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Technology & Treatment

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The "TrueBeam" Linear Accelerator

truebeam-patient.JPGThe Valley Hospital’s Blumenthal Cancer Center is proud to offer an evolutionary therapeutic technology for the treatment of tumors: the TrueBeam Linear Accelerator.

The TrueBeam™ system has been designed to optimize Conventional Radiotherapy, Stereotactic Body Radiotherapy (SBRT) and Stereotactic Radiosurgery (SRS). It is the latest advancement in radiation therapy technology developed to deliver powerful cancer treatments with pinpoint precision. Real-time imaging tools allow clinicians to “visualize” the tumor they are targeted to treat, allowing them to consistently treat these tumors with accuracy measured in millimeters.

By administering higher doses of radiation with more precision, this accelerator delivers treatments up to 400% faster than our former accelerators. Most treatments will take just a few minutes a day, whereas treatments with traditional linear accelerators take 30-60 minutes. With shorter treatment times and smoother operation, TrueBeam provides a more comfortable environment for the patient. The enhanced communication technology of TrueBeam also enables constant interaction between the patient and the therapist operating the unit, and three closed-circuit television systems enable the therapist to monitor the patient at all times.

Real-time imaging accounts for patient movement that can affect the ability to target the tumor accurately. “Since the TrueBeam’s approach is more targeted and focused, it is much more important to monitor a patient’s movements. Even the slightest movement a patient makes, even when they breathe, can move a tumor slightly out of place and jeopardize the ability to target the tumor with precision,” says Deborah Panetta, Director of Radiation Oncology. Real-time imaging tools account for this possible discrepancy by enabling the accelerator to program itself during certain instances of a patient’s breathing cycle, and for targeted treatments to be synced with respiration. Treatments are administered only when the patients’ tumors are in specific locations during the respiratory cycle. With a seamless integration of treatment, imaging, and motion management, the TrueBeam enables streamlined workflow, better efficiency, and improved safety.

TomoTherapy

TomoTherapy optimizes radiation therapy by delivering an advanced form of Intensity Modulated Radiation Therapy (IMRT) with unprecedented precision. This enables more accurate and more precise treatment of the tumor, while minimizing the dose to surrounding healthy tissue.

What’s unique about this technology is that a limited CT scan is taken prior to each daily treatment to determine the precise location of a patient’s tumor.  Radiation is then targeted and delivered to the specific area via tiny highly targeted beams that rotate in a helical pattern.

“Valley’s radiation oncologists are among the most experienced in the Northeast in the use of this cutting-edge technology, which allows us to deliver precision radiation therapy, “ explains Michael F. Wesson, M.D., Radiation Oncologist at The Valley Hospital. “This technology reduces exposure of healthy tissue to radiation, which means a reduction in side effects for our patients.”

During a patient’s course of treatment, which can take up to nine weeks, a tumor can move and change in size. The ability to do 3-D imaging immediately before each treatment to verify the location of a tumor increases the precision of the treatment. “We are now able to perform Image Guided Radiation Therapy (IGRT), which is the new state-of-the-art for radiation therapy treatment,” says Chad DeYoung, M.D., Director of Radiation Oncology.

The Valley Hospital Department of Radiation Oncology has a long and proud track record of innovation. Valley was the first institution on the East Coast to perform prostate seed implant therapy and the first to treat patients using Intensity Modulated Radiation Therapy (IMRT).

The Valley Hospital Oncology Services Program became the first in New Jersey and the New York metropolitan area to be awarded Disease-Specific Care Certification for cancer care from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). This certification serves as the Gold Seal of Approval™ for health care quality.

Gamma Knife

Gamma Knife CenterThe Valley Hospital was the first hospital in northern New Jersey to offer Gamma Knife stereotactic radiosurgery, a noninvasive tool designed to treat cancer and neurological conditions of the brain.

Gamma Knife radiosurgery is a safe and effective method for treating cancer and neurological conditions in the brain, head and neck. Trigeminal neuralgia and brain cancer are two of the many diagnoses treatable with Gamma Knife radiosurgery.

The commonly used phrase Gamma Knife “surgery” is largely a misnomer. The technology is not a “knife” in the traditional meaning of the word, nor is it “surgery” given that no incisions are made there is no overnight stay in a hospital or an extended recuperation period.

Instead, highly focused beams of radiation are directed to the treatment area. The shape and dose of the radiation are optimized to hit only the target, without damaging surrounding healthy tissue.

Gamma Knife radiosurgery provides safe and effective treatment for more than 40,000 patients treated every year around the world.  The procedure is simple and painless.  Patients are treated in one session and can resume normal activity shortly after treatment.

For information on Valley’s Gamma Knife Center, please go to www.ValleyGammaKnife.com.

CT Simulation

CT Simulation and 3D Treatment Planning Systems are the standard of care at Valley to plan each individual patient’s radiation therapy regimen. These technology choices once again demonstrate Valley’s commitment to excellence.

The CT Simulator, as opposed to a conventional simulator, is the most advanced geometric planning system available. In addition, Valley’s focus on patient safety mandates that all CT scanned patients receive as little radiation dose as possible. All units are calibrated and monitored to ensure optimal scan data with minimal exposure to the patient.

Treatment Planning

CT scan data is then used to plan all radiation treatments. The images generated by the simulator are transferred to appropriate 3D treatment planning computers and used by the Radiation Oncologists and Physicists to develop an optimal treatment delivery course.

The three-dimensional treatment planning system enables physicians to more precisely target the exact tumor and dosage needed. The system creates a three-dimensional “virtual patient” from CT images. All of the tissue, bone and air cavities that fall in the path of the radiation beam can be visualized and analyzed to determine how much radiation will be delivered to each area within the patient. The system provides views that have never before been available, allowing Radiation Oncologists to ensure maximum dose to the tumor site and minimal radiation to normal structures.

Brachytherapy

Seed Implants

Brachytherapy is an extremely valuable technique that has saved many lives. Often an alternative to surgery, brachytherapy techniques can be used in treating cancers of the prostate, lung, head/neck, pancreas, colon, esophagus and gynecological area. Valley was the first institution on the East Coast and second in the nation to introduce ultrasound-guided prostate brachytherapy – the revolutionary “seed implant” therapy for prostate cancer.

With brachytherapy, radioactive material is permanently implanted directly into a tumor. These implants allow radiation oncologists to deliver high doses of radiation to the tumor itself without affecting surrounding tissue.

At Valley, a Radiation Oncologist is on call to the operating room 24 hours a day to perform brachytherapy. In situations where a surgeon is unable to remove a tumor or feels that some cancer cells may be left behind, seed implants can be inserted into the patient in the operating room. This quick response sets Valley apart from other hospitals and gives patients a significant extra level of medical attention. Studies have shown that success rates with seed brachytherapy are better than or equal to surgery, and seed brachytherapy is a less invasive procedure with low rates of complications.

High Dose Rate Afterloader

At Valley, another type of brachytherapy using a High Dose Rate remote afterloader (HDR) is used to temporarily delivery high doses of radiation to small, clearly defined cancer sites such as skin, esophagus and lung. Because of the strength and control of the HDR source, patients only need a few treatments, which can be performed on an outpatient basis.


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