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.

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/.



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.

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/.



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.

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/.



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.

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/.



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.

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/.

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. 

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/.

Maintenance Programs For Small and Large Scaled Medical Equipment Facilities

Once installed medical equipment, such as linear accelerators, CT scanners, and other large scaled radiation therapy equipment must be properly maintained to ensure accurate results.  Regular maintenance and service improves the longevity of equipment and increases equipment reliability.

More often than not, health care facilities do not have the budget to maintain an in house equipment care team, instead services on equipment is outsourced.  Medical equipment is specialized, and sophisticated, biomedical engineers are responsible for the services performed to ensure they are done properly, in a timely fashion, and by qualified service professionals.

There is a complexity in managing and properly maintaining large scaled medical equipment, such as linear accelerators.  This complexity exists for several reasons including:

  • The specialization of equipment throughout medical facilities
  • The integration of medical equipment and electronic networks
  • The increase in requirements for compliance, safety, reliability, and accuracy
  • The need for outsourcing medical equipment maintenance and repair

It is crucial that these elements are all focused on during the maintenance of facilities medical equipment inventory.  This ensures equipment is maintained at the right time and application.

One way that biomedical engineers keep up with the intricacies of each unique piece of equipment is by using historical data for reference and through overseeing equipment audits.  This allows professionals to analyze their management programs to improve efficiency and compliance all while decreasing costs.

Health care professionals should establish baselines on their equipment.  Each facility is a different size and offers varied levels of technology.  This is why it is inaccurate to use dollars spent as a comparison.  Smaller, more budget conscience facilities may be required to purchase refurbished linear accelerators over brand new to stay within their facility’s financial requirements.

A better measurement to use is a program’s cost of service ratio.  This measurement accounts for technology and the expense of maintenance, the ratio helps determine the financial effectiveness of an equipment maintenance program.  This ratio is found through the division of total annual costs of operations by the initial cost of procuring equipment.  Establish a goal that provides your company direction on reducing costs while increasing overall efficiency.

Medical equipment maintenance programs of the past have been based on an as needed basis for repairs.   Equipment is not maintained and instead breakdowns are addressed as equipment breaks.  Newer methodology involving medical equipment maintenance is time, predictive, and conditioned based to a new risk-based process.    Prevention and corrective maintenance are now concerned with scheduled activities and repairs when equipment is out of service.  This maintenance method prevents the ability to set service intervals based on useful data.

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/.

Radiation Therapy: Everything There Is to Know About Radiation Therapy and More

There are several treatment options that are available to patients after a cancer diagnosis has been received.   Radiation therapy is an option for treating cancer, thyroid disease, non-cancerous growths, and blood disorders.  The benefit of radiation therapy is that it can be confined to specific areas where the tumor is.  It is targeted treatment that has a devastating effect on its target.

Whether your treatment is curative or palliative, radiation is an effective option.  It is important to understand that although radiation therapy is used in treating cancer it is also used for treatment to certain inflammatory conditions and benign tumors.  In this installment we will focus more on the application of radiation therapy as treatment for cancer.

Quick Facts on Radiation Therapy

  • In order to stop cancer cells from growing and dividing, radiation therapy delivers intense energy waves to the targeted area. Not only does radiation therapy stop cancerous cells from growing, it works to kill cancerous cells, slow cancerous cells growth, and shrink cancerous tumors in order to allow surgical oncologists to remove left over tumor.
  • There are side effects to any cancer treatment including radiation therapy. One of the biggest side effects of radiation is the effect it has to the healthy tissues surrounding the areas around the tumor.  Treatment to healthy tissues is minimized as much as possible however this does not mean that it will be left unaffected.  Most of the side effects to the healthy tissue or local to the area and are short term however other side effects like fatigue can occur throughout your body.
  • In order to make sure that radiation is placed in the correct location, radiation therapy goes through a simulation process before it is actually administered to an actual patient.

Radiation Therapy Is…

A linear accelerator is the most common piece of equipment used to administer external beam radiation therapy.  Linear accelerators deliver waves of energy in the treatment of cancerous and non-cancerous tumors.  The form of radiation delivered using LINAC systems is known as ionizing radiation, a high-energy type of radiation.  The radiation breaks up the DNA of the cells in a manner that disturbs their ability to cultivate, even causing complete destruction, death.

Radiation therapy can be used on its own or in combination with other forms of treating cancer such as chemotherapy.  Only your cancer specialist can determine what option of treatment will be best for your specific type of cancer.  Radiation therapy is used as a form of treatment in over 60% of patients that are being treated for cancer within the United States.

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/.

 

Different Options in Treating Cancer

There are many methods used in the treatment of cancer.  Oncology physicians will work with one another to determine the best treatment combination to treat your unique cancer situation.

Chemotherapy

Chemotherapy drugs are a type of poison that is given via injection directly into the blood stream.  Some chemotherapy treatments can be taken by mouth, all to treat and reduce the size of cancerous tumors.  Chemo is the treatment options that is most common when dealing with metastatic cancers such as, Carcinoma of Unknown Primary, C.U.P., that have spread throughout the body.  When your treatment includes surgery as well the term Adjuvant Chemotherapy will be commonly used.  This refers to medicine that is given after surgery to prevent reoccurrence.  Neoadjuvant Chemotherapy refers to medicine that is given prior to surgery to shrink tumors.

There are a number of chemotherapy options that can be used in treating cancer.  To be effective it must be tailored to the primary site of cancer.  Every patient and every cancer will require a different, specialized treatment plan.  Often times a combination of treatments needs to be used in order to fully treat cancer.  Chemotherapy is often used as one piece in combination to treat cancerous cells.

Radiation Therapy

Radiotherapy uses beams of radiation to destroy cancer cells.  Beams of radiation are aimed at precise areas where cancerous cells are located in order to shrink or eliminate the tumor.  Radiation is delivered using linear accelerators.  Linear accelerators can deliver high powered radiation beams directly to the tumors while missing the surrounding healthy cells.

Radiation therapy is used as both a curative and palliative treatment.  Curative treatment seeks a long-lasting cure and reduction of cancer cells returning.  Palliative treatment seeks to reduce and slow down the symptoms being experienced with the cancer when there is no chance of curing the patient.  When determining your radiation treatment, doctors will look at the size, type, location, shape, and stage of the tumor, as well as the health of the patient and overall purpose of treatment.  A plan will be developed and executed according to a strict plan.

Hormone Therapy

Hormone therapy uses sex hormones to treat hormone sensitive/dependent cancers like breast, prostate, and womb cancers where the cancerous tumors and cells grow because of estrogen and testosterone. Hormone therapy is often used in combination with other treatments.

Immunotherapy

Immunotherapy works in an effort to replicate the persons actual immune system to reject and destroy cancerous cells.  This can be done through “immunization” in which a patient own immune system is trained to see cancerous cells and destroy them.  It can also be administered in a way that recruits the patients own immune system to kill the cancerous cells.

Surgery

When it is possible, surgery is the best option at offering a cure for most cancers however is not appropriate for CUP patients.  Surgery is most often used in treatment when the primary site of cancer is identified.

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/.

Radiation Therapy: Goals and Understanding

High-energy x-rays or particles used to destroy cancerous tumors and cells is known as radiation therapy.  A number of doctors specialize in treating cancer.  A radiation oncologist is the specialist that is trained to deliver radiation therapy to treat cancer.  The team of cancer specialists treating you and your cancer will develop a radiation schedule that delivers radiation at consistent intervals over the course of a set time period.

Radiation Therapy Goals

The goals of treatment using radiation is to slow the growth of cancerous tumors and destroy cancer cells without causing permanent damage to the surrounding healthy tissues and cells.  Most often doctors will recommend radiation therapy as the first line of treating cancer.  It can also be given with great results after surgery or chemotherapy.  When this is done it is known as adjuvant therapy.  This targets the “leftovers”, the cells containing cancer after the initial treatment.

Sometimes it is not possible to destroy all of the cancer.  If this is the case with your cancer specialists will use radiation to shrink the tumor to relieve the symptoms.  This is known as palliative radiation therapy.  In palliative therapy treatment is done to reduce the pressure, pain, and symptoms of cancer.  It is done to create a better quality of life for the patient.  If palliative therapy is done it is not done necessarily to cure the cancer but instead to increase the quality of life after diagnosis.

If you are diagnosed with cancer there is more than a fifty percent chance that you will receive a form of radiation therapy in treating your cancer.  Many forms of cancer react better with a combination of treatments such as radiation therapy with surgery, chemotherapy, or immunotherapy.

Using a Linear Accelerator

The most common delivery of radiation therapy is external-beam.  This consists of radiation being delivered to the patient using a machine known as a linear accelerator from the outside of the body. This machine creates a beam of radiation that is delivered through the skin directly to the cancerous tumor.   Specialized computer software is used in conjunction with LINAC to adjust the size and shape of the radiation beam specific to each patient’s tumor.  Targeting the exact shape and size of the tumor and cancer cells allows radiation oncologists to avoid healthy tissues that sit near the cancerous cells.

Treatment is normally given every day, Monday – Friday, for several weeks.  If treatment is to be given to the head, neck or brain, a form-fitting support or plastic mesh mask is used to prevent the patient from moving during radiation therapy.

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/.