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Radiation Oncology Treatment Planning & Monitoring
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Extensive Planning Tools for More Precise Treatment
Calypso® is brand new 4-dimensional monitoring technology to localize and track the prostate throughout treatment, allowing for more precise and accurate radiation targeting. During radiation treatment, doctors work hard to protect healthy tissues near the tumor from receiving radiation. Sometimes though, the location of the cancer moves during treatment, even if the patient is set up perfectly. This is usually caused by internal organ motion that can not be controlled by the patient or physician. For men receiving treatment for prostate cancer, the most common side effects occur when the nearby normal organs (the bladder) receive small amounts of radiation causing urinary, rectal (rectum) and sexual side effects (penile base tissues).
Calypso has recently been upgraded with a new software program providing even greater accuracy. Conebeam CT allows radiation oncologists to generate CT images while the patient is on the treatment table. These are used to guide treatment (IGRT) and allow doctors to confirm positioning.
Since gaining FDA approval, Calypso 4D Localization System offers doctors assistance to objectively determine a tumor's location with great accuracy and continuously monitor its position throughout treatment. Miniature electromagnetic sensors (similar to seeds), called Beacon® transponders, are implanted into the prostate during treatment planning to continuously monitor position and motion of the organ in real-time. Before each treatment, Calypso® finds the beacons and helps the technologist re-align the treatment plan. Unlike other treatment planning tools, Calypso offers "real time tracking" which helps improve the accuracy of delivering radiation. If the prostate moves out of the targeting range during treatment, the system signals the therapists so that an adjustment may be made.
In January 2007, Fox Chase became the first treatment center in the region to use this technology for treatment planning.
High Intensity Focused Ultrasound (HIFU) is a new technology allows sound waves to generate heat, which can destroy cancer cells alone and in conjunction with radiation. HIFU allows high levels of ultrasound energy to create intense heat. The sound waves are narrowly focused on the tumor with great precision while sparing the normal surrounding organs/structures. Heat (hyperthermia) has been used for many years and there is a large published experience in the US and Europe; however, in the past, technology limited hyperthermia to superficial (shallow) tumors.
HIFU was introduced to treat patients with bone metastases, but will eventually allow Fox Chase physicians to treat deep tumors in the pelvis and elsewhere for the first time. HIFU works like a magnifying glass intensifying and focusing the sun's light on a specific point. HIFU's energy has physical properties that allow the beam to avoid harming tissues in the entry and exit pathways. The HIFU capability can be manipulated by the focusing devices, the temperature of the energy and the exposure time. Currently, HIFU is FDA approved for use in treating benign uterine fibroids. At Fox Chase, researchers will study the use of HIFU for prostate, gynecologic and gastrointestinal (GI) cancers.
Fox Chase will be the first treatment center in the region (as of October 2006) to validate this technology with MRI for oncology.
1.5T MRI scanner is used at Fox Chase in conjunction with HIFU to guide the hyperthermia (sound waves). A sophisticated software system allows the visualization of the patient's tumor in real time during treatment. The MRI's image interfaces with the software controlling the HIFU's targeting system. The coupling of these technologies ensures sub-millimeter accuracy.
MR spectroscopy (also called MRS, functional MRI or fMRI) is used along with 1.5T MRI in the Department of Radiation Oncology by radiation oncologists to further tailor radiation treatment, specifically now for certain prostate cancer and brain cancers. MR spectroscopy is helpful in identifying the metabolic activity of the tumor, confirming the boundaries and bulky areas. MR spectroscopy brings a new capability to treatment planning and allows more precise tailoring of radiation treatment.
In October 2006, Fox Chase became the first treatment center in the region to use this technology for treatment planning.