Mobile CT lines up for adaptive proton planning

The AIRO mobile CT system is being commissioned for use with the centre's Mevion S250 proton therapy system. Image courtesy of Orlando Health UF Health Cancer Center

CT is an integral part of adaptive image-guided proton therapy (IGPT). It is used to monitor changes in a cancer patient’s anatomy caused by weight loss and/or tumour shrinkage, as well as for treatment plan adaption. CT simulation scans are usually performed in imaging suites outside proton therapy treatment rooms. This set-up, however, can cause workflow inefficiencies and inconvenience for both staff and patients alike.

Compact mobile CT systems may change all this, by enabling scanning to be performed within proton treatment rooms. The Center for Proton Therapy at Orlando Health UF Health Cancer Center has successfully installed a mobile CT system for patient localization and set-up in its compact proton therapy vault. The research team has now described the commissioning process and the dosimetric implications of adaptive planning with the mobile system (J. Appl. Clin. Med. Phys. doi: 10.1002/acm2.12319).

The scanner (the AIRO Mobile CT System) being commissioned for use with the centre’s Mevion S250 proton therapy system is a 16-slice helical scanner that acquires images with 120 kV, 10-250 mA and a field-of-view (FOV) up to 51.2 cm. Designed for intraoperative surgery, the large FOV enables the scanner to capture the entire patient surface including immobilization devices and the treatment couch.

The commissioning process

A critical part of the commissioning process is setting up the stopping power curve for an in-room CT scan so that dose calculations on the scanner are dosimetrically matched to the treatment planning system.

“This groundwork is important so that if adaptive planning is performed on the in-room CT, one can be certain that the changes in dose are due to changes in anatomy and not to differences in the CT scanner or scanning protocols,” medical physicist Twyla Willoughby told Physics World. “This is very important in being able to make clinical decisions regarding adapting a treatment plan. When comparing two different CT scanners for dose comparison, any changes in CT values and in the calculated stopping powers can lead to changes in the dose along the proton path or to a change in the range of proton therapy.”

To do this, Willoughby and colleagues scanned an electron density CT phantom on a simulation CT scanner and the mobile CT, and compared the mean CT numbers to determine differences. They imaged a phantom containing 16 rods and 13 tissue substitute materials with varying plug patterns, table heights, and mA with fixed 120 kV. Images of plugs representing brain, lung 300, lung 450, cortical bone, adipose, breast, liver, solid water, and true water were analysed. They then determined the stopping power ratios (SPRs) by entering averaged CT numbers into a stoichiometric SPR calculation algorithm.

The last step of the commissioning process involved confirming dosimetric equivalence for dose calculated on CT scans from the two scanners. The researchers developed heterogeneous, single-field, non-robust plans on thorax, pelvis and head phantoms, to test the dose accuracy for proton beams traversing large areas of heterogenous media. They also generated five different clinically reasonable treatment plans on five different phantoms to test the accuracy of the adaptive system in common clinical scenarios.

Key findings

Lead author Jasmine Oliver and colleagues reported that proton dose calculations on CT image sets acquired by the mobile CT scanner could be used to calculate dose with relatively high accuracy, similar to the simulation scanner.

They cautioned that dosimetric equivalency testing, using visual display of isodose lines and water-equivalent thickness (WET) values between the planning and in‐room CT scanners, should be performed before any in-room CT system is deployed for adaptive planning purposes.

Test results showed that CT numbers differed between the scanners. Low-density plugs had a higher CT number in the mobile CT compared with the simulation scanner, while high-density plugs had a lower number. Dose on the mobile CT extended deeper by about 5 mm compared with the original treatment plan.

To create equivalent dose distributions, it was necessary to adjust the SPR curve’s low-density data points of the mobile CT, to obtain better proton beam range agreement based on isodose lines. When the authors compared the stochiometric-based SPR curve and the “dose-adjusted” SPR curve, they observed slight improvement on gamma analysis between the treatment plan and the mobile CT plan for single-field plans at the 1%, 1 mm level. Clinical plans at 3%, 3 mm demonstrated equivalent dose.

“Our results demonstrated that performing the stoichiometric analysis for a given phantom and CT scan may not provide dose equivalence between two different CT scans… it was important to verify the dosimetric equivalence of the two CT image sets with their corresponding stopping curves,” wrote the authors. “To achieve this, it was necessary to directly map CT values and adjust them to yield better dosimetric comparisons at the end-of-range.”

The mobile CT system in the proton treatment vault is currently used to perform “re-simulations” for patients who may have anatomical changes due to radiation therapy. “It is used on all of our breast patients to monitor target swelling, on lung patients to monitor fluid in the lungs and tumour changes, and on head-and-neck patients to monitor tumour shrinkage,” Willoughby explained. “These things dramatically affect the proton range and modulation, and can cause significant changes in the treatment plan if they go unmonitored.”

The cancer centre does not offer pencil beam scanning (PBS) proton therapy. However, the authors believe that, based on their experience, the image quality of the mobile CT scanner is good enough for dose-recalculation on PBS as well as double-scatter systems.

Cynthia E Keen is a freelance journalist specializing in medicine and healthcare-related innovations

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Putting image-guided radiotherapy to the test

25 Sep 2018 Sponsored by Modus QA

Early adopters are exploiting a novel motion phantom to explore the possibilities of real-time magnetic-resonance guided radiotherapy for improved cancer treatment and neurosurgery

Upcoming techniques based on magnetic-resonance guided radiotherapy (MRgRT) could enable clinicians to compensate for patient movements to a much higher degree, thanks to the clarity offered by MR imaging. Real-time tracking methods that can pinpoint changes in the position of a tumour translate to improvements in dose conformality by keeping radiation on target and sparing healthy tissue.

As vendors, early adopters and clinicians bring new ideas to fruition, a key part of their success depends on having the right development tools, which includes motion (or 4D) phantoms. Accurate models give researchers the chance to safely explore solutions for overcoming hurdles that can be faced in the clinic as a result of tumour motion. Scenarios include when a patient breathes, causing organs and tumours to move, or when there’s peristaltic motion through the digestive system.

We’ve designed our system to be compatible and expandable, and even – to a certain degree – customizable

Enzo Barberi, director of MR product development at Modus QA
Tumour movement has always challenged cancer treatment and manufacturers have worked hard to mitigate the issue as much as possible.

“Image guidance for radiation therapy has been around for well over a decade and most linacs have some form of cone-beam CT or EPID imaging that allows to them to roughly see where the target is,” says Enzo Barberi, director of MR product development at Modus QA – a developer and manufacturer of quality assurance tools for advanced radiotherapy and medical imaging. “But those imaging techniques provide little information about soft tissue.”

In contrast, MR imaging can reveal soft tissue in exquisite detail, which – when linked to a radiotherapy system – shines a welcome light on where the cancer is at any moment in time.

Barberi, who’s been working in this field for almost three decades, confirms that it’s a very exciting time in terms of the technology and the clinical development of next-generation techniques exploiting MR linacs. “In both systems that are available today, you can image while you are applying radiation,” he points out.

Real-time imaging hits the target

On-board MR imaging offers numerous possibilities for advancing radiotherapy treatment. For example, if gas happens to pass through the intestinal tract of a patient during radiation treatment, real-time MR imaging can detect whether the tumour has moved. And, if the target is now positioned outside the safety margins, the beam can be turned off until the gas has passed through and the tumour moves back into position.

“It’s a dramatic example of how the combination of these two techniques in parallel and in real-time can make a big difference in terms of accuracy in hitting the target when it’s moving,” Barberi comments. Real-time imaging using MR could also see the end of so-called gating, where patients are required to hold their breath to keep their chest stationary – a development that could speed up treatment as well as reducing discomfort.

Bringing these new techniques into the clinic requires reliable tools for quality assurance (QA). MRI-compatible models make it possible to test the ability of novel imaging sequences to track a wide range of movements – such as those resulting from respiration. Verification is important too.

“Using phantoms like Modus’ programmable QUASAR MRI 4D motion product in combination with dosimetry inserts allows early adopters to calculate and measure the dose that is administered to a moving target and ensure that they are actually hitting this moving target and not the surrounding healthy tissue,” says Barberi.

These early adopters are important beta-testers for Barberi and his team, as they are at the frontier of MRgRT. Users require a phantom design that’s flexible, practical and easy to deploy, allowing them to gather as much data as possible for a range of possible patient scenarios.

“Modus focuses very heavily on workflow as we understand that time on the system is valuable,” Barberi comments. “If we can make our QA tools and QA procedures fast and efficient then sites are not only more likely to use them, but they will also appreciate the fact that we’re not taking up a lot of their magnet and linac time simply for setup or integration or when they have to switch over from one mode of measurement to another.”

Early adopters drive development

Features of the QUASAR motion phantom include a spherical target that can mimic numerous trajectories of a tumour in the body, including those seen during breathing. “We can add not only linear motion in and out of the phantom, but we can also add twist and offset that sphere so that it follows a complex 3D path as time plays out,” Barberi explains.

His team acknowledges that different investigators will have different demands, such as when it comes to dosimetry. “Users may wish to use ion chambers or film dosimetry or 3D gel dosimetry,” Barberi notes. “So we’ve designed our system to be compatible and expandable, and even – to a certain degree – customizable.”

Barberi’s group is already working on a second wave of inserts for the MR-safe motion phantom, thanks to the early-adopter programme. The new inserts will focus not just on soft tissue sites, but also modelling deep organ areas and more complex types of motion.

There is no shortage of challenges coming down the pipeline, but Barberi has a great team and is confident in Modus’ approach – having seen its flagship products develop successfully along a similar path. “Working with many different clinicians, physicists and OEMs over the years, we have families of different inserts that we can draw upon,” he says.

Barberi describes MRgRT as a “game changer”, and companies such as Modus are part of a big global effort to support upcoming advances that serve to accelerate the adoption of MR-linac systems for clinical treatment. Initiatives include STARLIT (System Technologies for Adaptive Real-time MR image-guided Therapies), a consortium developing techniques for next-generation motion compensation that includes two large equipment vendors – Elekta and Philips – along with small- and medium-sized companies and academic centres. “We are also equally proud to be a partner with ViewRay, supporting the requirements of an equally respected vendor, and their early adopting customers,” he says.

For more information about the QUASAR phantom, visit https://modusqa.com/mri/motion

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First UK radiation treatment using MR-guided linac

25 Sep 2018 Tami Freeman

The Royal Marsden and the Institute of Cancer Research (ICR) in London have performed the first treatment in the UK using an MR-linac – the Elekta Unity system.

The Elekta Unity, which received its CE mark in June 2018 and is being clinically implemented in European cancer centres, combines high-field (1.5 T) MR imaging, precision radiation therapy and intelligent software to deliver MR-guided radiotherapy.

“It’s hugely exciting to be able to trial this technology here at the ICR and The Royal Marsden,” says Uwe Oelfke, head of the Joint Department of Physics. “Together we’ve made world-leading advances in radiotherapy through our research and we expect Elekta Unity to allow us to make another step change in improving cancer treatment. This trial is for prostate cancer, but we anticipate Elekta Unity will help us improve radiotherapy for a wide range of cancers, including hard-to-treat forms such as lung and pancreatic cancer.”

The patient received treatment as part of the PRISM clinical trial, which will assess the feasibility of delivering radical radiotherapy for prostate cancer using the MR-linac. The patient had a localized prostate cancer and started hormone treatment in May 2018. His PSA (prostate-specific antigen) level indicated that he was ready to start radiotherapy and he was offered treatment on the Elekta Unity.

“Tumour shape and position relative to healthy tissue evolve over the course of treatment and can change during an individual treatment session,” explains Alison Tree, who is leading the PRISM trial. “The ability to detect those changes and adapt therapy in real time allows us to improve the precision of radiation therapy, more effectively treating the tumour while preserving healthy tissue.”

Tree notes that the Elekta Unity will also enable radiation treatment of patients who would not be candidates using more traditional radiation delivery systems.

“For decades, the radiation oncology community has dreamed of the day when we could see what we treat in real time just as our surgical colleagues do, and we are excited that this day has arrived,” says Oelfke. “Radiotherapy is important to the treatment of around 40% of the people who are cured of cancer. But if we want to fully unlock the potential of radiotherapy by making it even more precise, we need to be able to see a patient’s tumour while we deliver the radiation treatment. The MR-linac will make this possible.”

The Royal Marsden and the ICR are founding members of Elekta’s MR-linac Consortium, a collaborative industrial–academic partnership that Elekta founded with seven centres and technology partner, Philips, in 2012.

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Machine learning: a game-changer for radiation therapy

19 Sep 2018

Deep-learning organ segmentation* will be featured in the upcoming release of RaySearch’s RayStation treatment-planning software. RayStation 8B* is set to ship in December.
Finance, automotive, agriculture, telecoms and professional sports: these are just a few of the diverse industries being fundamentally disrupted by the inexorable rise of machine-learning technologies (more generally known as artificial intelligence or AI).

Machine-learning algorithms can solve problems by learning from experience, and without being explicitly programmed. In so doing, they can already control self-driving vehicles, spot plagiarized academic papers and translate the spoken word from one language to another.

And that’s just for starters. The long-game looks even more compelling.

RaySearch Laboratories certainly thinks so. The Stockholm-based oncology-software company is currently making significant investments in machine-learning and “big-data” – a fusion of technologies and applications that promises to transform radiation therapy and other cancer-treatment modalities such as chemotherapy and surgical intervention.

“Machine learning has the potential to support and augment radiation oncology teams while freeing up their time,” explains Fredrik Löfman, head of machine learning and algorithm at RaySearch. “The power of sharing knowledge through machine-learning models will have a huge impact. Any clinic could potentially generate the same tumour target volume and radiation treatment plan as the best clinics in the world do. Radiation oncologists and medical physicists will all learn from each other through machine-learning models.”

Knowledge transfer

With these opportunities in mind, Löfman is intent on scaling RaySearch’s in-house capability and collective domain knowledge in machine learning. Right now, he heads up a dedicated division of machine-learning engineers located in RaySearch’s Stockholm headquarters.

“Ours is a multidisciplinary programme,” Löfman explains. “We have mathematicians, computer scientists and physicists with backgrounds in different industries [such as automotive and finance] that are further along with machine-learning technologies than healthcare. Cross-fertilization with these sectors is crucial.”

This open, outward mindset is evidenced in several high-profile R&D collaborations that, RaySearch hopes, will fast-track its innovation in machine-learning technologies. On the academic side, RaySearch is funding joint research at the KTH Royal Institute of Technology in Stockholm (automation of radiation therapy), while clinical partners include the Princess Margaret Cancer Centre in Toronto (automated treatment planning and model training) and Massachusetts General Hospital in Boston (deep learning for target-volume delineation and analytics prototypes).

“We have a history of collaboration with The Princess Margaret and Mass Gen,” says Löfman, “so when we started the machine-learning division it was natural for us to partner with these institutions.”

Partnership = progress

The tie-up with The Princess Margaret, Canada’s largest radiation-therapy facility, has been in place for more than a decade and focuses on the use of machine learning to automate treatment planning in the radiation-therapy clinic. The goal is twofold: to deliver workflow efficiencies versus manual treatment planning (with plans delivered in minutes rather than hours or days) and to generate personalized treatment plans tailored to the unique needs of each patient.

It’s been a productive collaboration. Last year, for example, RaySearch licensed The Princess Margaret’s AutoPlanning technology, a custom AI and machine-learning system that harvests information from a database of proven high-quality radiation-therapy plans – effectively learning from and optimizing against thousands of prior clinical treatments.

AutoPlanning itself is the result of a six-year cross-disciplinary initiative involving researchers at The Princess Margaret and Toronto’s Techna Institute. The development work was led by Tom Purdie, a medical physicist at The Princess Margaret, and his colleague Chris McIntosh, a computer scientist at the hospital.

“Machine learning is a natural fit for automating the complex treatment-planning process,” explains Purdie. “It will enable us to generate highly personalized radiation treatment plans more efficiently, [thereby] allowing clinical resources or specialist technical staff to dedicate more time to patient care.”

Ultimately, Purdie reckons that machine learning will help to lower the cost of cancer treatment. “We’re going to reach a stage – in the not-too-distant future – where we will be relying on machine-learning technologies to deliver the highest-quality cancer care,” he adds.

Into the clinic

RaySearch, for its part, is pressing ahead with the roll-out of advanced machine-learning capabilities into the radiation-oncology clinic. In December, the vendor will unveil RayStation 8B*, the latest release of its treatment-planning software with machine-learning-automated organ segmentation (quantitative 3D visualization) and machine-learning-automated treatment planning.

“We are evaluating the automated treatment planning with several clinics just now, so we are getting more and more data on how it performs,” says Löfman. “As a vendor, we can point to the efficiencies of automation, we can point to the consistency inherent to the approach. But in terms of treatment quality and patient outcomes, it’s the clinics that will need to provide the real-world evaluation and validation.”

The collaboration with The Princess Margaret has broadened in scope too, with the two partners signing an agreement in July to jointly develop RayCare, the vendor’s flagship oncology information system (OIS).

Watch this space, says Löfman: “Ultimately, RayCare OIS will use machine learning to improve workflow efficiency, manage resource allocation and enhance quality assurance across different treatment modalities – medical oncology, radiation oncology and surgical oncology.”

* Subject to regulatory approval in some markets

Fredrik Löfman and Tom Purdie will present a live webinar on “Machine learning and automation in radiation oncology” on 26 September 2018. Register now to view the webinar.

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IBA completes proton therapy installation in record time of nine months

LOUVAIN-LA-NEUVE, 1 March 2018 – IBA (Ion Beam Applications S.A.), the world’s leading provider of proton therapy solutions for the treatment of cancer, and Proton Partners International, announce today that they have completed testing of the UK’s first high energy proton beam machine on 16 February at the Rutherford Cancer Centre in Newport, South Wales. Following a record nine month installation programme, the center plans to treat the first patients with its Proteus®ONE solution in March.

Leveraging its longstanding expertise, IBA has again demonstrated its superiority in installing proton therapy systems and set a new installation record of nine months since synchro-cyclotron delivery. This new global record further increases accessibility to proton therapy for cancer patients in the UK while IBA’s closest competitor will take at least 50% more time for the installation in its center. It demonstrates IBA’s speed of delivery from contract signature to first treatment, and secures the customers’ investment as they can deliver treatment in line with their business plan.

The single room Proteus®ONE proton beam therapy solution, installed and maintained by IBA, is the industry’s only truly compact image-guided IMPT proton therapy system. It has a unique open gantry environment designed to ease the treatment workflow of the radiation therapists and to optimize the patient experience by providing a comfortable and calming environment. Proteus®ONE also offers the most advanced proton therapy technology on the market as it combines pencil beam scanning with 3-D cone beam computed tomography large field of view for true volumetric imaging at isocenter. Its compact design makes it easy to install, integrate, operate, and finance.

Olivier Legrain, Chief Executive Officer of IBA, commented: “We are delighted that we have been able to work with Proton Partners International and the Rutherford Cancer Centre to successfully make proton therapy available for cancer patients in the UK for the first time. By installing this equipment in only nine months we have further demonstrated that IBA is the leading proton therapy company in combining cutting-edge proton therapy technology with market leading delivery for the benefit of patients.”

Mike Moran, Chief Executive Officer of Proton Partners International, added: “We are thrilled that the UK’s first proton beam therapy system has been approved for treatment at our Rutherford Cancer Centre in Newport. Through working with IBA we have ensured that our centers are installed with the latest cancer technology in the fastest way possible for the benefits of patients. We are extremely proud to be at the forefront of delivering this innovative cancer treatment.”

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Mevion receives 510(k) clearance for HYPERSCAN pencil beam scanning

LITTLETON, MASS., 3 January 2018 – Mevion Medical Systems has received FDA 510(k) clearance for the MEVION S250i Proton Therapy System®including HYPERSCAN™ pencil beam scanning (PBS) technology. HYPERSCAN PBS introduces novel energy layer switching and automated collimation systems. These advantages enable the S250i™ system to deliver faster, sharper, and more robust PBS proton radiation treatments.

“The S250i system represents the next generation of intensity modulated proton therapy (IMPT) delivered in the most compact proton therapy platform,” said Joseph Jachinowski, CEO of Mevion Medical Systems. “We are proud that the MEVION S250i system now has received both FDA clearance and CE mark. This is a very important milestone in our efforts to make precision proton therapy available to more patients in the fight against cancer.”

Next Generation Intensity Modulated Proton Therapy (IMPT) 

The MEVION S250i™ system is a compact proton therapy system capable of delivering conformal radiation therapy treatments using HYPERSCAN pencil beam scanning technology. The design of HYPERSCAN PBS technology overcomes clinical challenges that were previously faced by first generation PBS systems. Pencil beam scanning systems shape the delivered radiation dose by “painting” tumors spot-by-spot and layer-by-layer with sub-atomic particles. Prior to HYPERSCAN PBS, scanning proton systems struggled with delivery speed. Long delivery times can undermine the high precision of the treatment due to the target tumor shifting under normal organ motion such as breathing.

HYPERSCAN PBS uses a compact beam delivery path reducing delivery times to less than 5 seconds for some fields. This “hyper-fast” treatment delivery reduces treatment errors due to the sensitivity to motion that current PBS technologies face when treating tumors affected by organ motion. In addition, HYPERSCAN PBS utilizes, the Adaptive Aperture™ proton multi-leaf collimator (pMLC)  This technology uses a robotically controlled collimation system, capable of trimming the edges of the beam at every layer of delivery. This capability delivers up to a three times sharper drop off in radiation at the delivery field edge. This improves sparing of healthy tissue and limits unnecessary radiation to sensitive locations.

World’s First HYPERSCAN PBS Installation 

MedStar Georgetown University Hospital in Washington, D.C. will be the first hospital in the world to offer this latest generation of HYPERSCAN PBS once final onsite testing is completed this month.

“We are excited to be not only the first and only proton therapy system in the Washington, D.C. area, but also the first in the world to offer these advanced proton therapy treatment capabilities to our patients and community. Currently, patients who seek proton therapy need to leave the metropolitan D.C. area, which can be a significant burden on families,” said Brian T. Collins, MD, clinical director of MedStar Georgetown Proton Therapy Center. “We will now be delivering advanced proton therapy, fully integrated into our broad set of comprehensive cancer care offerings. This is critical to the patients we serve.”

Built on Leading Compact Proton Therapy Technology 

The MEVION S250i system is based on Mevion’s high efficiency, low financial risk S250™ Series platform. The core technology of the S250 Series is the world’s only gantry mounted superconducting synchrocyclotron. This compact, fully integrated platform has years of successful clinical experience and proven financial viability. While proton therapy has clear dosimetric advantages, the costs of early systems has been a significant barrier to adoption. The MEVION S250i reduces this barrier through lower capital costs, reduced operating costs, and increased treatment throughput. Mevion customers have achieved the fastest per-room patient ramp-up in the history of proton therapy. Demonstrating that compact proton therapy is a viable option for any size cancer center is core to Mevion’s mission of making proton therapy accessible to as many patients as possible.

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RaySearch receives first order for RayCare oncology infomation system

17 January 2018 – Anderson Regional Cancer Center (ARCC) in Meridian, Mississippi, USA, has placed the first order for RayCare*, a next-generation oncology information system (OIS). RayCare is an innovative system designed to support comprehensive cancer care. It integrates seamlessly with the RayStation treatment planning system, but that’s just the start – RayCare will connect all the oncology disciplines, enabling users to fluidly coordinate tasks and ensure optimal use of resources.

Over subsequent releases, RayCare will evolve into a machine learning OIS with unique capabilities to coordinate oncology tasks, supporting comprehensive cancer care organized around each patient’s needs. Many cancer patients receive a combination of treatment types, driving the need for combined workflows for radiation therapy, chemotherapy and surgery.

ARCC decided to map out a future for their clinical workflows that would support advanced technology and data driven decision making. They determined that the best approach would be to move to a new treatment planning system and a new oncology information system that together would support their linacs and TomoTherapy systems, in order to have a unified platform for planning, treatment and assessment.

Paul King, Chief Medical Physicist, says: “We evaluated all the leading systems and were extremely impressed by the possibilities of RayCare. It delivers on everything we were looking for. Getting all of these pieces integrated together will help us tremendously. RaySearch is an innovator with the leading technology in this area and I have great confidence in their ability to meet our needs into the future. We will keep exploring the cutting-edge of technology in order to secure the best possible care for our patients. RayCare will help us achieve this aim.”

Dr. Scott Anderson, Radiation Oncologist and Medical Director, says: “We find ourselves in the position that we are at a decision point where we can stay static in a satisfactory status quo, or we can move into what will be the standard in the future. We look forward to working with RaySearch Laboratories to shape the future of longitudinal cancer care. Survivorship and tracking patients long term will be the benchmarks of cancer care moving forward. This new system that is being developed will give us better tools to do so.”

Johan Löf, CEO of RaySearch, says: “I am delighted by this first RayCare order and very excited about helping ARCC achieve an efficient, integrated system for the future. RayCare is fundamentally different compared to other OIS systems, and we have invested a great deal of time and effort into creating something that will truly change the way that cancer is treated. Our goal is to advance cancer treatment with high-performance tools that combine treatment planning, workflow and data management, resource optimization, machine learning and follow-up in an effective way.”

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California Proton Therapy Center re-launches California Protons

SAN DIEGO, CA, December 7, 2017 – California Proton Therapy Center, LLC today announced the official re-launch of California Protons, a cancer treatment center located at 9730 Summers Ridge Road in San Diego. California Protons features an expanded physician group and new management team and ownership, effectively positioning the Center for continued excellent patient care, as well as growth and success. 

All of the treatment rooms at California Protons are equipped with the most advanced proton beam technology, allowing doctors to treat even the most complex and aggressive cancers. The Center uses pencil-beam scanning technology to precisely target tumors while protecting healthy, normal tissue and surrounding organs. Protons can be delivered within an accuracy of less than two millimeters, making this treatment especially effective at combatting cancer in sensitive areas such as the brain, spine, lung, breast and prostate, and is widely regarded as the best option for treating pediatric patients with cancer.

Dr. Andrew L. Chang, the department Chief of Pediatric Cancers at California Protons, is president of the Proton Doctors Professional Corporation (PDPC), the oncologist group providing clinical leadership at the Center. Dr. Carl Rossi, who has treated more than 9,000 prostate cancer patients with proton therapy – more than any other physician in the world—is the Medical Director of the Center. The Center’s physicians have more than 50 years of collective proton therapy experience.

“At California Protons, we are committed to continuing the delivery of outstanding and effective patient care,” says Dr. Carl Rossi. “By expanding our existing affiliations with the University of California, Rady Children’s Hospital in San Diego and other healthcare institutions throughout the state, we will increase patient access to the Center and, among other things, enhance our ability to participate in clinical trials and research.”

“The Center has been recapitalized and the investor group has provided additional financial support to allow the Center to grow,” says James J. Loughlin, Jr., Managing Partner at Loughlin Management Partners + Co., the healthcare turnaround specialists who are working with the physicians and ownership on the transition plan. “The re-launch of the Center as California Protons is an exciting event and we look forward to a highly successful future working with the team of expert proton physicians, nurses, physicists, technologists and dosimetrists at the Center to make this state-of-the-art cancer fighting tool available to all of the residents of San Diego and California.”

About California Protons 

One of only two proton therapy centers in California and 25 nationwide, California Protons combines cutting-edge proton treatment capabilities with a team of radiation oncologists who amass more than 50 years of collective proton therapy experience. The Center leverages revolutionary intensity-modulated pencil-beam scanning technology to release a high dose of cancer-killing radiation that conforms precisely to the unique shape and size of the tumor. This approach effectively targets and treats even the most complex and aggressive cancers, sparing surrounding healthy tissues and organs. 

For more information, please visit www.CaliforniaProtons.com

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RaySearch releases RayStation 7 with support For RayCare and Mevion HYPERSCAN

8 December 2017 – RayStation® 7*, the latest release of RaySearch’s innovative radiation therapy treatment planning system, adds new functionality and a wide range of improvements. Significant additions include support for HYPERSCAN technology from Mevion Medical Systems, and integration with RayCare*, the next-generation oncology information system shortly to be launched by RaySearch.

The functionality additions in the new release are in line with RaySearch’s ambition to unify treatment planning for as many systems as possible, eliminating the complications and additional steps that arise from using multiple software systems. This release also contains several enhancements to existing functionality that will contribute to improved workflows and planning efficiency.

Proton therapy is an important focus for RaySearch, and RayStation 7 contains some significant new features for the area. A key inclusion is support for Mevion’s HYPERSCAN pencil beam scanning technology. In addition, RayStation now supports uniform scanning for proton therapy systems from Mitsubishi Electric. Other proton therapy improvements include snout rotation for passive proton techniques and MLC collimation for PBS and passive techniques.

Further key refinements to RayStation functionality include the addition of robust constraints in MCO, simulated organ motion for robust optimization and evaluation, multi-atlas-based segmentation and conformal arc planning for photons.

In December this year, RaySearch will launch a groundbreaking new oncology information system, RayCare, which will integrate fully with RayStation. The new RayStation 7 release includes functionality to ensure a seamless experience for users of the combined systems.

Johan Löf, CEO of RaySearch, says: “We are working to support an integrated approach to cancer care. RayCare, which is about to be launched, is a huge leap for us in terms of unifying the main oncology disciplines. By adding support for Mevion’s HYPERSCAN technology and uniform scanning for Mitsubishi machines, we have taken another step towards our goal of harmonizing treatment planning. And we will add support for more systems in the near future.”

* Subject to regulatory clearance in some markets.

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IBA, Beaumont Hospital to develop next-generation proton therapy delivery

Louvain-la-Neuve, Belgium, 25 September 2017 - IBA (Ion Beam Applications SA), the world's leading provider of proton therapy solutions for the treatment of cancer, is pleased to announce the research agreement with Beaumont's Proton Therapy Center to develop the next generation proton therapy delivery technique called scanned proton arc therapy (SPArc). Proton arc therapy has the possibility to further improve the quality of the treatment by enhancing the dose conformity at the tumor level while reducing the total dose received by the patient. By better shaping the tumor dose it can further reduce dose to critical organs. In addition, arc therapy technique increases the robustness of the treatment plan, and may further improve the adoption of dose escalation and hypo-fractionation. This agreement is the first step in a long-standing partnership started several years ago.

Craig Stevens, M.D., Ph.D., Chairman, Radiation Oncology, Beaumont Health, commented: "Beaumont Hospital has been leading the research in radiotherapy for decades, and we are proud and eager to start working on such an innovative project with IBA. The level of expertise combined will bring proton therapy to the next level. Proton arc therapy has been contemplated for some time, and recent improvements in beam quality and delivery are enabling us to develop this clinically viable product. Proton SPArc therapy should allow us to improve dose conformity at the tumor, while further reducing dose to surrounding healthy tissue without the need for cumbersome and expensive beam shaping systems."

Nicolas Bronchart, Executive Vice President, Research & Development Proton Therapy, added: "IBA is once again pushing the limit of proton therapy and together with Beaumont's Proton Therapy Center we will bring a technology that could offer further benefits for patients. The initial development will take place on our compact IMPT* system, the Proteus®ONE, but IBA's strategy has always been to offer break-through advancements to our entire product line. IBA's proton therapy systems are built on the most versatile platform allowing for future upgrades and making IBA a future proof choice." 

* Intensity Modulated Proton Therapy

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