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Treatment Room A

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Radiation Oncology Clinic Opens Improved Treatment Room

Dr. Zac Labby explains the features the Varian TrueBeam Radiotherapy System in the UW Health Radiation Oncology Clinic’s newly upgraded Treatment Room A.

The UW Health Radiation Oncology Clinic recently completed upgrades to Treatment Room A, offering patients precise and efficient treatment in an aesthetically pleasing environment.

At the heart of these renovations is a new Varian TrueBeam Radiotherapy System, a highly sophisticated radiation machine that complements the clinic’s impressive array of state-of-the-art radiotherapy equipment.

New features of Treatment Room A include the following:

  • Advanced imaging - The TrueBeam’s imaging system is integrated into the treatment system, which enables clinic staff to efficiently take patient images and readily compare them with images from the treatment plan. “We are able to capture the same types of images we could before, but with improvements in image quality and the way the system analyzes those images,” says Dr. Zac Labby, assistant professor in the Department of Human Oncology at the University of Wisconsin School of Medicine and Public Health.
  • A highly adjustable couch - The new couch in Treatment Room A provides for easier patient alignment. If a patient is out of position, the couch can be adjusted remotely with great precision. “With a couch that can move in six different directions, we can adjust without having to move the patient and take another image,” says Stephanie Bailey, UW Health Radiation Oncology technical supervisor. “It makes the treatment times quicker for the patient.”
  • High-energy radiation - The TrueBeam in Treatment Room A can deliver high-energy radiation, which is useful in treating tumors deep within the body. “The higher the energy, the more the beam penetrates,” Labby says. “We don’t need a high-energy beam for all cases, but it can be useful when treating a deep-seated target. In these cases, the high-energy beam may offer better, more treatment-efficient plans.”
  • Optical Surface Monitoring System (OSMS) - This is a patient positioning and monitoring system that uses three ceiling-mounted cameras to create a 3D model of the patient’s surface in real time. The system continuously compares these images to the optimal positioning determined during treatment planning to aid in patient setup and treatment accuracy. “With the OSMS technology, we can see when a patient moves even just a little,” Bailey says. “We can then turn the beam off and realign the patient if necessary.”
  • Respiratory gating system - This is a video-based system that enables clinicians to correlate tumor position to the patient’s breathing. It uses an infrared camera that tracks a reflective marker on the patient. By turning on the beam only when the treatment area is within a set range, it can help ensure highly accurate treatment of the lungs, liver, pancreas and breast, for example. “With the respiratory gating system, we can monitor a patient’s breathing cycle. This gives us greater confidence that we’re treating the patient consistently,” Labby says.
The respiratory gating system can also be used to acquire sharper CT images. During treatment, clinicians often use cone beam CT imaging to align patients to the reference CT scans taken before treatment. Cone beam CT scans can take about one minute to capture and are often blurred because of the patient’s breathing. Using the respiratory gating system, the CT scan can be captured only when the patient is at a specified position in the breathing cycle, resulting in a much clearer image than conventional cone beam CT. “This gives us more confidence in seeing abdominal organs like the liver, pancreas and stomach that move a lot during breathing,” Labby says.
  • A welcoming environment - Treatment Room A offers a welcoming and comfortable environment with images of Parfrey’s Glen on the walls and ceiling and a separate changing room for privacy.

These features will improve the patient experience and increase the clinic’s capacity to provide complex treatments.

The radiation machine in Treatment Room A is one of three TrueBeams in the department. Many properties of these machines are matched, which means that patients receive identical treatment on any of these units without needing a new treatment plan. This can help with patient scheduling issues and ensure continuity of treatment if one machine needs a few days for maintenance.

Although these technologies are new for Treatment Room A, many of the same technologies are operational on other UW Health machines including the new TrueBeam at the UW East Clinic. “Therapists rotate on a regular basis, so they know this technology very well as do all of our physics faculty and staff,” says Dr. Dustin Jacqmin, DHO physicist and assistant professor.

DHO Department Chairman Dr. Paul Harari notes, “We want UW cancer patients to have access to state-of-the-art cancer treatment in addition to expert faculty and staff who can fully leverage the tremendous power and precision of these new technologies. This important upgrade to Treatment Room A is a merely a reflection of the remarkable technology and patient care advances that have transformed UW Radiation Oncology in recent years.”