Posted in | News | Medical Robotics

Multileaf Collimators Mounted on Robotic Arms Offer Clinical Benefits

Accuray Incorporated, the premier radiation oncology company, today launched its new TomoTherapy® H™ Series, featuring the TomoHDA™ System, with faster planning, faster delivery and increased quality. The TomoHDA System was unveiled at the 54th Annual American Society for Radiation Oncology (ASTRO) Meeting in Boston.

Key features of the TomoHDA System include:

  • Accuray's new TomoEDGE™ dynamic jaws technology provides users with added flexibility in treatment delivery by sharpening dose fall off and accuracy. In many cases the use of TomoEDGE for head and neck tumors and prostate cancer treatments has resulted in the reduction of beam-on time by half. With the TomoHDA™ System this new technology is standard and can be applied to both TomoHelical™ and TomoDirect™ treatment modes for 3DCRT and IMRT deliveries.
  • The high-performance VoLO™ Technology – an enhancement to the TomoTherapy® treatment planning system – leverages the new dose calculation algorithm and advanced graphics processing technology to increase clinical efficiency, throughput and flexibility in developing both simple and the most complex radiation therapy plans.

"We are committed to our TomoTherapy customers and continue to innovate to provide the most advanced treatments in radiation oncology with the goal of improving patient care," said Joshua H. Levine, president and chief executive officer of Accuray. "The new TomoTherapy H™ Series offers treatment solutions for the entire spectrum of radiation therapy. It will enable unprecedented speed and efficiency ensuring the highest quality of care from the routine to the most complex cases."

The TomoHDA System is a fully-integrated 3D image-guided, full spectrum radiation therapy system and builds upon the proven TomoTherapy Hi-Art® and TomoHD™ technologies. The TomoHDA System offers multiple new benefits including performance enhancements, unrivaled dose distributions and faster treatments.

The TomoHDA System is part of the new TomoTherapy H Series. Included in this series of products, is the new TomoH™ System, the gold standard for image-guided IMRT (intensity-modulated radiation therapy) treatment, providing streamlined 3D CT daily image guidance and ultrafast MLC (multileaf collimator) modulation, enabling the delivery of the dose to achieve excellent target homogeneity while sparing surrounding healthy tissue. Also included in the series is the TomoHD™ System - including TomoDirect - a full spectrum solution that provides high quality treatments to every patient for any clinical indication requiring radiotherapy.

The new TomoEDGE™ dynamic jaws are capable of sharpening the dose and allow customers to treat more patients with the TomoTherapy System. The jaws are optimized to sweep across the target, minimizing dose to healthy tissue and critical structures adjacent to the target and opening to the desired maximum size to reduce treatment time. The result is a balanced treatment delivery that is as unique as each patient.

Using the high-performance VoLO Technology, the TomoHDA™ system allows ultra fast creation of highly conformal treatment plans with the flexibility to design a personalized treatment plan specific to the individual needs of each patient. For example, the application of VoLO technology on breast cancer treatment plans has been shown to reduce dose calculation and treatment planning optimization time to as few as three minutes. TomoHDA also includes a fan-beam computed tomography (CT) system capable of producing images 50 percent faster, facilitating improved patient re-positioning time and therefore less overall time for the patient to be on the treatment couch.

"Having been involved in the creation of and research collaboration for the new TomoEDGE, we have seen firsthand that this is one of the most versatile radiation therapy treatment options available," said PD Dr. Florian Sterzing, M.D., Consultant Radiation Oncologist at University Clinic of Heidelberg. "The new functionality enables improved quality of radiotherapy application and allows us to treat even more cancer patients."

The TomoHDA System also includes Citrix®-based remote planning with web-based review capabilities, providing the ultimate flexibility for clinicians to develop and approve treatment plans from virtual workstations.

"TomoTherapy's ability to treat the full range of disease sites, including even the most complex tumors, makes it an invaluable resource for cancer patients," said Wade Gebara, M.D. Chief of Radiation Oncology at Berkshire Medical Center, Pittsfield, Mass. "With increased speed and reliability, the new TomoTherapy System will provide the opportunity for more patients to benefit from this personalized technology."

Also on display in Accuray's ASTRO booth (#7101) is the CyberKnife M6 FIM Sytem – part of the CyberKnife® M6™ Series – which is pending FDA 510(k) clearance and not yet available for commercial distribution in the United States. The new CyberKnife M6 FIM and FM Systems feature the InCise™ Multileaf Collimator, which combines the benefits of beam shaping with the flexibility of non-isocentric, non-coplanar delivery. The new InCise Multileaf Collimator (MLC) was designed specifically for stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT) treatments, giving the system the capability to extend its radiosurgical precision into a broader field of applications. The system is intended to treat large and irregular tumors more efficiently with excellent dose gradients, to expand the number of patients eligible for treatment.

Researchers at Fox Chase Cancer Center in Philadelphia – who compared treatment plans created with a theoretical MLC on the CyberKnife System to those created originally with the CyberKnife Iris™ Collimator and conventional Intensity-Modulated Radiation Therapy (IMRT) plans – found that an MLC mounted on a robotic arm could potentially offer numerous clinical benefits, including faster treatment delivery, better target coverage and a sharper dose fall off could be achieved than a typical gantry- based IMRT plan or previous CyberKnife treatments. The Fox Chase researchers demonstrated the potential to create treatment plans that would spare critical structures around tumors better with a robotically mounted MLC, providing the ability to treat tumors using a higher dose without increasing the normal tissue toxicity.

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