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Australia's Prince of Wales Hospital Launches New Era of Targeted Lung Cancer Treatments with Elekta's Advanced 4D Motion Management Technology
Date:10/31/2011

cannot tell us in which part of the respiratory cycle it was captured," Dr. Wong explains. "Conversely, Symmetry provides a dynamic 4D cine/picture of the movement of the tumor mass throughout the entire respiratory cycle. This is especially important in lung cancer treatment given the natural excursion of the tumor with the breathing cycle. Symmetry enables us to see the tumor's movement in real time."

Symmetry: From planning to treatment

Hypofractionated SBRT of lung tumors at Prince of Wales involves several Elekta solutions, encompassing planning through to treatment.

To ensure a consistent patient breathing pattern during treatment, planning CT scans are performed with Active Breathing Coordinator™. This Elekta technology enables acquisition of a breathing trace that shows peak inhalation and exhalation points during normal breathing.

"Patients are instructed to hold their breath for 12 seconds at both peak points so that CT scans can be acquired," says Simon Downes, Director of Medical Physics. "The images show the tumor's position at both maximum inhalation and maximum exhalation, and guide treatment planning."

Clinicians plan lung treatments with XiO® treatment planning system. MOSAIQ® Oncology Information System is used to verify and record the plan. For immobilization, Prince of Wales clinicians use BodyFIX®, and Symmetry provides the needed data on tumor position – with Symmetry CBCT scans acquired just before treatment. Patients are treated on the center's Elekta Axesse™ system.

"All of these different systems come together seamlessly to allow us to perform these lung treatments," Downes observes. "In particular, it's remarkable how well Symmetry maps the tumor's position. In a second Symmetry CBCT scan after treatment, we found that we had achieved less than a two millimeter positional error, meaning that the clinical target v
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