Bladder brachytherapy An indispensable part of radiation therapy

Why brachytherapy for bladder?

Brachytherapy is a well-known treatment for certain types of bladder cancer, with good clinical outcome. A key advantage of brachytherapy is the potential to spare the bladder, which improves the quality of life for the patient.


G. Kovács et al. GEC-ESTRO ACROP recommendations for head & neck brachytherapy in squamous cell carcinomas: 1st update – Improvement by cross sectional imaging based treatment planning and stepping source technology / Radiotherapy and Oncology 122 (2017) 248–254 [https://www.thegreenjournal.com/article/S0167-8140(16)34346-8/pdf]

Doctor and patient

Ensuring a smooth clinical workflow

Connectivity to MOSAIQ® OIS

Confidence for you and your patients


  • Contributes to paperless brachytherapy workflow information
  • Automated scheduling and billing process
  • Documented dose and structure sets
  • Automatically exchange treatment plans created with Oncentra Brachy and treatment records generated by the afterloader
  • Perform dose tracking based on the treatment plan and treatment record for the selected and verified patient
  • Provide a more efficient and electronic way to capture information that will be included in the patient’s Continuity of Care Document (CCD), data as required for meaningful use (Stage 1 and beyond)

Applicator selection

Diagnostic imaging guides the applicator choice


Bladder applicators

Broadest range of CT/MR compatible applicators

The Luneray® Applicator consists of an integrated catheter/needle system, designed to enable laparoscopic, minimally invasive bladder brachytherapy procedures

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Luneray
Luneray

Applicator insertion

Combination of laparoscopy and cystoscopy, to view both sides of the bladder wall. With laparoscopic instruments, the bladder wall is cleared for accessibility, the borders of the clinical target volume (CTV) are marked by titanium clips, and three to four brachytherapy catheters are positioned in parallel along the bladder wall. Both catheters’ ends protrude from the patient’s skin.

  • Unique catheter/needle system enables minimally invasive catheter placement
  • State-of-the-art needle design for optimal maneuverability and precise placement
  • Enables organ-sparing, laparoscopic procedures – supporting a patient friendly treatment and quick recovery
“The Luneray catheter creates new opportunities to treat select bladder cancers in a minimally invasive way.”
G. Smits, MD, PhD
Urologist
Rijnstate Hospital, Arnhem, The Netherlands

E. van der Steen – Banasik, MD
Radiation Oncologist
Arnhem Radiotherapy Institute, The Netherlands

Imaging

Determine applicator position relative to tumor and OaR


X-Ray
X-Ray
CT
CT

Treatment planning

Homogeneous dose delivery on the target while sparing the OaR


Oncentra Brachy

Comprehensive treatment planning software

Designing the optimal dose distribution can be a time-consuming job. The latest version of Oncentra Brachy offers a series of useful tools that simplify many repetitive tasks, such as contouring and reconstruction. Oncentra Brachy buys you time to focus on what counts: creating the optimal dose distribution.

Oncentra Brachy also helps you optimize treatment plan accuracy, providing easy navigation to any plane that offers the most relevant information per region of interest. Template solutions for repetitive tasks, such as the new Implant Modeling tool and the popular Applicator Modeling feature, help reduce implant reconstruction time. DVH presets and the ROI Catalog Manager can help improve accuracy and reproducibility. Powerful inverse planning optimization automates volume-based planning, making the process fast and efficient.

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Reduce implant reconstruction time

  • Instant applicator reconstruction in relation to anatomy
  • Contains the complete geometry of Elekta’s gynecological applicators
  • Includes the measured source paths of ring applicators
  • Accounts for dose attenuation resulting from shielding during planning and shields are fully visible

Dose distribution calculated by ACE

  • Algorithm based on the TG-186 recommendations published by the AAPM workgroup in 2012
  • Algorithm based on the TG-186 recommendations published by the AAPM workgroup in 2012
  • Discriminates between tissue, air and bone
  • Accounts for tissue heterogeneities, lack of backscatter from areas with no tissue, applicator attenuation and shielding

Implant modeling tool

  • Reconstruct multicatheter implants immediately
  • Drag & Drop 3D applicator geometry for accurate and fast reconstruction
  • Extra Coordinate System (ECS) allows quick and easy navigation to the correct plane views

Automatic dose optimization

IPSA

  • Paired with the Dwell Time Deviation Constraint (DTDC)
  • Limits high variation in dwell times

HIPO

  • Improves plan optimization with Dwell Time Gradient Restriction (DTGR)
  • Control high and low peaks in dwell times
  • Focus optimization where it is needed with needle locking

Treatment delivery

Safe, simple, intuitive brachytherapy workflow


Flexitron

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Five simple features are the basis for the Flexitron way of working, introducing a new standard in treatment delivery

  • Standardized transfer lengths, less prone to human errors during reconstruction as there is only one indexer length.
  • Reference zero at entrance of applicator, no need to measure the distal tip.
  • Metric dwell position numbering, 1 mm step size in a treatment window of 400 mm.
  • Forward stepping results in a reproducible source positioning within 0,5mm accuracy
  • Intuitive user interface, smooth navigation saves time.

Why Flexitron?

  • Simple quality assurance
  • 40-channel option for large implants
  • Connected to major oncology systems such as MOSAIQ®
  • Safe investment with future upgrade potential
  • Available in either Iridium-192 or Cobalt-60*

* Not available in all countries.

Patient out

Find out about brachytherapy for other body regions


 
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What our customers say

Clatterbridge Cancer Centre, United Kingdom

Clatterbridge Cancer Centre, United Kingdom

 

BrachyAcademy

Empowering through education


Peer-to-peer education platform for brachytherapy professionals

The BrachyAcademy comprises a complete peer-to-peer medical education library and includes programs such as clinical workshops and training visits to leading hospitals worldwide.

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BrachyAcademy
 

About Brachytherapy

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Elekta also offers the only online brachytherapy portal for patients including awareness materials:

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Elekta Care™



Elekta Care supports you from startup through your product's lifecycle with comprehensive options from education, training and upgrades to solutions allowing you the highest uptime and improved operational efficiency.

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Elekta Care

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