RADIOTHERAPY

     

      Nowadays, the new technology does not strange to us anymore. Since we are already in 21 Century the new technology keeps on and on especially the technology that has been used in medical science to treat numerous of disease such as radiotherapy. Radiotherapy or radiation therapy is a new advanced technology that's been used in cancer and tumour disease treatment. Radiotherapy used high energy ray to destroy and treat the cancer tissue by exposing that tissue to the ray. This may be used with other treatment such as surgery and chemotherapy.

      Radiotherapy has been discovered by a Germany physician named Wilhem Rothgen which is the first person discovered the x-ray. It's been used by another physician to diagnose broken legs and allocated the foreign substance in the body on certain part. Following year in 1896, the other scientist Antoine-Henri Becquerel discovered a certain element called radioactivity that spontaneously emitted ray. After that, Becquerel has collaborated with Pierre and Marie Curie to find more about the element of radioactive.

      Finally, they have discovered the new radioactive which is radium and later on they found that radium can be used to kill the cancer cells. Emil Grubbe is a student doctor in Chicago became a first person that has been used x-rays radiation to cure the cancer.

TRUEBEAM

      Today, this kind of radiotherapy that used to treat cancer has been upgraded with more high technology being used in that system. The new system (TrueBeam) that's being used nowadays brought a lot of special characteristics and been modified by using high energy ray to spot the cancer or tumour without destroying the healthy tissues.

      TrueBeam is more fast, accurate and efficient compared to the other system. Other than that, TrueBeam usually only took a few minutes to do the diagnoses and treatment to patients than older system or surgery which usually took almost an hour. This system is generated by a machine called Medical Linear Accelerator that integrates imaging and radiation delivery. The Truebeam can be targeted at a tumor from any angles in three-dimensional shape to know its size, shape, and location. It also rotated around the patients to deliver the amount of radiation needed in correct angles with submillimetre accuracy and varying intensity. There are two types technique that has been used in the TrueBeam such as Intensity Modulated Radiotherapy (IMRT) and Image Guided Radiotherapy (IGRT).

CHARACTERISTIC OF TRUEBEAM

Latest Treatment

• IMRT

• IGRT

• Gated RapidArc

• SBRT

• SRS     

Enhanced Imaging System.

• TrueBeam kV Paired Imaging.

• TrueBeam Cone Beam CT – CBCT

• TrueBeam MV Imaging.

• TrueBeam Fluoroscopy.

• Gated RapidAch Technology - produce a 3D image with 360 degrees of rotation 60% faster compared to the other technology with 25% lesser of usage dose.

Open Interface.

• Calypso system, the positioning device.

• Monitor the moving tumour at the real time.

• ARIA® oncology information system.

• Capable to transfer big files data such as the imaging picture files

• The gated RapidArc system.

• Enable third party clinicians monitoring the motion of tumour.

Fast and Precise.

• Deliver treatment up to 50% faster compared to the previous version of Varian technology.

• IGRT and CBCT can be done in 60% less time and 25% less dose compared to other technology.

• Pinpoint accuracy.

• Performs accuracy checks every ten milliseconds throughout the entire treatment.

FEATURE OF TRUEBEAM

      The TrueBeam system boasts multiple layer of safety for patient, the system component and the user. Among the system's safeguard area physical, software, audible and visual mechanism specifically designed to help ensure safe operation of the treatment. These features work together to help improve patient safely, while allowing clinicians to navigate the complexities of cancer care with coincidence.

• Touch Ground

These components include the KV imaging panel, KV imaging source, the MC imaginKVpanel and if unskilled, the lower portion of the electron applicator.

• Capacitive Collision Detection System

These components are a non-contact layer of safety that stops the motion of the KV imaging source if the active area is encroached upon.

• Machine Motion Model

These components provide a 3D representation of the mechanical aspects of the entire system and prevent component-to-component collision.

• Zone Rules

The component is motion restriction safeguards which prevent hardware collision. It is also restricting any remote and some targeted motions from being performed during patient setup and treatment delivery if the system detects that a collision is possible.

• Live View Monitoring System

These systems act as a virtual presence, allowing the therapist to remain focused on the patient.

• Visual and Audio Monitoring System

This visual mechanism affords the user ample coverage of the treatment room with pan, tilt and zoom capabilities for optimal viewing. The audio mechanism enables constant interaction between the patient and therapist.

• Standardized User Interfaces

The pendants, couch side panel and treatment control console are all icon driven and use the same optical indicators for consistency and ease of recognition.

• Pre-treatment Dry Run Capability

Dry run is used to verify motion clearance prior to executing a plan with beam delivery. The dry run functionality moves all Truebeam external motion axes through their planned movement for the entire treatment, but does not deliver any dose to the patient.

• Laserguard II Infrared Laser Collision 

Laserguard II is an integrated patient and equipment collision detection system. The system uses an infrared laser scanning device that continuously monitors the contoured region between the collimator face and patient. If an object enters its protection zone, then Laserguard II stops motion prior to a potential collision

Input Process of TrueBeam

1. The data captured after using the TrueBeam Varian treatment are transfer to the Treatment Planning System (TPS) to generate treatment plan
2. A physicist check the plan quality and evaluate its deliverability then approve.
3. The plan are sent to the Treatment Management System (TMS)
4. The plan are then transferred to the linear accelerator(fastest straight pathway of data) for delivery.
5. The treatment plan from TPS sent through DICOM to the database (network drive)
6. For analysis, the TrueBeam trajectory log files of the treatment plan are recorded and transfer to the database (network drive).  

Processing Of Truebeam

1. The TrueBeam Varian Medical Systems, a new log file called trajectory log file system.
2. By using the new log trajectory log file system the data will provide a definite Quality assurance (QA)-Quality Control (QC) check which can increase the safety of Radiation Therapy (RT).
3. The log file will find the patient ID then compare the delivered data against their original planned values of their jaw position, the beam energy, the gantry angle, the collimator angle, couch angle and the number of segments used for the next treatment.
4. This TrueBeam log file analysis has an ability to catch any error related to data transfer quality without any additional effort.
5. The comparison between The TrueBeam log files from the database with the DICOM treatment plan files exported from treatment planning system (TPS).

Output Process

1. The MATLAB (MathWorks, Natick, MA) software use the beam on-off status and MultiLeaf Collimator (MLC) leaf positions from the TrueBeam log files to calculate and reconstruct the equivalent fluence map.
2. The MLC positions recorded in the log files are then will be validated by a physicist.
3. The QA are checked manually weekly to reduce any possible error.
4. Automatic TrueBeam trajectory log file analysis ensure the data delivery quality,it is efficient, accurate, used less human involvement that might cause error during data input process.
5. The data are printed into report for the physicist informan.

 
 

Overall Process