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Surface contour scanning system - Improved accuracy and efficiency -High level of integration -Multiple applications.

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Presentation on theme: "Surface contour scanning system - Improved accuracy and efficiency -High level of integration -Multiple applications."— Presentation transcript:

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2 Surface contour scanning system - Improved accuracy and efficiency -High level of integration -Multiple applications

3 Laser-Camera Technology Optical triangulation

4 Sentinel, LS100 - Discrete installation - Technical evaluation at Karolinska, Stockholm - Clinical evaluation in Uppsala - First installation in Uppsala

5 Sentinel, LS200 - Attractive design - Simpler installation - Service friendly - Design ready Q Delivery Q2 2007

6 Sentinel system – SW and HW High level of user friendliness –Connectivity –Simplicity –Efficiency

7 Connectivity - Network support

8 Sentinel – multiple applications -Patient Positioning -Motion Detection -Respiratory Gating

9 Sentinel – Patient Positioning cPOSITIONING -Improved accuracy -Efficient workflow -User friendly -No additional markers -No added radiation

10 User friendliness – Clinical mode

11 User friendliness – Advanced mode

12 Efficiency - Performance and Work flow Scan time is typically 3-5 seconds Surface matching takes typically 1 second Sub-millimetre accuracy

13 Sentinel – Motion Detection cMOTION -Does not require active supervision -Visualization -Recording -Alarm

14 cMOTION workflow cMOTION -Integrated workflow with cPOSITITION or Stand-alone functionality -Markerless solution -Alternative to manual supervision (camera + monitor), userfriendly solution. cPOSITIONINGcMOTION

15 Sentinel – Respiratory Gating cRESPIRATION Respiratory gating in the Sentinel system

16 Background Respiratory motion can affect the delivered dose distribution –Especially in the thorax/abdominal region Available solutions –Increased margins More dose will be delivered to the surrounding healthy tissue Organs at risk must still be protected, which may be very difficult if they move near or into the desired target volume –Gated treatment Dose delivery is synchronized with respiratory motion Potential for dose escalation, resulting in higher delivered dose to the tumor while healthy tissue is spared The correlation between internal and external (surrogate) motion must be known

17 Establishing correlation How can we establish the correlation between internal and external motion? –4D CT study –Gated fluoroscopy (on a conventional simulator) End exhale End inhale 0% 100% Amplitude Gating window

18 Breathing patterns Inter- and intrafractional variations –Changes in frequency and amplitude –Thoraxic vs. abdominal breathing –Irregularities (coughing, unexpected breath hold, patient movement) Solution –Coached breathing/biofeedback –Parallel monitoring of both thoraxic and abdominal respiratory motion –Algorithms for detecting irregularities

19 The cRespiration workflow Gated CT study (retrospecive/ prospective) Gated treatment planning and delivery 3D CT study (gated) Gating parameters

20 Prospectively gated CT study CT CT room 3D CT study (gated) LS Respiratory signal Patient Establishing of gating parameters Real-time generation of gating signal Gating parameters

21 CT CT room 4D CT study 3D CT study (ungated) LS Respiratory signal Patient Sorting of CT data according to respirator y phase Selection of phases suitable for treatment 3D CT study (gated) Gating parameters Retrospectively gated CT study

22 Gated treatment planning and delivery Gating enable (SW/HW) LINAC treatment delivery Treatment room LS Respiratory signal Patient Real-time generation of gating signal 3D CT study (gated) Gating parameters Treatment planning RT plan

23 The cRespiration concept Simplicity –No markers to be placed –Integrated workflow through the whole process Confidence –No additional dose –Sub-millimeter accuracy, measured at the same locations every fraction without manual guidance –Parallel monitoring of thoraxic and abdominal breathing –Immediate detection of irregular breathing or patient motion Versatility –Support for several modes of operation – deep inspiration/end expiration breath hold, as well as coached and free breathing –Tight integration with CT and Linac equipment from major vendors

24 Milestones June 2008: Clinical validation activities begin –In cooperation with the Academic hospital in Uppsala –Philips Big Bore CT –Elekta Precise Linac July : AAPM in Houston, Texas –First public demo of the cRespiration module Q4 2008: –Commercial release to all markets 2009: –Support for additional CT and Linac equipment, e.g. Varian, GE, Siemens

25 Sentinel - Integration in a RT clinic, c4D software System modules –Patient alignment –Full network support –Motion detection (available Q2 2008) –Gating functionality (available Q4 2008) Interfaces –DICOM-RT interface for patient setup –Interface to Elekta iCOM –Interface to Varian 4D console –Interface to Visir R&V –Interface to Hexapod couch (Q2 2008)


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