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Covering all the angles in radiation therapy

Clinical physicist Dr. Jacco Steenhuijsen with radiographer Tamara Scheenstra

The first installation of the Brilliance CT 16-slice Big Bore system in Europe was in Catharina Hospital, Eindhoven, in July 2005.

 

Toward the end of 2003, the radiotherapy department at the Catharina Hospital in Eindhoven, The Netherlands, decided to upgrade their old Philips single slice CT system to a multi-slice system.  “We needed the high speed provided by a multi-slice system for, among other things, respiratory-gating studies, so the 16-slice Big Bore configuration was a really attractive option,” says clinical physicist Dr. Jacco Steenhuijsen.
 
Designed for radiotherapy applications
At present, the Brilliance CT 16-slice Big Bore is the only multi-detector CT system available on the market designed specifically for radiotherapy applications, the requirements of which are quite distinct from those of standard radiology.

 

One major requirement is clearance. To simulate radiotherapy treatment effectively, patient position during the CT simulation and final treatment with a linear accelerator needs to be identical.  The Brilliance Big Bore features a bore size of 85 cm (giving a clearance identical to that of a linear accelerator) with a true 60 cm field of view – currently the largest available in the industry.

 

The promise of quality – delivered
Installation began in early July and the department was ready to perform CT simulation with its first patients on the Big Bore by July 18th.  “From the start we were extremely satisfied with this new system, not just with the imaging quality, which is superb over the whole FOV, but also with the standard of engineering,” points out Dr. Steenhuijsen.  “The patient table, in particular, is absolutely level and stable, something that’s essential in a system used for therapy planning to enable us to accurately simulate the situation in the linac room.”

 

Integrated planning
In conjunction with the installation of the Big Bore CT, the radiotherapy staff at Catharina Hospital began evaluating the latest version of Philips’ Pinnacle³ treatment planning system.  Embodying Philips AcQSim³ CT simulation software and Syntegra multi-modality registration software, Pinnacle³ is a fully integrated virtual simulation and 3D planning system.

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Catharina clinical physicists Drs Gert Meijer (l) and Jacco Steenhuijsen

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“Setting up the Pinnacle³ system was my first assignment on joining the department and I fully expected to be occupied for a long time familiarizing myself with the software before getting the system operational,” explains Dr. Gert Meijer.  “But to our satisfaction, we had the system up and operational within weeks.  Philips has obviously done its homework here.  The interface is so intuitive you can tell it has been really designed with the users in mind.”

 

4D gating studies
With the hardware and software in place, Dr. Meijer and his colleagues are currently working with Philips to refine the software for 4D gating applications.  3D data sets correlated with the patient’s breathing cycle (using a respiratory sensor) can be used to create 4D cine images by the addition of a time domain.  This allows for more accurate target delineation of lung tumors.

 

Completing the picture
The Catherina’s Nuclear Medicine Department has recently installed a Philips Gemini PET/CT system.  “Integrating the metabolic information obtained from the Gemini system into Pinnacle³ will enable us to determine whether radiation of secondary tumors needs to be included in the treatment planning, says Dr. Steenhuijsen.  “This more complete picture should greatly improve the effectiveness of cancer therapy”

Related links

+ Catharina Hospital (Catharina Ziekenhuis)

+ Brilliance 16-slice Big Bore CT

+ Pinnacle³ treatment planning system

+ Read full Medical Perspective article: edition14, 
   June 2006 (pdf)

 

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