Erasmus MC in Rotterdam, the Netherlands, is the first hospital in Europe, and one of the first worldwide, to clinically deploy Varian's HyperSight imaging solution.
The Erasmus MC is using their Ethos therapy systems equipped with HyperSight to treat prostate, lung, esophagus, rectum, and breast cancer patients. Targets in the upper abdomen are in their sights for the future. The Erasmus MC team is amassing clinical experience and conducting research into the clinical potential and value of HyperSight.
Sharper images
The images generated using HyperSight show improved spatial and contrast resolution to define tumor volumes more precisely. “Due to the improved image quality, the AI-based segmentation of the critical organs during online adaptive treatments seems more accurate; therefore, we might make fewer adjustments ourselves," reports Judith Sluijter, Technical Physician.
Adaptive therapy with confidence
The Erasmus MC clinical team has increased confidence in generating adaptive treatment plans because HyperSight enables them to better distinguish between anatomical structures. “Previously, the gold markers used to verify tumor position caused significant streak artifacts and image distortions that made it difficult to accurately determine the boundaries of the prostate and rectum,” explains Kimm Fremeijer, Senior Radiation Therapy Technologist. “Thanks to HyperSight imaging’s new Metal Artifact Reduction algorithm, the streak artifacts are no longer visible; the markers are sharp and no anatomical information is lost. This innovation offers great advantages in defining the target area and assessing the radiation therapy plan." It also means that in the Erasmus MC the option of adaptive radiation therapy may soon be extended to patients with joint replacements and metal implants.
Streamlined off-line adaptive workflow
The Erasmus MC team is also looking forward to using HyperSight imaging to improve the clinical workflow for offline adaptive radiation therapy. Patients typically receive their treatment over multiple sequential days, and CBCT imaging is performed every treatment day to determine the shape and position of the tumor and surrounding healthy tissue. “If that CBCT image shows major anatomical changes compared to the reference situation, we need to create a new radiation therapy plan, including additional CT imaging, for correct dose calculation. With the improved image quality of HyperSight CBCT in combination with the Hounsfield Units accuracy, it is possible to omit the acquisition of the additional CT image: the generation of a new radiation therapy plan including dose calculation can take place directly using the HyperSight CBCT image," explains Sluijter.
Stijn van de Schoot, Medical Physics Expert, adds: "This way of working ensures that we can translate a lot of ad hoc work into structured tasks in a more streamlined workflow. In fact, all the building blocks for this workflow are already present. The experiences we are now gaining with HyperSight CBCT imaging are useful to fine-tune this future workflow.”
Potential patient benefits
The Erasmus MC team sees the potential benefits for patients. “In the future, we can perform replanning based on the HyperSight CBCT images obtained during radiation therapy treatment instead of scheduling patients for additional CT imaging. In addition, the sharp images may lead to smaller safety margins in future and thus to a lower radiation dose for healthy surrounding organs, reducing the risk of side effects," says Fremeijer.
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The information captured herein represents the genuine experience of the attributed individuals and may not necessarily represent the views of Varian or the above-referenced institution. Individuals were not compensated for their participation. Radiation treatment may not be appropriate for all cancers. Individual results may vary. For more information, please visit www.varian.com/safety.