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Precision Imaging in Radiotherapy

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Abstract

Delivering exact radiation doses through image-guided radiation therapy to specific areas of a tumour demands ever increasing accuracy from the radiotherapy solutions. Currently, this need for precision images is being met by Agfa’s Computed Radiography (CR) solution. A digital simulation and portal imaging system for both low- and high-dose applications, it handles low- and high-energy X-rays. It is capable of acquiring radiographic quality images in a radiotherapy environment using CR technology.This enables the acquisition of digital images, which, in comparison with conventional film, results in higher contrast images. Launched in early 2005, this solution is the result of Agfa building upon its worldwide standard technologies in general radiation and its experience in developing unique solutions for other specialist markets such as orthopaedics, paediatrics and mammography.

How it Works
An X-ray image is recorded onto Agfa’s unique image plate, which is held in a dust-proof cassette.This image plate is coated with a phosphor layer that is sensitive to stimulation by incoming X-ray photons. Following exposure, the cassette is inserted into the Agfa CR 25.0 digitiser, which reads the information via a laser beam.

This activates the phosphor grains on the image plate to release energy in the form of light. This light is then collected as a digital image and processed – with Agfa’s patented MusicaTM image processing software – to obtain an exact digital image for display. The digital image can then be adjusted or reprocessed using Agfa’s CR Quality System (QS), a dedicated software package to enhance the imaging quality procedures within the department – something that has, until now, only been available in more expensive radiotherapy application areas. Once any adjustments have been made, the images can be made available on any hospital network via Digital Imaging and Communications in Medicine (DICOM) or by printing onto film using Agfa’s DRYSTARTM 5300.

Dedicated Plates and Cassettes
At the heart of the newly designed CR Radiotherapy Solution are cassettes that have been thoroughly evaluated in radiotherapy departments around the world.These cassettes, with their tungsten internal filter – a system patented by Agfa – provide significantly enhanced detection, while the lighter weight of the casing makes them more ergonomic and, therefore, more flexible for image manipulation when compared with others currently on the market. The CR radiotherapy high-dose cassettes offer optimal image quality at an extremely wide dose response of greater than 400 monitor units and are available for both high- and low-dosage applications. The CR RT low-dose cassettes for low-dose CR portal imaging provide excellent image quality in the low-dose range. Unprecedented Precision Images
Ann Meersschaert,Agfa’s Global Product Manager for CR radiotherapy applications, was asked to comment on the new solution. “The drive to develop the CR Radiotherapy Solution came as a result of our awareness of our customers’ requirement for precision images of a quality that have hitherto been unavailable to them. Field tests in sites across Europe and NorthAmerica, and approvals from ETL SEMKO, Europe, the Food and Drug Administration (FDA) in the US, the Canadian Standards Agency (CSA) and the State Food and Drug Administration (SFDA) in China, showed us that we had been successful in providing a solution to meet that need and we were delighted to launch our CR Radiotherapy Solution. We have taken the proven components of our other CR solutions, and used Agfa’ tise in imaging and information management to create a tailor-made system that we are confident will address the specific challenges faced by professionals within the radiotherapy field.”

A Flexible, Cost-effective Solution
Talking of the future, Ms Meersschaert adds, “The CR Radiotherapy Solution’ use enables the simultaneous support of multiple simulation and treatment rooms. By offering a wider radiation field and image quality that equals or even exceeds that of some Electronic Portal Imaging Device (EPID) systems, the solution complements any department. Now, EPID systems can interface with the Agfa CR Radiotherapy Solution, reducing the need for film, chemicals, dark room facilities and storage, making it a cost-efficient choice for the radiotherapy department.The cost-conscious department can depend on a highly reliable system, at a measurably lower cost when compared with charge couple device (CCD-based) and amorphous silicon (ASi) EPID systems. All in all, we believe we are offering a solution that will prove of great value to our customers, both now, and in the future.”

DICOM RT Archive
According to Dave Wilson, Director of Enterprise RIS/PACS solutions: “Agfa has enhanced our Radiotherapy Solution offering, with the launch of the DICOM RT Storage. Agfa’s IMPAX 6.0 Picture Archiving and Communication System (PACS) offers a DICOM archive within a radiotherapy environment. IMPAX also enables access to enterprise wide information through Information System integrations and access to historical patient data and images.”

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