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Ildiko Csiki, M.D., left, Fen Xia, M.D., Ph.D. and Tony Cmelak, M.D., examine the new radiosurgery technology. (photo by Susan Urmy)

VICC debuts new radiosurgery suite

BY: DAGNY STUART

6/26/2009 - Vanderbilt-Ingram Cancer Center has opened a new radiation oncology treatment suite featuring stereotactic radiosurgery, technology that provides more precise targeting of tumors and faster delivery of the correct dose of radiation for patients diagnosed with benign or malignant tumors.

VICC's new Novalis Tx radiosurgery unit is the first of its kind in Middle Tennessee.

“Here at Vanderbilt we are at the forefront of delivering stereotactic, or more focused, radiation,” said Arnold Malcolm, M.D., interim chair of the Department of Radiation Oncology. “We also are looking at hypofractionated radiation, which means giving a curative dose in a shorter period of time without damaging normal tissues.”

The new radiosurgery system, developed by Varian Medical Systems and BrainLAB, has several advantages over existing technology, said Malcolm.

“A standard accelerator table goes up and down or left and right. The unit has six degrees of motion, which is double the current range, and it gives us yaw and pitch movement,” said Malcolm.

“When you can turn the robotically controlled table to all of these different angles you are essentially using the table to bend the beam the way you want it.”

Technicians place infrared markers on the patient, line up the patient to those markers and the machine will precisely target the infrared markers. The delivery of radiation is so precise it can target tissue less than a millimeter in size.

“When we talk about clinical accuracy, we're trying to limit as much as possible the amount of adjacent tissue that we have to treat while treating the tumor and that is key to a cure with minimal toxicity,” said Malcolm.

The new technology delivers an accelerated radiation dose much faster than before and reduces required beam-on time by half.

Precision and speed are especially important when a tumor is located in the prostate, liver or other organs that move. Even breathing can cause the targeted tumor to move, taking the targeted tissue out of treatment range and exposing healthy tissue to unnecessary radiation.

“With other machines, technicians have to keep stopping the treatment because they're tracking the motion of the target,” explained Malcolm. “With this machine, treatment is so quick and precise that movement isn't such an issue.”

“This leading edge technology is a major breakthrough and allows neurosurgeons and radiation oncologists the ability to precisely and non-invasively guide a narrow beam of radiation directly to the tumor,” said Reid Thompson, M.D., professor and vice chair of the Department of Neurosurgery.

“We can safely treat patients with surgical precision without an incision. This is especially important for patients with tumors located near vital structures in the brain and spinal cord, where traditional surgery might not be possible.”

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