Virginia Commonwealth University Medical Center offers precise treatment for tumours

Richmond 10 January 2006The Virginia Commonwealth University (VCU) Medical Center now offers one of the most precise systems in the world to treat both cancerous and non-malignant tumours, making many operable that once were not. By combining two state-of-the-art systems for advanced precision image-guided radiosurgery, the VCU Medical Center's new Trilogy Image-Guided Treatment Center is now ready to treat patients. Stereotactic radiosurgery specialists from the VCU Massey Cancer Center's department of radiation oncology and VCU's Harold F. Young Neurosurgery Center are the first to combine two powerful systems: Trilogy, a premier linear accelerator made by Varian, and ExacTrac, an advanced X-ray positioning system made by BrainLAB.


Together these systems enable doctors to visualize and target tumours within 0,4 millimeters of accuracy. The treatment's accuracy may improve patient outcomes by enabling physicians to reach more tumours and treat them more effectively, including those located near blood vessels and other critical structures in the brain or spinal column. In addition, doctors can spare more healthy tissue around the tumours.

The non-invasive procedure is performed on an out-patient basis and provides a high degree of safety and comfort. "Using the system's robotics and sophisticated image guidance, we can verify the tumour's exact position while on the treatment couch with unprecedented precision", stated William Broaddus, M.D., Ph.D., the team's neurosurgery leader. "And the increased accuracy we have in brain radiosurgery also can be applied to the spine and other parts of the body."

Because the system allows for precise, high doses, the length of treatment can be considerably shorter than with conventional radiation. "This stereotactic radiosurgery can be delivered in a single dose instead of over several weeks", stated Ted Chung, M.D., Ph.D., of Massey's radiation oncology team. "Side effects are minimal, and patients can get on with their lives sooner", he added.

"While many technologies offer three-dimensional image guidance, our combined system offers a fourth dimension - it accounts for a patient's breathing in real-time - so we can target the radiation beam to a fraction of a millimeter", added Stanley Benedict, Ph.D., associate professor and chief of clinical physics.

Unlike other "non-invasive" treatments, the Trilogy and ExacTrac systems do not require doctors to screw frames into patients' heads to immobilize them. Initially the group will treat brain and spinal cord tumours, and later this year will treat other tumours and lesions of the breast, prostate and lungs. The multi-speciality clinical team consists of neurosurgeons, radiation oncologists and dosing experts, physicists, therapists and nurses. The procedure is covered by most health insurance.

The new combined systems and treatment suite enhance the existing stereotactic radiosurgery programme, which was developed by the two departments in 1991 and since has treated more than 400 patients. In most cases, image-guided radiosurgery treatments at the Trilogy Image-Guided Treatment Center take less than an hour. The clinical care team plans the treatment in advance by incorporating previous images such as MRIs, PET scans and CT scans to accurately identify the lesions, target treatments and evaluate adjacent body structures.

On the day of treatment, patients undergo a final CT scan. On the treatment couch, patients are comfortably positioned by staff members. During the treatment, they are moved robotically while the staff in the control room monitor the patient by video and follow the data and images received from Trilogy and ExacTrac. Some patients may receive sedation or other medications to maximize their comfort. Combining the treatment planning, verification, delivery and recovery time, patients spend up to eight hours at the treatment centre. They can then go home and resume normal activities.

The Virginia Commonwealth University Medical Center is one of the nation's leading academic medical centres and stands alone as the only academic medical centre in Central Virginia. The medical centre includes the 780-bed MCV Hospitals and outpatient clinics, MCV Physicians - a 600-physician-faculty group practice, and the health sciences schools of Virginia Commonwealth University. The VCU Medical Center, through its VCU Health System, offers state-of-the art care in more than 200 speciality areas, many of national and international note, including organ transplantation, head and spinal cord trauma, burn healing and cancer treatment.

The VCU Medical Center is the site for the region's only Level 1 Trauma Center. As a leader in health care research, the VCU Medical Center offers patients the opportunity to choose to participate in programmes that advance evolving treatment, such as those sponsored by the National Cancer Institute through VCU's Massey Cancer Center, Virginia's first NCI-designated cancer centre. The VCU Medical Center's academic mission is supported by VCU's health sciences schools of medicine, allied health, dentistry, pharmacy and nursing.

Leslie Versweyveld

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