2003, with one used Siemens MRI.
Today, the CEO operates a fleet of 89 MRIs in 62 cities in Russia and eastern Europe. After noticing that a high percentage of patients were diagnosed with cancer, expanding into oncology was a natural evolution for the company.
First it was an Elekta Gamma Knife treatment unit, then an Accuray CyberKnife. Next, came a Varian TrueBeam linear accelerator and currently, Dr. Stolpner is about six months away from completing construction on a two gantry proton beam center in suburban St. Petersburg.
In fact, Dr. Stolpner and I are business partners and I am so very familiar with the challenges that he has faced in providing radiation therapy treatment options in Russia. He seemed like the perfect person to talk to about shielding.
Philip F. Jacobus: When you decided that there was a need for radiotherapy, what did you know about shielding?
My very first purchase was an Elekta Gamma Knife. Actually, I did not think too much about the therapy room construction shielding because I was more worried about the regulations surrounding cobalt. Our government is very strict about the use of cobalt and other radioactive materials and has a lot of regulations surrounding it. We had to follow a strict protocol when we installed our first Gamma Knife.
This was my first exposure to the shielded therapeutic room shielding. In many ways, I am self-taught, and by visiting with other physicians and experts in the field I learned that the treatment room had to be protected with about 20 to 25 centimeters of ordinary, simple concrete. I went on to learn that in general, the more powerful the treatment option (higher energy of the radiation used), the thicker the concrete has to be.
PJ: What are the thickness requirements for the different delivery systems?
Of course, every country is different in its regulations for radiation protection. Russia is different from Europe which is different from North America, as I know, but here in Russia, the Gamma Knife requires the least amount of shielding.
For instance, for our CyberKnife our shielding was two meters of concrete in certain directions whereas for our Varian TrueBeam, it was two and a half meters of concrete and thickness. As for proton therapy, sometimes the walls are 15 feet thick! In other places, the walls for proton therapy can be only 6.5 feet thick but proton walls are definitely thicker. And of course the construction of the treatment rooms and auxiliary environment, the infrastructure, is planned by a special team of engineers and physicists. There are a lot of rules which have to be taken into account when dealing with radiation protection. When the high-energy treatment modalities are used, radioactive or ionized particles in the air arise, so special requirements for ventilation should be considered.