CTVision System. Accurate Imaging for Precise Treatment.

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1 CTVision System Accurate Imaging for Precise Treatment

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3 Adapt in Real Time A radiation therapy treatment plan is a snapshot in time. But as time moves on, changes in patient anatomy and tumor characteristics can undermine the desired therapeutic outcome unless the plan keeps pace in real time. With the advent of the CTVision System for in-room CT imaging, clinicians have up-to-the-minute diagnostic information at their fingertips and can quickly adapt the plan just prior to treatment. The result can be a critical improvement in precision and an important difference in therapeutic quality. Fully Integrated for Quality and Speed CTVision is the only fully integrated Image-Guided Radiation Therapy (IGRT) solution, bringing the same fast, highcontrast diagnostic CT imaging standard used for treatment planning into the treatment room. With CTVision, a SOMATOM CT Sliding Gantry travels along parallel high-precision rails for quick and easy diagnostic imaging of the patient on the treatment table. After the scan, the CT gantry returns to the park position, other procedures can be performed, and radiation therapy can start immediately. The CTVision solution is designed for ready integration with new and existing Siemens linear accelerators such as PRIMUS, ONCOR, and the ARTISTE Solution. CTVision significantly reduces the extrinsic and intrinsic uncertainties associated with patient setup and organ motion a critical consideration in advanced clinical scenarios such as Structure-Guided Radiation Therapy (SGRT ) and Volume-Guided Radiation Therapy (VGRT ). We can treat our patients immediately, with much more confidence. M.W. Münter, MD Assistant Professor German Cancer Research Center (DKFZ) Heidelberg, Germany 3

4 With CTVision, knowing about changes in critical structures on a daily basis especially soft-tissue interfractional changes allows us to adapt the therapy as needed and accurately target the evolving cranial topography. Ron R. Allison, MD Professor and Chairman Department of Radiation Oncology The Brody School of Medicine at East Carolina University Greenville, NC 6

5 CTVision allows us to identify and localize the exact location of the prostate, seminal vesicles, and rectum without any internal or external markers, even for bariatric patients. James Wong, MD Chairman, Department of Radiation Oncology Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, NJ

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7 The Highest Standard of Quality in Diagnostic Imaging When high-performance IGRT is the goal, CTVision is the solution. CTVision was the first and only system to integrate a CT-on-rails scanner with a medical linear accelerator to bring IGRT delivery into the treatment room. In clinical practice, oncologists can now obtain gold-standard quality diagnostic images with the patient in the actual treatment position. This information can then be immediately applied, helping to improve treatment precision. CTVision provides: Unmatched visualization with up to 82 cm field-of-view (FOV) of the bony anatomy, soft tissue, markers, and real-time tumor motion Superb soft-tissue contrast for conformal avoidance and tissue differentiation for all tumor types Unparalleled image quality across the broadest spectrum of clinical challenges Greater diagnostic precision based on the ability to view planning and high-quality treatment images with Adaptive Targeting software in the same modality Excellent patient accessibility and easy accommodation of patient load capacity up to 550 lbs (250 kg) These images illustrate interfractional changes revealed during CTVision IGRT. In each example, a slice from the planning CT is shown on the left, while a slice taken during daily IGRT is shown on the right.

8 Excellence in Every Environment CTVision not only provides the highest diagnostic CT imaging quality available it also delivers the flexibility to meet a wide range of institutional requirements: The CT system can be installed 90 respective to the linear accelerator to account for various treatment room sizes A selection of CT scanners offers options for all levels of clinical and investment needs Existing Siemens linear accelerators can be easily retrofitted The integrated system offers the speed and versatility demanded by emergency-room environments Virtually all radiation therapy applications are supported, both curative and palliative Configured for Confidence CTVision capitalizes on the long-proven performance of the SOMATOM CT family, including the SOMATOM Sensation Open. This innovative system combines the advantages of a large-bore CT with advanced multi-slice CT technology. Its 82 cm gantry bore and 82 cm FOV provide the greatest flexibility for patient accessibility and advanced applications such as 4D respiratory gating. In addition, bariatric patients with breast cancer, lung cancer, and Hodgkin s lymphoma can be scanned in the proper position. To achieve the lowest possible radiation exposure, SOMATOM CT technology also allows for dose reductions of up to 65% while still providing unparalleled image quality. CTVision performs seamlessly with all of Siemens highly advanced linear accelerators, each offering a variety of features designed to meet specific institutional and clinical requirements: ARTISTE ARTISTE offers a comprehensive portfolio of image-guided and advanced treatment delivery tools, along with significant workflow advantages. ARTISTE enables clinicians to choose the appropriate treatment technique for each patient, make critical adjustments on the spot, and deliver true Adaptive Radiation Therapy (ART) according to individual patient needs. ONCOR The ONCOR family of linear accelerators ensures outstanding configuration flexibility in a leading-edge radiation therapy treatment solution optimized to meet the widest range of IGRT needs. PRIMUS The PRIMUS Linear Accelerator combines enhanced beam accuracy with treatment automation to provide maximum radiation to the tumor, minimum dose to surrounding healthy tissue, and less time-on-table for patients.

9 CTVision allows a fast application of IMRT [Intensity-Modulated Radiation Therapy] and a CT-based image-guided positioning control with excellent image contrast...allowing a real ART approach for interfractional changes of the target volume or the patient s geometry. M.W. Münter, MD Assistant Professor German Cancer Research Center (DKFZ) Heidelberg, Germany Versatility of Choice: The SOMATOM CT Family EMOTION DUO EMOTION 6 EMOTION 16 SENSATION OPEN BORE SIZE 70 cm 70 cm 70 cm 82 cm EXTENDED FIELD-OF-VIEW (EFOV) 70 cm 70 cm 70 cm 82 cm TUBE 3.5 MHU 5 MHU 5 MHU STRATON MHU Equiv. 30 MHU MAXIMUM SLICES /40 ROTATION SPEED 0.8* 1, 1.5s std 0.6* 0.8, 1, 1.5s std 0.5* 0.6, 1, 1.5s std 0.5 1s std *Optional 9

10 The Strong and Stable Solution CTVision combines the strength and stability of the 550 TxT Treatment Table with the speed and accuracy of Siemens linear accelerators. The 550 TxT table is engineered to the highest standards of precision, offering a carbon tabletop specifically designed to meet the requirements for CTVision Systems, and a unique lifting mechanism that can easily handle a patient load capacity of 550 lbs (250 kg). As a result, the highest-quality CT examinations, including topogram, spiral, and sequence scans, can be performed with uncompromised efficiency and functionality right in the treatment room. Optimal Workflow with Treatment Planning CT Dataset To save treatment time and maximize the clinic s investment, the integrated CTVision solution supports CT and IGRT planning with a single unit in a single room. Workflow is unparalleled: by using the same room and the same table for imaging and treatment, patient repositioning is reduced or eliminated, scanning time is optimized,and accuracy is enhanced. The result is a more efficient use of existing resources, along with greater clinician confidence in treatment planning and patient outcomes. 10

11 Example: CTVision Protocol S T E P 1 Access the CT dataset for radiation therapy planning (RTP). S T E P 2 Immobilize the patient on the 550 TxT Treatment Table. S T E P 3 Apply CT-visible landmarks (BBs) to the patient s anterior and lateral skin markings. S T E P 4 Position the patient within the CT bore with inferior and superior margins sufficient to scan the target. STEP 5 Perform the scan. STEP 6 Review the CTVision dataset and identify BBs. In the meantime, and without disturbing the patient, rotate the table by 180 and adjust the patient in the treatment position. STEP 7 Fuse the CTVision dataset and the planning CT automatically with the Adaptive Targeting software to determine the required table adjustment. S T E P 8 Adjust patient position by moving the table to the new coordinates. 11

12 We found that daily intrinsic prostate movements can be easily and precisely corrected for any patient, independent of their size, before each radiotherapy session, allowing extremely precise prostate cancer treatment. James Wong, MD Chairman, Department of Radiation Oncology Carol G. Simon Cancer Center at Morristown Memorial Hospital Morristown, NJ 12

13 Seamless, Patient-Friendly Workflow The ultimate goal of radiation therapy is to safely deliver the maximum dose to the tumor while sparing healthy tissue. To help meet this goal, the Adaptive Targeting software automatically registers the treatment planning CT to the actual CT dataset and calculates a 3D table offset; as a result, potential positioning errors are corrected and the most effective treatment is ensured. Clinicians can perform Adaptive Targeting offline with the syngo RT Oncologist workspace. This workspace provides all the necessary data and applications required for localizing and contouring the target and critical adjacent structures, visualization, and review of prior treatment history all in the privacy of the oncologist s office. When going online, syngo RT Therapist* offers a single integrated system that enables the therapist to perform patient setup, imaging, verification, and treatment delivery with one fast, highly efficient workflow. syngo RT Therapist also provides optional transparent connectivity with major oncology information systems. The use of CTVision reveals a shift in tumor position from the original planning CT, allowing clinicians to make timely adjustments to the treatment plan that enhance the potential for safe and precise radiation therapy. * COHERENCE Suite of Oncology Workspaces is currently being rebranded to syngo Suite for Oncology. syngo RT Therapist is pending FDA 510(k) clearance and is presently not available for commercial distribution in the United States. Please check with your sales representative for current registration status. 13

14 Service Built on Experience CTVision is backed by one of the most extensive service and support organizations in the world, offering a wide range of programs specifically designed to meet the needs of Siemens radiation oncology customers. Siemens Oncology Learning Center offers comprehensive training on the efficient and effective operation and service of linear accelerator equipment and software VELOCITY is an exclusive service that can speed commissioning time from three weeks to three days MOMENTUM is a suite of services that allows customers to apply the latest treatment techniques with greater efficiency, speed, and effectiveness Siemens On-Site Oncology Applications Specialists work on-site with treatment staff to streamline workflow processes and develop greater user comfort and confidence with new technology and procedures Siemens Remote Service (SRS) is a comprehensive infrastructure for optimizing system availability, preventing unscheduled downtimes, and improving patient planning and throughput 14

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16 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and are subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications and options, as well as standard and optional features that do not always have to be present in individual cases. Siemens reserves the right to modify the design and specifications contained herein without prior notice. Please contact your local Siemens sales representative for the most current information. Note: Any technical data contained in this document may vary within defined tolerances. Original images always lose a certain amount of detail when reproduced. Please find fitting accessories: CTVision, PRIMUS, ONCOR, ARTISTE, Structure-Guided Radiation Therapy, SGRT, Volume-Guided Radiation Therapy, VGRT, Adaptive Targeting, 550 TxT, COHERENCE, VELOCITY, and MOMEMTUM are trademarks and syngo, SOMATOM, and STRATON are registered trademarks of Siemens Medical Solutions USA, Inc. Contact Address Siemens Medical Solutions USA, Inc. Oncology Care Systems 4040 Nelson Avenue Concord, CA USA Telephone: (US & Canada) Siemens AG Medical Solutions Henkestraße 127 D Erlangen Germany Telephone: Images courtesy of: Ron R. Allison, MD, Brody School of Medicine at East Carolina University, Greenville, NC M.W. Münter, MD, German Cancer Research Center (DKFZ), Heidelberg, Germany James Wong, MD, Scott Merrick, and Jeff Gao, Carol G. Simon Cancer Center at Morristown Memorial Hospital, Morristown, NJ , Siemens AG Order No. A91OCS-212-C1-4A00 Printed in USA OCS-212 KL JO 5M Siemens Medical Solutions USA, Inc. Oncology Care Systems 4040 Nelson Avenue Concord, CA USA Headquarters Siemens Medical Solutions USA 51 Valley Stream Parkway Malvern, PA USA Telephone: