Clinicians Use Advanced Radiotherapy Imaging Techniques from Elekta to More Accurately Visualize Moving Tumors in Patients with Lung Cancer

By Elekta, PRNE
Sunday, October 17, 2010

To support better radiation targeting accuracy, the Leeds Teaching Hospitals NHS Trust rolls out cutting-edge technology

LEEDS, England, October 18, 2010 - A 67-year-old female patient with lung cancer presented physicians with a
difficult challenge: her tumor was small and it rode up and down with her
breathing. During her treatment set up, all doctors saw on their therapy
system's imaging equipment was a blur of motion. Fortunately, Leeds Teaching
Hospitals NHS Trust was able to utilize its Symmetry(TM) motion management
software; new imaging technology from Elekta that enables clear visualization
of moving targets.

"For this patient, and many similar lung cancer cases, Symmetry is
invaluable," says her physician, Kevin N. Franks, M.D., Consultant in
Clinical Oncology at St. James Institute of Oncology, Leeds Teaching
Hospitals NHS Trust. "Our first patient's tumor was just 1.4 cm in size and
its range of motion when she breathed was 2.4 cm because it was close to her
diaphragm. Treating a small tumor with this kind of motion would normally
have excluded her from aggressive treatments such as Stereotactic Body
Radiation Therapy [SBRT], particularly if you can't see it well on imaging

Symmetry provided sufficient scan quality to isolate the "moving" tumor
and the patient — the first at Leeds to benefit from the technique –
received five SBRT treatments, which use precise stereotactic targeting and a
potent dose designed to achieve control of the tumor.

Symmetry captures tumor position virtually invisible on static imaging

Symmetry is a feature set of Elekta's X-ray Volume Imaging (XVI) package
of software for Image Guided Radiation Therapy (IGRT). The software enables
clinicians to add the fourth dimension (i.e. 4D) of motion to enhance image
guidance with the patient in the treatment position just before therapy.

Leeds physicians had been able to use their 4D CT scanner to observe the
tumor moving with the patient's breathing. However, they were able to see
only an ill-defined blur when they used 3D XVI on their Elekta Synergy(R)

"It's like trying to take a picture of a fast-moving object using a
camera that has a slow shutter speed," says Jonathan Sykes, Joint Lead
Radiotherapy Imaging Physicist at Leeds. "But by taking the 4D CT planning
scan — which showed the 'envelope' of space within which the tumor was
moving — and matching that to 4D Symmetry reconstructions, which show where
the tumor is during the breathing cycle, the scan quality was sufficient to
localize the tumor."

After this first localization, three-minute 4D Symmetry scans were
repeated three times for each of the five treatment sessions to localize the
tumor, a second scan to verify needed patient position corrections and a
third scan to ensure proper patient immobilization. Of note, the treatments
are delivered while the patient is breathing freely.

"The 4D-XVI scan allowed us to see the tumor clearly and check that the
tumor motion had not changed from the planning 4D CT scan. It made the team
confident of the tumor localization," Dr. Franks says. "Without Symmetry,
SBRT might still have been possible as the tumor was distant from critical
organs, but we would have had to increase the treatment margins around the
tumor to account for the increased uncertainty about the tumor's position.
The worst case scenario is not using SBRT and treating her with a
conventional technique that is likely less effective."

Since this first patient, Leeds physicians have used Symmetry in
treatments of three additional patients with lung cancer. To download a case
study detailing the application of Symmetry at Leeds, visit

About Elekta

Elekta is a human care company pioneering significant innovations and
clinical solutions for treating cancer and brain disorders. The company
develops sophisticated, state-of-the-art tools and treatment planning systems
for radiation therapy and radiosurgery, as well as workflow enhancing
software systems across the spectrum of cancer care.

Stretching the boundaries of science and technology, providing
intelligent and resource-efficient solutions that offer confidence to both
healthcare providers and patients, Elekta aims to improve, prolong and even
save patient lives, making the future possible.

Today, Elekta solutions in oncology and neurosurgery are used in over
5,000 hospitals globally, and every day more than 100,000 patients receive
diagnosis, treatment or follow-up with the help of a solution from the Elekta

Elekta employs around 2,500 employees globally. The corporate headquarter
is located in Stockholm, Sweden, and the company is listed on the Nordic
Exchange under the ticker EKTAb. For more information about Elekta, please

Stina Thorman, Vice President Corporate Communications, Elekta AB, +46-8-587-254-37, stina.thorman at, Time zone: CET: Central European; Michelle Lee, Director, Global Public Relations and Brand Management, Elekta, +1-770-670-2447, michelle.lee at, Time zone: EDT: Eastern Daylight

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