Our Cancer Care Specialists
Our Cancer Care Technologies
3-D Conformal Radiation Therapy
Three-dimensional conformal radiation therapy (3D-CRT) uses computers, CT scans and MRI scans to create detailed, three-dimensional representations of the tumor and surrounding organs. The treatment team uses these images to shape the radiation beams to match the size and shape of the tumor. The tools used to shape the radiation beams are multileaf collimators or custom fabricated heavy metal blocks inserted between the beam and the patient. Nearby normal tissue receives less radiation exposure because the radiation beams are targeted directly at the tumor.
Accelerated Partial-breast Irradiation (APBI)
Accelerated partial breast irradiation (APBI) is high-dose-rate (HDR) internal therapy for breast cancer, administered following a lumpectomy. There are several different applicators including SAVI®, Mammosite®, and Contura®. A radioactive Iridium-192 seed at the end of a metallic wire and contained within a computer-controlled HDR delivery system is directed to 50 or so pre-defined positions within a set of catheters, which are inserted into the lumpectomy site through plastic tubes or a balloon. The HDR delivery system directs the seed sequentially along each catheter tube, stopping at pre-defined dwell positions and delivering radiation along the length of the tube within the lumpectomy site and immediate surrounding area. Treatment is delivered twice a day over five treatment days. After each application, the radioactive seed is withdrawn from the tubes into a lead-lined box and the patient (now non-radioactive) can go home. After the ten treatments are completed, the balloon or catheter array is removed.
Calypso 4D Localization System ("GPS for the Body"®)
The Calypso® treatment system finds and tracks the position of the prostate or lung tumor throughout radiation treatments. Since the prostate or lung tumor can move with breathing or the filling of the bladder or rectum, it is sometimes necessary to track organ or tumor movement in real-time and turn the radiation on and off depending upon whether the target is in the right place. The system works by implanting a tiny Calypso coil into the organ. The device is energized by an external magnetic field which causes the coil to send out a radio signal that can be located by the same external device that creates the magnetic field. This is similar to the GPS systems used in cars, but on a much more local scale. The process provides the ability to view the location and movement of the prostate or lung tumor. With this precise view of the location, adjustments can be made to the direction of the radiation beams during treatment, or the beam can be turned down if the radiation cannot track the tumor.
Computer Tomography (CT) Scanning & Simulation
Computer Tomography (CT) Scanning & Simulation allows the cancer specialists to design a treatment plan specifically for the patient based on the size, location, and shape of the tumor. The patient will have three-dimensional images (CT Scans) taken. These are used with the treatment planning software that helps determine how to best deliver the radiation beams while reducing damage to surrounding areas. In some cases, it may be necessary to mark the patient’s skin with a tiny marker so that the patient is perfectly realigned in the correct position for every session of radiation therapy. The need for a temporary or permanent marker will be discussed with the patient before the simulation.
Image-Guided Radiation Therapy (IGRT)
Image-Guided Radiation Therapy (IGRT) combines three-dimensional images, such as CT scans, with the precise technology of either 3-D or intensity-modulated radiation therapy (IMRT) to pinpoint and treat cancerous tumors. The images allow the cancer specialists to precisely localize the tumor each time radiation therapy is administered. This improves both accuracy of delivery and safety by reducing radiation exposure to other areas of the body including nearby tissue and organs. IGRT is used to treat tumors in areas of the body that are prone to movement, such as the lungs, liver, and prostate gland, as well as tumors located close to critical organs and tissues.
Intensity-Modulated Radiation Therapy (IMRT)
Intensity-modulated radiation therapy (IMRT) is an advanced form of external radiation treatment that allows precise targeting of tumor cells. The CT simulator localization scan or other three-dimensional images provide the radiation oncologist with an understanding of the shape and location of the tumor. With 3D planning, the radiation oncologist specifies the dose from various beams and sums up those doses to calculate the dose to tumor and normal tissue (forward planning). With IMRT, the radiation oncologist specifies the dose desired to give the tumor and the doses acceptable to the normal tissues (as low as possible). Then the computer system provides millions of alternative beam positions and the varying intensities of each beam, comparing one plan to the next until the best plan is identified. This is called inverse planning. Since each beam is broken up into many sub-beams of varying intensity the process is called intensity-modulated radiation.
Low-Dose Rate (LDR) Brachytherapy
Low-dose rate (LDR) brachytherapy delivers radiation using a radioactive device or implant placed inside the body. The device delivers a low dose of radiation to a limited area over a period of 20 to 50 hours. It is one of the most focused, precise forms of radiation therapy and spares much of the surrounding tissue. LDR can be used to treat various cancer sites, such as prostate, uterus, or cervix.
Stereotactic Body Radiation Therapy (SBRT)
Stereotactic body radiotherapy (SBRT), also known as stereotactic ablative body radiation (SABR), is an advanced type of radiation therapy that delivers high doses of radiation using several beams of varying intensity aimed at a very targeted area of the body. Due to the high intensity of the radiation dose, only one to five doses are given over a single day., Treatment can take up to a week and a half when the five treatments are given every other day. Three-dimensional images, such as CT or MRI scans, are used in the simulation process to direct the beams precisely while reducing radiation exposure to other areas of the body. Patients with small, well-defined tumors who cannot tolerate surgery are good candidates for SBRT.
Stereotactic Radiosurgery (SRS)
Stereotactic radiosurgery (SRS) is a type of stereotactic radiation therapy that can be used in place of or in conjunction with surgery for single tumors that have spread to the brain. It is given in one session, although the treatment can be repeated if necessary. There are two possible SRS treatments. In one, a machine focuses approximately 200 beams of radiation on the tumor from different angles while the patient’s head is kept in the same position. In the other version, a computer-controlled linear accelerator moves around the patient’s head to deliver radiation to the tumor from different angles.
Volumetric Arc Therapy (VMAT)
Volumetric arc therapy (VMAT) is an advanced form of IMRT that allows a targeted, three-dimensional dose of radiation to be delivered directly to a tumor. The machine that delivers radiation can deliver the dose to the entire tumor in a 360-degree rotation, up to eight times faster than IMRT alone.
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