Respiratory gating system and software – first in South Africa rolled-out

Leading cancer care business, Icon Oncology is proud to announce the first implementation in South Africa of a new respiratory gating system. This new system is designed to increase accuracy and reduce damage of healthy tissue during radiation therapy.

According to Icon Oncology COO, Dr Ernst Marais the investment in the new system is aligned to the company’s strategy for deploying best-in-class technology in cancer treatment in the country.

“We continuously identify and invest in new generation technology and software to ensure the best possible outcomes for our patients. We are excited to champion the innovative Respiratory Gating for Scanners (RGSC) from Varian Medical Systems in our flagship oncology unit at Mediclinic Constantiaberg and look forward to rolling it out to other key facilities across the country.”

“Respiratory Gating for Scanners (RGSC) is Varian’s solution for respiration-synchronized image acquisition for CT and PET-CT scanners. Its intuitive software helps simplify the imaging and treatment process by synchronizing the patient’s breathing to the imaging system to provide a clear picture of the tumour of the patient.” This explains Simon Meredith, General Manager and country lead for Varian, a Siemens Healthineers company.

What is the RGSC respiratory gating system?

RGSC is used to characterise a patient’s respiratory patterns and monitor the patient position during diagnostic CT image acquisition. The purpose of the system is two-fold. Firstly, to achieve a reproducible breathing pattern during image acquisition, and secondly, to accurately target tumours located close to organs at risk (OARs) during radiation treatment.

Accuracy and precision of radiation therapy are key to successful patient outcomes. This requires localising the target (tumour) and positioning the patient to their treatment location. “Breathing can sometimes interfere during the radiation treatment of some cancers. A gating system enables us to treat cancer with greater accuracy and coach patients in real-time to maintain a reproducible breathing pattern during treatment” explains Ivan Oelofse, National Medical Physics Manager for Icon Oncology.

respiratory gating system and software

Siemens SOMATOM® Definition AS Scanner, image courtesy of Siemens AG.

How it works

  • The respiratory gating system tracks a marker block that is placed on the patient’s abdomen or thorax during a CT scan. It then provides the necessary information to diagnostic devices to acquire images synchronised with the breathing motion.
  • Using a simple infrared camera and a marker block, the system tracks the patient’s breathing pattern, range of motion, and provides recorded information to the CT scanner.
  • After acquisitions, the image data is synchronised with the recorded breathing trace of the RGSC system.
  • The scanner generates image sets representing the different phases of the breathing cycle.
  • This is then used by the clinical team to plan treatment delivery.
  • The system supports prospective, retrospective and breath-hold image acquisition.
  • It allows for integration into the clinical workflow for motion managed treatment delivery.

Importantly the solution delivers significant improvements; “In terms of dynamic localisation measurements, the RGSC system showed 76% agreement with test data, where the previous Real-time Position Management (RPM) system showed a 66% agreement. (Shi C et al 2017).

Key benefits of the new cancer care system

cancer care

Using a simple infrared camera and a marker block, the system tracks the patient’s breathing pattern, range of motion, and provides recorded information to the CT scanner.

  • The audio and wireless visual coaching features help patients to achieve a reproducible breathing pattern during image acquisition.
  • An integrated database with the ARIA® oncology information system and Eclipse® treatment planning system streamlines the clinical workflow.
  • The software user interface is intuitive and helps to simplify the image acquisition and treatment delivery process.

Patient at the centre

“We are excited by the introduction of such technology, to the benefit of our patients. Mediclinic has been working with Icon Oncology to ensure a seamless journey with the best possible outcomes. This technology will contribute to those outcomes, and thus the value we offer our patients,” says Henk Laskey, Hospital General Manager of Mediclinic, Constantiaberg.

“At the heart of any investment in cancer technology is our patients. A cancer journey is a scary experience. This investment not only provides for better clinical outcomes for our patients, but also helps us to improve the overall patient experience. Technology is wonderful when its impact can be measured by a better experience for our patients,” says Marais.

Shi C., Tang X., Chan M., “Evaluation of the new respiratory gating system’, Precis Radiat Oncol. 2017 December; 1(4): 127–133.