GE CT Scanners – Doing Business In Michigan

Should I Replace or Upgrade My LINAC System?

Having a shiny LINAC system in your clinic entitles you to benefits and services other clinics lacking this technology do not. Such a system is imperative when dealing with minute cancer situations and can not only give the medical staff an edge but also give patients a guarantee of quality others cannot. That said, a proper LINAC system is, quite obviously, not a cheap system to not only implement initially but maintain over time. At one point a clinician or technician may decide the time has come to upgrade to what’s best out there, but such a decision is not so black and white. This article should briefly outline why so.

What Do You Have?

When making the decision to upgrade, you have to look at what you have already implemented. What you have may actually be satisfactory despite being old. LINAC systems themselves are as pricy as one may expect but are also modifiable with different parts that make up the whole. Linear accelerators can be classified as defined by their part status. Essentially, your linear accelerator can be classified from older and lacking upgrades, through newer but lacking and older and possessing upgrades, to newer and possessing upgrades. Where your system lies on the spectrum indicates whether or not making upgrades is worth the cost when considering the competency.

What is Your Budget?

Depending on the overall budget and success of your clinic you may find it smarter to simply upgrade certain parts on your older LINAC system. If money is no object you can naturally swap out your system – even if it’s new – for a newer, more modern and up-to-date model. Having an infinite source of funds is most likely not the case for most clinics, so you must take budget into effect and decide if your system is old enough to really warrant a true upgrade. Remember, upgrading certain parts of your system will always be cheaper than an outright replacement, and going with used upgrades is still a viable and more cost-effective option.

Do You Have Time?

When replacing a LINAC system completely, time is of great importance. Upgrading certain parts on a system can take hours and can be done overnight, but swapping out an entire system can take much, much longer. Are you able to survive with such an important machine out of the office for so long? If your system isn’t too old and has competent upgrades, then it can be hard to justify that absence. Any experienced clinician understands his or her own office enough to know whether or not that absence is detrimental to overall clinic success.

As an independent LINAC service company, Acceletronics is dedicated to delivering the best equipment performance and services for linear accelerators and CT scanners across all major brands and models, as well as new and refurbished LINAC systems for sale. More information can be found online at https://www.acceletronics.com/.

Treating Cancer with External Beam Radiation

Cancer treatment has continued to evolve with new technology and knowledge on new innovative techniques to increase the effectiveness with fewer treatments needed. External beam radiation therapy is a form of treatment that aims radiation from a machine called a linear accelerator. The beam of radiation is aimed at a targeted area where tumor cells are found. This type of radiation therapy is a local treatment and treats the specific area in a person’s body such as lungs and not their entire body. There are several options when using external beam radiation therapy with all the same goal to deliver the highest dose of prescribed radiation to a tumor while protecting the surrounding tissue. Below each treatment type is explained more in detail.

3D conformal radiation therapy

This type of technique is a common option in radiation therapy in which it uses images from CT, MRI, and PET scans to create a precise plan for the treatment area. The process allows doctors to sculpt radiation beams to the shape of a tumor and often used in instances where the tumor is oddly shaped or if the tumor lies close to healthy tissue/ organs. The radiation beams can then be directed at the target from several angles as needed.

Intensity-modulated radiation therapy (IMRT)

Intensity-modulated radiation therapy (IMRT) is an advanced type of 3-D conformal radiation therapy to treat cancer and noncancerous tumors. IMRT is used by multiple small photons and proton beams aimed at targeted tumor cells with varied, controlled intensity. During each treatment, the beam shape and the beam strength will continue to change to give higher doses to certain parts of the tumor as needed. Due to the greater level of accuracy, IMRT is a possible treatment option for patients that may have reached the maximum allowable dose from conventional radiation therapy with reoccurring tumors.

Image-guided radiation therapy (IGRT)

Image-guided radiation therapy (IGRT) is a form of IMRT. What sets this type of treatment apart from IMRT is that it not only uses imaging scans before radiation sessions begin but also uses them during the actual radiation therapy session. Tumors can shift inside the body due to breathing or other body movements that can sometimes be hard to control. IGRT allows doctors to locate and track tumors during the procedure to deliver more precise radiation therapy. Technical adjustments can be made by the radiation oncologists when the tumor moves outside of the targeted area helping to limit radiation exposure that could damage healthy tissues nearby and decrease common radiation side effects.

Consideration When Buying A Linear Accelerator

Purchasing a new Linear Accelerator can be a very costly investment that can range between $1 million and upwards to over $5 million. This cost alone is not the only expected fees associated with this equipment since delivery charges and secondary equipment such as a simulator, treatment planning computer, the treatment room itself, and the compensation for the radiographers/ physicist salaries. There is a lot of options to consider when replacing or installing new radiotherapy equipment and a few helpful tips below may help make the decision process a little simpler.

The Resale Value

Before purchasing any new or refurbished linear accelerator, it is important to ask yourself the question “How much will my Linac system be worth if choosing to replace or upgrade it in the future?” The answer to this may affect your company’s ability to purchase equipment in the future so the best way to solve this is by three other factors. First is obsolescence, this factor will greatly impact the long-term maintenance of any equipment. As parts continue to get older, replacement parts will become more and more difficult to locate for obsolete equipment. This also will make service personal harder to find as well since they will not be as familiar with repairs on older machines. Research the manufacturing company and choose one that has been in business for a decent amount of time, If you feel the company will not be around in the next ten years it will most likely not have very good resale value.

Re-licensing Fees

When shopping for a new linear accelerator, if a machine requires new relicensing it will become more costly to a buyer hence making it less attractive for purchase. Providing the license on the equipment will increase the demand which will, in turn, make it have a higher resale value as well. Company’s such as Varian and Elekta have always had higher resale value because of the licensing fees/ software and relocation charges being less than their competitors.

Technology Reimbursements

The centers for Medicare and Medicaid Services utilize reimbursement rates to entice clinicians to accept the use of new, proven treatment for the future. For example, several years ago when CMS code 77421 was released, image-guided radiation therapy (IGRT) became widely accepted and hundreds of linear accelerators were upgraded, therefore. A linear accelerator that has the technology to benefit from higher reimbursement rates which certainly affect the price of a machine in the market of used equipment. Systems that use IMRT, IGRT, and CBCT technology will lead more than machines without these capabilities. The future can be a mystery when attempting to predict which technologies will be reimbursed in the following years but company’s such as Varian and Elekta have a long history of systems that have the possibility for upgrades which has helped them increase in value on used products.

What is Equipment Relocation?

Linear accelerators and CT simulators are large, that’s obvious. Any business who has obtained an accelerator understands the headache of moving such a large and delicate machine to their offices. When moving offices or simply needing to move an accelerator from one place to another there are companies that have staff on hand who are specialized in moving this equipment so you the business owner do not have to worry about how it’s going to get done. These companies offer a range of services related to accelerator relocation so there should be a service to fit any needs a business may have.

Quality Moving

The companies that specialize in moving large equipment are specialized because of the talent on hand. These employees are specially trained to handle large equipment moving with ease and delicacy that these machines require and can do so with advanced logistics that other companies do not possess. With these logistics intact these companies can ensure your equipment is free from damage of any kind during the moving process and can move the equipment over a small area to even internationally. You’ve no-doubt seen videos of unqualified employees attempting to move large equipment and failing miserably causing thousands of dollars of damage to the company, so it pays tremendously to hire a professional relocation company that can handle the move in a professional and careful manner.

Installation

Simply moving equipment is great, but what about those who need it and moved as well as installed in their offices? Equipment relocation isn’t just moving equipment from one place to another but also making sure the instrument is properly installed using the correct tools for the job. The machines usually involved in relocation such as linear accelerators are simply impossible to move on your own, so the crews at these relocation companies are able to use specific rigging materials to make sure the equipment is lifted and moved to right where it needs to be as carefully as can be. The process of installing the electrical components of these instruments is also handled by professional and experienced engineering specialist who can handle the job with the proper care and respect.

Testing

Once an instrument like a linear accelerator is moved to a new location and properly installed in the right spot in the office it still requires careful calibration before it can be used properly. The companies that supply relocation services also provide physics support related to calibration and testing. This completes the full suite of process and steps necessary when transporting a large instrument like a linear accelerator from one office to another and is a full suite that certain relocation companies can offer.

Key Points to Consider for Linac Removal

Removing a 25,000 lb piece of machinery from a medical clinic or hospital, what could go wrong? It can be crucial to other surrounding equipment and to your facility to have safe and efficient removal services performed so that your facility will have peace of mind knowing that this process will be handled correctly. A few tips below will help this removal process go more smoothly and will get you to the goal of out with the out and in with the new more quickly.

Removal Path

To start, cleaning of any removable clutter is always overlooked and can become an obstacle that can be avoided. Measuring will be the next step to take when its time to start moving any type of equipment. A tape measurer will be your best friend since when it comes to moving high or low energy linacs, each have a minimum requirement for the number of inches required for room clearance. Accurately measuring all building doors including the vault and outside door along the removal path is very important. Prior to the arrival or replacement equipment, a professional vendor will request a rig info sheet to be submitted to guarantee that there is no door frames or walls that will need to be removed. If the vendor does not ask about the measurements beforehand, this is a red flag that you should be looking for equipment elsewhere.

Safety Concerns

When transporting heavy equipment at any times, the safety of the removal team is of utmost importance. If the above-mentioned measurements are done inaccurately and realize that a vault door must be removed with late notice, this will pose a very big safety hazard. Depending on size, vault doors can easily weigh a few thousand pounds and unfortunate deaths have resulted when removal of these doors have been done incorrectly. When they doors need to be removed, it is critical that they are removed by professionals that have experience in the field. Last minute decisions for vault door removal will also cut into extra expenses that was not part of the company budget so it again if very important for the measurements to be calculated right the first time. Proper liability insurance should be provided by your vendor when on site during the removal process as well.

Loading Space

Once you have the old equipment outside the next step is often overlooked as well. The loading area needs to have enough space in order to load the linear accelerator into trailer for transportation. Facilities will typically need to block off any side streets or parking spots to allow a safe loading area. If loading space is unavailable, the removal team will need to utilize a forklift of suitable size to lift and move machinery to the trailer manually.

Facility Jobs

No matter the size or details of removal that is performed, there will be responsibilities of the facility that will be requested. Generally, the removal team will ask local facility engineers, electricians, or plumbers to turn off the water or other power sources that are attached to the specific equipment that is being removed. This will protect the office building from having potentially dangerous live power to the area and helps to not disrupt any of the surrounding rooms that lighting and power may be connected to as well. Many times, the facility will manage and schedule the removal times so that it is occurring after hours or assist in security throughout the building.

Improving LINAC Service Response Time

Linear accelerators and complex support devices are at the heart of today’s radiation oncology. As technology continues to advance and change the way in which LINAC systems treat cancerous tumors, it becomes increasingly difficult to manage the way in which equipment maintenance, malfunction, and breakdowns are managed. The strategies to manage quality, mitigate risk and analyze failures have improved to adjust to the changing needs of radiation oncology equipment.

Manufacturers of oncology equipment add guidelines to ensure successful management of equipment maintenance including system monitoring and cyclical measurements of key functions verse pre-specified tolerances. This information was previously documented by hand whereas in today’s environment data can be recorded, distributed company-wide, and stored electronically. IT plays an integral role in storing and managing the data which can then be integrated into the everyday workflow in the radiation oncology department.

Work to cultivate IT clinical management solutions in the radiation department is often done in house working in collaboration with equipment vendors. This process is an essential component in quality management of radiation oncology equipment services.

Service and support of linear accelerators are a key element in quality management in the radiation oncology department. In most facilities, radiation therapists will report all technical problems with the LINAC to a clinical medical physicist who then reports the events of the machine’s failure to the vendor’s dispatch center to schedule support. When this call is made the therapist or physicist reporting the LINAC failure will provide the identification of the linear accelerator, the location of the machine, and a detailed report of the problem including what issues led up to the failure..

Depending on where the machine is located, the vendors dispatch center will provide information to equipment engineers at their technical support help desk. Together the user and engineers will attempt to diagnosis the issue at hand and coordinate actions for repair.

Facilities looking to improve the efficiency of support and service to linear accelerators when failure occurs can implement key changes in the overall process. These procedure modifications include:

Lessen the number of steps involved in reporting the LINAC failure to the vendor’s support team.
Reduce duplication and surplus in the diffusion of information related to the linear accelerators’ failure.
Record events electronically for improvement and evaluation of delivering services related to LINAC maintenance and repairs.
Utilize remote support from vendor approved engineers that are familiar with the installed system and its maintenance and service history.

3 Tips For Installing or Replacing a Linear Accelerator

New linear accelerators can cost a medical facility between 1 and 5 million dollars. The expense of owning a LINAC does not stop once it has ben purchased. There are items outside of the actual equipment purchase such as a simulator, training computers, treatment rooms, salaries, ongoing training, operation expenses, maintenance, repairs, and more. The total cost of large scaled medical equipment is never one that should be underestimated. Whether you are installing a brand new or refurbished linear accelerator, installing a LINAC for the first time, or replacing an existing one there are three tips the professionals at Acceletronics want to give you.

Step One – Plan, Plan, and Plan Some More

The installation planning process for a linear accelerator takes between six months to eight years. The length of time for planning your project can span almost any length of time.

When planning new technology, you will first want to establish the technology that you need in order to treat patients. What types of cases will you be treating? Consider the options IMRT, IGRT, and so on.
If you are installing a linear accelerator in new construction, you will want to consider the constraints that come along with that. What local permits do you need, do you have the proper power supply needed for this large scaled equipment, are there constraints that will limit your installation? If you are renovating a space consider the rooms constraints, size, location of isocenter and so forth.
Create a timeline for major milestones. When will the vault be completed, when are vendors scheduled to install computers? When planning these things consider potential areas where conflict can occur and come up with a backup plan.
Once the goals are established, a budget is needed to acquire the new equipment. Consider other aspects as well such as training, equipment needed to run the LINAC and treat patients, and the extra items that can be forgotten about when focusing on the large scaled purchase.

Step Two – Hire Based on Experience

When hiring a team of professionals, it is crucial that you hire experts. Experts are needed for designing the vault, construction, providers of equipment and supplies, IT support, clinical implementation teams, and such. Don’t trade cost for quality. Sometimes a little bit more money now can save you a great deal of money later on down the road. Ask for references when working with different vendors. Hire only those vendors that understand the collaboration effort needed to install medical equipment such as CT Scanners and Linear Accelerators.

Step Three – Commit to Quality

When buying a used or refurbished linear accelerator there is a three-step process that you should follow to ensure you get a machine that meets your needs and beyond. These steps include: a review of the LINAC’s service history (look at major service events such as waveguide replacement), review the machine’s utilization and beam hours, and perform a physical inspection of the machine.

Removing a Linear Accelerator

Many times, when a facility gets a new or refurbished linear accelerator, they are replacing an older piece of equipment that needs to be removed. If you have ever worked with a LINAC you can only imagine how difficult the removal process can be. Not only is it a large piece of machinery you are dealing with the removal of a highly sophisticated machine that is quite expensive. On top of all of that it is important to remember you are working with in a medical facility that is busy treating patients. Removing a linear accelerator, CT scanner, or any other large scaled machinery is not a simple task by any means.

Through careful planning, companies like Acceletronics can minimize the hassle when removing and installing linear accelerators. Our team of experts specialize in the removal of linear accelerators. Our staff with guide you throughout the process to ensure your facility continues to run as expected and that the disruption to patient care is minimal.

First things first, safety is the top priority! Not only do we want to keep our employees safe, we are continually improving safety techniques to ensure safety for all. Here are some of the ways that we work to establish a safe environment when removing large scaled medical equipment like linear accelerators.

Areas that will be accessed in removal of the linear accelerator are all blocked off. This includes areas of the medical facility, parking areas, and side streets when necessary.
Accurate measurements are taken to prevent any emergency vault door removal. Removing the vault doors poses a risk to personnel and patients within the facility. Measuring, planning, and careful execution prevents this risk.
Water, lock and tag power is all shut off to the treatment room where your linear accelerator is location. This prevents injury to the rigging team. These tasks are completed by facility personnel who are familiar with the utility systems and helps to prevent dangerous mistakes that can happen when individuals unfamiliar to the location are tasked to complete utility shut down.
A plan is always in place for the handling of any materials deemed hazardous.

Many times, relocation of linear accelerators can occur on weekends or after hours which will help to eliminate any disruptions that may occur. It is important to work with companies that adhere to health protocols of your facility when working with you. The goal is to minimize risk to patients while ensuring quality patient care.

Budgeting is another area that the professionals at Acceletronics work with clients. Purchase and removal of LINAC systems is not inexpensive by any means. In order to help mitigate the costs and ensure you are not spending more than you need to when removing a linear accelerator, we offer you tips.

Planning and transparency is needed from the beginning to the end of the equipment removal process. In order to prevent confusion, errors in communication, or logistic issues that can increase costs it is crucial to have everyone working on the project in the know. Every detail, every change, and every hurdle needs to be thoroughly addressed with each and every person involved in the process. This will save you money. Preventing errors with detailed planning and complete transparency will keep expenditures within the quoted allotment.
When planning the time when the equipment will be removed choose a period that will cause the least amount of disruption to the operations of your facility. Although it may cost a bit more to have the removal take place on the weekends or a holiday it is less costly then a disruption to patient care.
Often companies can get credit for machines that are still in operational condition. Credit for working parts can decrease the cost of removal. The savings that is passed on to you will be determined by the year of the LINAC, the make, model, and condition.

Finally, the execution of removing the systems comes into play. After some major pre-planning and all of the pieces of the puzzle working to complete a whole picture the removal process can occur.

As previously mentioned, accurate measurements are a key element is removal. Costly errors occur when measuring is not precise. Before we arrive on site, facilities will give us a complete rig info sheet. This will ensure that there are zero surprises when moving the LINAC through doorways.

It is also important that a pathway clear of obstruction is obtained when removing a linear accelerator. Facilities should plan for the removal of furniture and unnecessary items in order to create a barrier free exit.

After the machine is removed it needs to be transported. It is important that a loading area is prepared to allow for this to easily occur. Most often a semi is needed. To ensure the semi has access to the loading area it is crucial that the area is sectioned off and that the exit is kept clear. The smoother this process goes the less it will cost your facility.

If you have any accessories or additional equipment that needs to be removed it is important to plan ahead. It is less expensive to remove the main piece of equipment and accessories all at one time instead of completing the removal in multiple steps. The more steps involved in the process the more costly it tends to be. Accommodating removal of everything in one day is the least expensive way in which to execute medical equipment removal.

Once the room is clear of the LINAC and depending on your plan, the next steps can start to unfold. There are many factors involved in coordinating the removal of a linear accelerator. It is important to hire the right team to achieve your vision, and we think the professionals at Acceletronics can help! We have years of experience in the removal and installation of new and refurbished linear accelerators. Our team specializes in CT scanners and linear accelerators and would be delighted to partner with you in purchasing, removal, installation, servicing, and more.

Exploring Radiation Therapy Treatments Part 1

Medical facilities have a lot to consider when purchasing new or refurbished medical equipment. It is imperative to offer clients the highest patient care possible while also meeting the goals of the facility. As patients we often don’t consider the rigorous behind the scenes work it takes to bring us the latest and greatest treatments. We just want to know that we are getting the best possible treatment for our unique situation. This is especially true in the treatment of cancer.

Being told you need radiation is perhaps one of the scariest things you will hear. Everyone has their own experience while going through the process to eliminate their cancer however, it seems the “negative” always outshines the positive as we are seeking answers to questions before our own treatment begins. We are here to help. The following installments will give you a solid understanding on the ins and outs of treatment. Information reduces anxiety and at a time when anxiety is at all time high the last thing you want is to have unanswered question in connection with your treatment.

First and foremost, lets talk about the medical equipment that will be used in treating your cancer with radiation therapy. Linear accelerators are large machines that can be quite intimidating. In all honesty, the size of the machine and the impact of the treatment are both extreme and just their sight can create anxiousness. The truth is there is no reason at all to be intimidated by the size or treatment that is provided by linear accelerators, LINAC.

A LINAC is a large piece of medical equipment that uses elevated electromagnetic waves to accelerate electrons into extreme energy in a linear path that travels through an accelerator waveguide. These electrons collide with a heavy metal target and the result of the collision is the production of high energy x-rays (photons) that are delivered to the patient. Linear accelerators have special features that allow these beams to be shaped to conform to the tumors shape. The LINAC treatment angles can be manipulated receiving a variety of angles through the rotating gantry and movable treatment couch.

Linear accelerators, LINAC, continue to evolve. Radiation therapy continues to advance as well. What does this mean for patients?

Increased survival rates, more efficient treatment, fewer side effects, faster results, and more await patients with the advancements of LINAC systems. The radiation therapy process doesn’t have nerve wracking to patients. In our next installment we will dive further into the treatment, side effects, and questions patients often ask when discussing treatment with radiation therapy.

The People Behind the Installation of a Linear Accelerators

Purchasing a linear accelerator takes a great deal of planning, an experienced team to pull it all together, and a commitment to purchasing a quality piece of equipment. The planning process, as previously stated includes:

Understanding the goals of your clinic
Facility Planning
Schedule
Budget

In this installment we will look at the team of experts that you will need as you go about purchasing and implementing treatment using a large scaled piece of radiation therapy equipment such as a LINAC. Putting an experienced team of experts in place starts by involving individuals who share a similar vision for the facilities project. A unified group of professionals who will communicate with one another throughout the project. This team should include: vault designer/construction, provider of the LINAC, physics support, IT team, and the facilities clinical team for implementation. Choosing the best players for your team ensures success. It is your responsibility when making a purchase of this magnitude to perform due diligence every step of the way.

Vault Designer/Construction

Only a specialist can design and construct a vault that is capable of safely accommodating a linear accelerator. Not every construction company can create this safe space, it requires experience. Having a reliable company, with proven results in your corner will not only save you money but also critical time as you begin planning the installation of your linear accelerator.

Linear Accelerator Provider

Not all LINAC and radiation therapy equipment providers are the same. Don’t purchase equipment based solely on the basis of price as this is not the true cost of owning a linear accelerator. It is crucial, whether you are purchasing a new, refurbished, or used linear accelerator that you work with a company that provides the necessary specialized installation and support needed throughout the ownership of the equipment. Vendors such as Accelectronics, that can complete sales, delivery, installation, servicing, replacement parts, and removal provide reliability and accountability that many companies cannot compete with.

Physics Support

Successful treatment and patient outcomes only can occur when a continuous quality assurance program is in place. This group must have the tools and knowledge needed to make sure the installation and implementation of said equipment in your facility will be successful. This can include but is not limited to the assurance that you are offering the best possible treatment, to ongoing FAQ support.

IT Team

The hardware and software of all types of medical equipment is ever changing, the same is true of radiation therapy equipment such as linear accelerators and CT scanners. An IT team must be in place to ensure that equipment is kept up to date with the latest upgrades. They also must understand the overall impact to the facility a new piece of equipment such as a LINAC will have. Different systems must work together. It is up to your IT team to implement this network in order to have successful patient outcomes.

Implementation

Once the other pieces of the puzzle are in place including technology, the clinical implementation team will work together to ensure the best treatment plans are delivered to patients. This team includes: in-house therapists, physicists, and dosimetrists. This team is in place to guarantee an optimization treatment from beginning to end.