Radiosurgical Techniques Developed to Treat Spine and Lung Tumors

Satish Jaywant, associate professor of radiation oncology at Robert Wood Johnson University Hospital (New Brunswick, NJ, USA), presented his latest work using stereotactic immobilization, cone beam computed tomography (CT), and the Integra Radionics ImageFusion software algorithms to achieve stereotactic accuracy for extracranial targets. Targets in the cervical, thoracic, and lumbar spine, as well as the lung, were treated with the noninvasive XKnife Body Localizer. Both systems were developed by Integra Radionics (Plainsboro, NJ, USA), a subsidiary of Integra LifeSciences Holdings Corp.

Dr. Lu Wang, assistant professor of the Fox Chase Cancer Center
(Philadelphia, PA, USA), demonstrated at the meeting the use of four-dimensional (4D) CT images, taken inside the simulation room, to account for target motion in lung tumors. 4D CT involves taking multiple images, over time, of the same location in the body so that the tumor's extreme and average positions can be factored into the treatment plan to ensure adequate radiation coverage. Fox Chase has used the XKnife RT (radiotherapy) planning software, XKnife MMLC beam shaper, and XKnife Body Localizer, combined with CT image guidance, to treat over 30 patients with spine, lung, and liver cancer.

Dr. Jim Grimm, from Christiana Care Health Services (Newark, DE, USA), presented an innovative method of improving the accuracy of XKnife cranial radiosurgery to 0.2-mm on most linear accelerators. Dr. Grimm's SAlinac system uses automatic film test analysis and video registration of laser alignment together with a wireless handheld device that provides real-time realignment advice as necessary. The SAlinac system is not yet available for sale and was presented as a work in progress.

Unlike conventional surgery, XKnife radiosurgery is completely noninvasive and does not require a surgical incision. Cancerous or other diseased tissue can be treated with focused radiation beams from a linear accelerator (linac) that are precisely guided using CT, magnetic resonance imaging (MRI), and positron emission tomography (PET) images. Surrounding healthy tissue is spared and patients are typically able to leave the hospital immediately after their approximate 30-minute single treatment.

Integra Radionics systems are currently sold in the United States through the Integra NeuroSciences sales organization.


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