Comparison of IMRT & VMART Dose Distributions

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Dynamic IGRT: Focusing on precision

Versa-HD is the world’s first linear accelerator to feature integrated dynamic 3D-volume imaging (Image Guided Radiation Therapy – IGRT). This allows imaging of the tumor with CT – like quality to be acquired and reconstructed immediately before a treatment, with the patient already set-up in the treatment position.

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Beyond Dynamic IGRT: Clarity-USG Guided IGRT

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Extracranial 4-D Radiosurgery

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4-D Extracranial Radiosurgery

• 1-7 Treatment Sessions
• Uses powerful motion management technologies- Gating, tracking, freezing or inclusive techniques
• No knife, painless, bloodless noninvasive procedure, hence no infections
• Treatment on outpatient basis
• Treatment time-15 minutes

Indications

• Medically inoperable Stage 1 lung cancer
• Primary liver cancer/Mets: inoperable or waiting for transplant
• Rec. head and neck cancer
• Pancreatic Ca: inoperable
• Early Stage Prostate Ca
• Spine METS- Solitary or multiple

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Frameless Intracranial 6D-Stereotactic Radiosurgery

Frameless SRS Advantages

• Single Treatment Session
• No knife, painless, bloodless non-invasive procedure, hence no infections, no hemorrhages
• Treatment on outpatient basis
• Treatment time- 3mts using FFF technology
• Max. Lesion size = 3cms

Typical SRS Targets

• Acoustic Schwannoma: Intracanalicular, Maximum diameter- 3cms and paucity of brainstem compression
• Non- Acoustic Schwannoma: airing from oculomotor nerve, trigeminal nerve, Abducent nerve and jugular bulb.
• Pituitary adenoma: Recurrent or residual functioning or non-functioning adenomas located 3mm away from optic-chiasm, maximum diameter – 3cms

Frameless SRS Advantages

• Single Treatment Session
• No knife, painless, bloodless non-invasive procedure, hence no infections, no hemorrhages
• Treatment on outpatient basis
• Treatment time- 3mts using FFF technology
• Max. Lesion size = 3cms

Typical SRS Targets

• Convexity Meningiomas: in elderly trial patient & those near cortical functional brain areas (Language/sensory/motoretc)
• Skull base meningiomas arising from dura of clivus/petrous, cavernous sinus sphenoid wing & olfactory groove
• Pineal gland tumors: postop residual or recurrent disease
• Central neurocytoma: postop residual or recurrent disease

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Frameless Intracranial 6-DOF Radiosurgery

Frameless SRS Advantages

• Single Treatment Session
• No knife, painless, bloodless non-invasive procedure, hence no infections, no hemorrhages
• Treatment on outpatient basis
• Treatment time- 3mts using FFF technology
• Max. Lesion size = 3cms

Typical SRS Targets

• Small/large volume deep seated AVM’s with a nidus volume (<10cm3)
• Small volume cortical AVM’s located at eloquent areas in brain
• Large volume (>10cm3) lobar location- post embolization residual
• Angiographic obliteration rate: 65-85% (depends on marginal dose)
• Disadvantage of RS: 9-18mo delay in complete obliteration

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Frameless Functional 6D-Stereotactic Radiosurgery

Frameless SRS Advantages

• Single Treatment Session
• No knife, painless, bloodless non-invasive procedure, hence no infections, no hemorrhages
• Treatment on outpatient basis
• Treatment time- 3mts using FFF technology

Typical SRS Targets

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Image Guided CT/MR based Brachytherapy