Marc Posner, MD, a radiation oncologist at Northwestern Lake Forest Hospital outside of Chicago, has been using the Clarity visualization system from clinical solution manufacturer Elekta for several years now. The noninvasive, nonionizing soft tissue visualization to support radiation therapy treatment is used in the facility for a number of procedures, namely, imaging the prostate for treatment of cancer. So when Elekta recently unveiled the FDA-cleared Autoscan feature for the Clarity system, Posner was excited to get his hands on it.
“I developed a relationship with Clarity and their system right from the get-go when we first started using [Clarity 4 years ago],” said Posner. “So when the time came for them to develop this Autoscan technology, they wanted my input on it. I saw Alpha 1. I saw their very first model.”
Clarity with Autoscan provides an alternative to traditional handheld scanning and is a platform with which to build future real-time imaging applications that will track the prostate and surrounding anatomy during treatment. Posner believes that not only will the Autoscan feature—which can be retrofitted onto the existing Clarity system—prove worthwhile in the coming years, but it can improve the treatment that the facility currently administers.
“There’s a certain advantage to the Autoscan in that it is less anatomy dependent and is less dependent upon the patient having a full bladder,” Posner said. “There are certainly some patients I scan today who would be easier to set up had I had Autoscan available to me.
“The real value of Autoscan is not what it’s going to do for me today but tomorrow. Tomorrow, what Autoscan is going to do is allow me to track that prostate in real time during treatment. This is not absolutely critical for the treatments I’m doing today, but tomorrow, I would like to be performing hypofractionation. I would like to be reducing the number of treatments. Instead of telling a guy that he has to come in for 8 weeks of daily treatments, I want to be able to say, ‘I’ll have you finished in five treatments.’ “
One of Autoscan’s greatest attributes is the way in which it lowers dose. In an age when more people are cognizant of dosage, any strategy for reducing the dosage to a patient is beneficial. Not only is Autoscan nonionizing, but the ability to visualize anatomy in real time allows technicians to deliver more focused treatment and reduce the dosage given to the surrounding sensitive structures, as well as streamline and shorten treatment cycles.
“There’s no additional radiation being given to the patient at any time,” Posner said. “As everyone is becoming more sensitive and aware of excessive radiation doses, both therapeutic and diagnostic, here’s a tool that can reduce the diagnostic radiation load because we don’t need to use x-rays to line up the patient on a daily basis or even in real-time imaging. That’s a lot of extra dose. This system has no extra dose, so we can reduce the dose to the patient that way. By being more accurate in our targeting, in both the planning phase and the treatment phase, we can reduce the amount of dose that gets to the sensitive structures, which should translate into reduced short-term and long-term side effects.”
Unfortunately, due to tightened budgets, Northwestern Lake Forest Hospital does not yet have the Autoscan feature, but it may in the near future. Posner, however, having experienced the solution first hand, remains adamant that Clarity with Autoscan will make a significant impact on the quality and effectiveness of their diagnostic and therapeutic processes.
“I think it will dramatically help with the imaging in the more difficult cases,” Posner said. “Some men are hard to image; some men are easy to image transabdominally. But the Autoscan takes a transperineal approach so the scanning head is much closer to the prostate and gives a sharper image. Defining the prostate for treatment planning and for daily delivery of radiation, in most cases, should be substantially improved. It definitely has applications today as well as tomorrow, which is why I’m fighting for it today.”