Real-time Position Management ? System - 8 Pages

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Catalogue excerpts

Real-time Position Management™ System COMPREHENSIVE SYSTEM FOR TOTAL MOTION MANAGEMENT RPM gates the imaging and treatment beams on and off at predetermined intervals based upon the patient’s breathing pattern, and also detects unexpected motion in any direction. Key features > Respiration-synchronized imaging and treatment > 3D real-time patient position monitoring detects unexpected motion > Patient-friendly system eliminates the need for breath holding > Versatile – interfaces with CT, PET/CT, PET, On-Board Imager® kV imaging system, and PortalVision™ MV imaging system > Pretreatment fluoroscopic verification of gating > Supports all standard breathing protocols, including free-breathing > Easy to use, easy to learn > Backed by Varian experience and world-class customer support The Varian Real-time Position Management™ (RPM) system is a patient-friendly, video-based system that compensates for target motion, enabling improved imaging and treatment in areas such as lung, breast and upper abdominal sites. RPM is accurate and easy-to-use, and provides both respiratory gating for respiration-synchronized imaging and treatment, as well as 3D real-time patient position monitoring. It is comfortable for the patient and accommodates all clinical breathing protocols, including free-breathing.

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RESPIRATION-SYNCHRONIZED IMAGING AND TREATMENT 3D REAL-TIME PATIENT POSITION MONITORING* RPM Respiratory Gating technology enables correlation of the tumor position with the patient’s respiratory cycle. Using an infrared tracking camera and a reflective marker placed on the patient, the system measures the patient’s respiratory pattern and range of motion and displays them as a waveform. In addition to respiratory gating, RPM Patient Position Monitoring tracks the position of the marker block in three dimensions (vertical, longitudinal and lateral). Any unexpected movement of the marker block,...

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Menu bar Tool bar Periodicity meter Visual prompt Image window Respiration waveform 3D real-time patient position monitoring* Upper gating threshold Lower gating threshold Beam on/off indicator RPM software runs on the PC workstation. RPM workstations are networked to a multiuser gating database. MAJOR COMPONENTS OF THE RPM SYSTEM Infrared tracking camera Predictive Filter The infrared tracking camera is a video camera equipped with an array of LEDs that emit infrared light in the direction in which the camera is pointing. Dots on the marker block reflect the infrared light back to the camera,...

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RPM clinical process and workflow: Patient selection through pret RPM is in routine clinical use worldwide. Here is an overview of the clinical process: PATIENT SELECTION IMAGING FOR TREATMENT PLANNING When RPM is used with the Acuity™ treatment planning, simulation and verification system, evaluating patients for gated treatments is a simple and straightforward process. RPM integrates with the fluoroscopic mode of Acuity to establish the extent of the patient’s respiratory motion and the stability of breathing. Before and during image acquisition, stable breathing is established with the aid...

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reatment verification Images courtesy of AZ Sint Augustinus, Wilrijk, Belgium In these treatment planning images from Eclipse, the non-gated image shows motion artifacts in both the normal anatomy and target volume. The gated image shows clear definition of both the normal anatomy and target volume. In the non-gated image, 50% of the prescription dose is given to 49% of the normal lung volume. In the gated image, 50% of the prescription dose is given to 23% of the normal lung volume. TREATMENT PLANNING PRETREATMENT VERIFICATION The Eclipse™ treatment planning system displays the motion of targets...

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RPM clinical process and workflow: Treatment delivery TREATMENT DELIVERY The patient is positioned for delivery with the marker block in the same location on the chest or abdomen as during simulation. Gated radiograph positioning This technique is similar to radiographic image positioning with the On-Board Imager (kilovoltage) or PortalVision (megavoltage), enhanced by RPM to enable gated image acquisition. The system automatically acquires radiographs during the pre-determined phase of the respiratory cycle, when the treatment beam is gated on. The gated kV or MV radiograph is then compared to...

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SELECTED REFERENCES Correlation of the RPM Gating Marker Block and Internal Anatomy Berson AM, Emery R, Rodriguez L, Richards GM, Ng T, Sanghavi S, Barsa J; “Clinical Experience Using Respiratory Gated Radiation Therapy: Comparison Of Free-Breathing And Breath-Hold Techniques”; Int J Radiat Oncol Biol Phys. 2004 Oct 1;60(2):419-26. Shen S, Duan J, Fiveash JB, Brezovich IA, Plant BA, Spencer SA, Popple RA, Pareek PN, Bonner JA; “Validation Of Target Volume And Position In Respiratory Gated CT Planning And Treatment.”; Med Phys. 2003 Dec;30(12):3196-205. Vedam SS, Kini VR, Keall PJ, Ramakrishnan...

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O n co l o g y Sy s t e m s 3100 Hansen Way Palo Alto, CA 94304-1038 tel 650.424.5700 tel 800.544.4636 www.varian.com USA Headquarters California Varian Medical Systems Palo Alto, CA Tel: 650.424.5700 800.544.4636 Fax: 650.493.5637 www.varian.com USA Regional Offices California Varian Medical Systems Corona, CA Tel: 951.280.4401 Fax: 951.280.4300 European Headquarters Switzerland Varian Medical Systems International AG Zug, Switzerland Tel: 41.41.749.8844 Fax: 41.41.740.3340 Austria Varian Medical Systems Gesellschaft m.b.H. Voesendorf, Austria Tel: 43.1.698.56.56 Fax: 43.1.698.56.59 India Varian...

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