American College of Radiology Issues New Guidelines for Non-Urgent Treatments

On May 6th, 2020, the American College of Radiology (ARC) released new guidelines that can help radiology practices resume non-urgent treatments safely. Treatments that are considered non-urgent are mammograms, oncologic and orthopedic imaging, and image-guided biopsies. Most of these treatments do not include radiation therapy that often involves the use of Linear Accelerators and CT scanners. 

As Coronavirus cases continue to drop in most areas, radiology practices are starting to resume non-urgent care practices to patients. “Radiology practices largely followed the World Health Organization, Centers for Disease Control and Prevention, and SCP guidance to postpone non-urgent care. While local conditions prevent a single prescriptive strategy to resume such care, general principles can apply in most settings…” said American College of Radiology Commission on Quality and Safety Chair, Jacqueline A. Bello, M.D., FACR. 

Read more about the ACR guidelines here. 

Radiotherapy Treatments for Bowel Cancer Patients to Be Shortened Due to COVID-19

An international panel of cancer experts has recommended a one-week treatment protocol for patients who need radiotherapy. On April 7, 2020, the group discussed the best way to minimize the additional issues that radiotherapy treatment causes, namely, weakened immune systems. Surgery, which usually happens one to two weeks after radiotherapy, can be safely delayed by up to 12 weeks, says the expert panel. 

People with bowel cancer are more susceptible to severe complications from COVID-19 because their immune systems are weakened. Shortening the length of radiotherapy replaces the need for chemotherapy, which typically can make the immune system even weaker. 

"The COVID-19 pandemic is a global emergency and we needed to work very quickly to identify changes that would benefit patients. Our recommendations were published 20 days after our first meeting. This process normally takes many months, if not years,” said David Sebag-Montefiore, professor of clinical oncology at the University of Leeds and who lead the panel of cancer experts. 

The panel, which was comprised of 15 top cancer professionals, showed that surgery could be safely postponed after radiotherapy from oncology equipment was performed. This protocol allows surgery to be scheduled after the peak of the pandemic. 

Read more on how radiation therapy has been affected by the COVID-19 pandemic here. 

PTW Announces Big News for the BEAMSCAN MR

The PTW has announced the 510(k) clearance from the U.S. Food and Drug Administration (FDA) for the BEAMSCAN MR Motorized 3D Water Phantom. The BEAMSCAN MR is now available on the market within the U.S. PTW has already completed the installation of the first item in North America located at the Princess Margaret Cancer Centre in Toronto, Ontario, Canada. 

This new addition will provide a dedicated, fully equipped solution for beam data commissioning and annual QA of MR-LINACS. The center in Toronto is one of the largest cancer centers in the world. It is home to two state-of-the-art MR-LINAC systems, one being the Elekta Unity machine, which offers BEAMSCAN MR compatibility. To read more information about the BEAMSCAN MR and PTW, read this article here.

Replacing or Upgrading a LINAC? Here’s What You Need to Know.

Radiotherapy is a critical treatment process used in hospitals and clinics for patients with cancer. Therefore, it is extremely important to ensure that you are using the right equipment to gain the highest quality of care. Linear accelerator (LINAC) systems are one of the most expensive assets in terms of medical equipment today. Choosing to replace or upgrade LINAC equipment is a significant matter as it impacts the facility's operations, doctor's decisions, and the patient's health. There are four main categories that equipment can fall into that are based on a hospital or clinic's needs and capabilities.

Newer Equipment with Full Upgrades

Being able to provide the best level of care for patients should be the highest goal for any medical facility. Thus, having new equipment with upgraded features offers the best of the best in terms of care. If a clinic needs to move, it would still be cost-effective to pay the relocation charges, which can be over $100k in expenses, instead of purchasing a new replacement LINAC system.

Newer Equipment with Fewer Upgrades

Choosing a LINAC system with fewer upgrades can save money and might be more appropriate for smaller clinics that see fewer patients. However, specific technologies, like portal imaging, may be beneficial for those who want higher-quality devices. There is a good chance that a facility will be continuing to use this equipment for a while before it depreciates. The best advice is to determine which upgrades would be most appropriate for your office.

Older Equipment with Full Upgrades

If your LINAC system is older than 20 years, it's likely your machine has paid for itself even after additional upgrades. Older equipment can still be reliable, but as technology progresses, they soon will end up costing you more money and become less efficient. Also, if a company needs to relocate, the relocation costs may end up costing you more than a new machine.

Older Equipment with Fewer Upgrades

This remaining category should generally be looked upon as the last consideration. In most cases, equipment will no longer perform the necessary tasks required for treatments. Replacement parts will continue to become sparse and more costly as new machines come into the marketplace, rendering older versions obsolete.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment.  Radparts provides high quality, user friendly, low cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

Monitoring of Patient Movement During Radiotherapy May Get Easier

Research from Washington University School of Medicine in St. Louis has found using new mmWave technology to be a great asset to perform precise monitoring of patient motion in real-time during radiotherapy treatments. The mmWave technology can monitor displacements with .1mm to 1 mm accuracy at low cost using a simple and easy to use device. Imaging with millimeter waves can overcome obstacles of current techniques like the optical tracking of a patient’s skin surface or CT scanning. This new device can also monitor breathing and cardiac motion that may, in time, replace respirometers or other breathing monitoring devices. To read more about the research and the outcome of mmWave technology, you can read this article for more information.

Beams Used in Radiation Therapy

The use of external beam radiation therapy is one of the most common forms of cancer treatments that a doctor or oncologist will recommend. This method involves radiotherapy equipment such as a linear accelerator that aims radiation from outside of a patient’s body and directly targets local areas of a cancer site. Various types of cancers can be treated with external beam radiation therapy, and depending on the unique characteristics of the tumor, a selection of systems and treatments will be formed for the best outcome. Not only are there different types of machines that can be used, but also the radiation beam used in external radiation therapy can come from three kinds of particles called photons, protons, and electrons.

Photons

The majority of radiation therapy machines use ionizing photon beams since they can reach tumors deep in the body. Photons are also used in x-rays, although they consume a much lower dose of the particle in comparison. The radiation that is delivered during photon treatment will damage the DNA of tumors and healthy cells alike. Radiation therapists aim to maximize the dose targeting the tumor while minimizing the radiation to nearby healthy tissues by creating different paths with multiple fields. To avoid overexposure to healthy cells, the treatment is generally given in stages over repeated scheduled sessions so that the healthy cells have time to repair.

Protons

Charged particle radiotherapy is an alternative method of radiotherapy that uses beams of protons or other positively charged particles such as helium, carbon, or other ions that are not photons. These types of beams can also reach tumors deep inside the body, but they perform differently than photons as they do not scatter radiation on their path and will stop once they reach the targeted tumor. Due to the physical characteristics of charged particles, it may be possible to cover the tumor area with only one radiation field, creating an advantage over the use of photons to spare more healthy tissues and cells. Clinical trials are continuing to compare the usage of these two energy types. There are cancer centers that are beginning to use proton beams in radiation therapy, but they have higher costs and require a larger space to fit the increased size of the equipment.

Electrons

Particles with a negative charge are electrons. Electron beam radiation therapy is designed to treat cancers like lymphoma and other tumors near the surface since these electrons do not go deep into the body. These therapy options can be done in two different ways:

1. Spot treatment - This method is used for one or more cancerous spots on the body that needs treatment.
2. Total Skin Electron Beam Therapy (TSEB) - This method is used when the entire surface of the skin needs to be treated. Other treatments called compensation treatments can be part of the treatment plan to guarantee that every area of the skin receives the proper dose required.

Radparts is the world’s largest independent distributor of OEM replacement parts for Linear Accelerators and Radiation Oncology equipment. Radparts provides high quality, user-friendly, and low-cost parts and support for linear accelerators and radiation equipment. More information can be found at https://www.radparts.com/.

World Cancer Day Brings Discussions for More Affordable Radiotherapy Treatment Options

In celebration of World Cancer Day on February 4^th, director of IAEA General Rafael Mariano Grossi raised awareness about radiotherapy and how widely used the treatments are throughout the world. He brought to light the fact that 1/3 of lower-to-middle-income countries do not have access to any radiotherapy treatments. A total of 28 countries in Africa do not have a single radiotherapy unit, which makes a cancer diagnosis almost a death sentence for many. It is estimated that 300,000 women die from cervical cancer each year, which needs to stop as this form of cancer can typically be treated and cured in developed countries. The IAEA continues to spread awareness and will establish nuclear and radiation medicine services and provide training to medical professionals to help change these statistics. To learn more, read this article.