Basic information about Elekta and its familiar with xvi and Iviewgt protocols and there import and defining the Target area clip box registration along with HEXAPOD 6Dof couch & Apex Dmlc setup
Quality Assurance in Radiotherapy. Web-based quality assurance; using medical web instrument to facilitate the education, collaboration and peer review, providing an environment in which clinical investigators can receive, share and analyse treatment planning digital data.
A summary of recent innovations in radiation oncology focussing on the priniciples of different techniques and their application. An overview of clinical results has also been given
1.Aim of Radiotherapy
The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible
2.Organ Motion
Intra-fraction motion
during the fraction
Heartbeat
Swallowing
Coughing
Eye movement
Inter-fraction motion
- in between the fractions
Tumour change
Weight gain/loss
Positioning deviation
Breathing
Bowel and rectal filling
Bladder filling
Muscle relaxation/tension
3. Respiratory motion affects:
Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate
Tumour displacement varies depending on the site and organ Location
Lung tumours can move several cm in any direction during irradiation
It is most prevalent and prominent in Lung cancers
4. Problems associated with respiratory motion during RT
Image acquisition limitations
Treatment planning limitations
Radiation delivery limitations
5. Methods to Account for Respiratory Motion
1. Motion encompassing methods
2. Respiratory gating methods
3. Breath hold methods
4. Forced shallow breathing with abdominal compression
5. Real-time tumor tracking methods
Summary:
The management of respiratory motion in radiation oncology is an evolving field
IGRT provides a solution for combating organ motion in radiotherapy
Delivering higher dose to tumor and less dose to normal tissue.
Limited clinical studies, needs to be studied further
IGRT – the future of radiotherapy
The vmat vs other recent radiotherapy techniquesM'dee Phechudi
VMAT is a new type of intensity-modulated radiation therapy (IMRT) treatment technique that uses the same hardware (i.e. a digital linear accelerator) as used for IMRT or conformal treatment, but delivers the radiotherapy treatment using a rotational or arc geometry rather than several static beams.
This technique uses continuous modulation (i.e. moving the collimator leaves) of the multileaf collimator (MLC) fields, continuous change of the fluence rate (the intensity of the X rays) and gantry rotation speed across a single or multiple 360 degree rotations
In 2000 IAEA published another International Code of Practice.
“Absorbed Dose Determination in External Beam Radiotherapy” (Technical Report Series No. 398)
Recommending procedures to obtain the absorbed dose in water from measurements made with an ionisation chamber in external beam radiotherapy (EBRT).
Quality Assurance in Radiotherapy. Web-based quality assurance; using medical web instrument to facilitate the education, collaboration and peer review, providing an environment in which clinical investigators can receive, share and analyse treatment planning digital data.
A summary of recent innovations in radiation oncology focussing on the priniciples of different techniques and their application. An overview of clinical results has also been given
1.Aim of Radiotherapy
The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible
2.Organ Motion
Intra-fraction motion
during the fraction
Heartbeat
Swallowing
Coughing
Eye movement
Inter-fraction motion
- in between the fractions
Tumour change
Weight gain/loss
Positioning deviation
Breathing
Bowel and rectal filling
Bladder filling
Muscle relaxation/tension
3. Respiratory motion affects:
Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate
Tumour displacement varies depending on the site and organ Location
Lung tumours can move several cm in any direction during irradiation
It is most prevalent and prominent in Lung cancers
4. Problems associated with respiratory motion during RT
Image acquisition limitations
Treatment planning limitations
Radiation delivery limitations
5. Methods to Account for Respiratory Motion
1. Motion encompassing methods
2. Respiratory gating methods
3. Breath hold methods
4. Forced shallow breathing with abdominal compression
5. Real-time tumor tracking methods
Summary:
The management of respiratory motion in radiation oncology is an evolving field
IGRT provides a solution for combating organ motion in radiotherapy
Delivering higher dose to tumor and less dose to normal tissue.
Limited clinical studies, needs to be studied further
IGRT – the future of radiotherapy
The vmat vs other recent radiotherapy techniquesM'dee Phechudi
VMAT is a new type of intensity-modulated radiation therapy (IMRT) treatment technique that uses the same hardware (i.e. a digital linear accelerator) as used for IMRT or conformal treatment, but delivers the radiotherapy treatment using a rotational or arc geometry rather than several static beams.
This technique uses continuous modulation (i.e. moving the collimator leaves) of the multileaf collimator (MLC) fields, continuous change of the fluence rate (the intensity of the X rays) and gantry rotation speed across a single or multiple 360 degree rotations
In 2000 IAEA published another International Code of Practice.
“Absorbed Dose Determination in External Beam Radiotherapy” (Technical Report Series No. 398)
Recommending procedures to obtain the absorbed dose in water from measurements made with an ionisation chamber in external beam radiotherapy (EBRT).
this slide sharer contents are basic principle of CT fluoroscopy , software and hardware parts of equipment and image aqua cation and radiation dose comparison and videos related to equipment .
Advanced diagnostic ultrasound system with eHD technology and CrystaLine configuration.
What is CrystaLine?
Improved imaging
in difficult to scan
patients.
Major technical improvements
provided by CrystaLine include the
CPI Technology to increase depth
of field, improving the imaging of
deep structures in difficult-to scan
individuals.
As one of the leading medical equipment manufacturers, we are involved in R&D, manufacturing and marketing. And as a global enterprise, our products are selling in more than 70 countries worldwide. We produce a wide range of Veterinary medical products used in Veterinary hospitals and clinics
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
2. HCG Apex Oncology Hospital - with NABH & JCI compliance.
It’s a Green Building (Eco Friendly Gold to Platinum rating) Hospital
•200 Beds Centrally A.C. hospital in Borivali, Mumbai
•Facilities of 2 Linear Accelerator for Radiation Oncology , Brachy Therapy, PET CT, Gamma Rays Machine
& Bone Marrow Transplant & Liver Transplant Facilities
•This is being first Private Cancer Hospital in Mumbai, Maharashtra
3. • DEPARTMENT OF RADIATION ONCOLOGY
• MEDICAL LINEAR ACCLERATOR –
ELEKTAVERSA HD with
APEX tm MLC (2.5mm).
Hexapod evo (hexapod couch)
4. • VERSA HD (ELEKTA)
conformal beam-shaping technology and High Dose rate mode delivery,Versa HD is designed to
provide the precision and speed necessary to deliver advanced stereotactic radiotherapy (SRT)
and stereotactic radiosurgery (SRS), techniques that demand the maximum accuracy in tumor
targeting and protection of critical structures.
• Reduce treatment times with rapid leaf speeds and high dose delivery
• Provide the potential to deliver SBRT/SRS in a standard time slot
• Lower non-therapeutic doses to protect organs-at-risk and potentially reduce the risk of
secondary cancer
• Exploit the full potential of high doses for advanced therapies by eliminating previous leaf
speed limitations
• Provide custom configurations for unique clinical needs
• Utilize the latest imaging technology to allow soft tissue visualization during treatment
5. Hexapod evo :
• The Hexapod evo RT System is guided by an infrared-camera that enables sub-millimeter patient
positioning accuracy in six degrees of freedom – correcting translational errors (x, y, z) and rotational
errors (roll, pitch, yaw).The result is improved clinical workflow and increased clinical confidence.
Accurate and remote geometric corrections of any misalignments detected by state-of-the-art image
guidance systems are enabled by the Hexapod evo RT System, yielding precise corrections in six
coordinates for IMRT, IGRT,VMAT and SRT tumor targeting.
• Improved patient access with lower loading and unloading height
• Computer-controlled robotic treatment couch top
• Six degrees of freedom (x, y, z, roll, pitch, yaw)
• Remote positioning correction
• Achieves sub-millimeter positioning accuracy with no additional manual corrections
zero fiddle factor
• IGUIDE graphical user interface is easy to use and self-explanatory
• Specifically designed for IMRT, IGRT, SRT and volumetric modulated arc therapy (VMAT
6. APEX DMLC:
Apex DMLC brings additional versatility to treatments on an Elekta linear accelerator. Apex
facilitates practice expansion into stereotactic treatments while enabling a range of additional
clinical applications.
2.5mm high resolution beam shaping ideal for small fields
• Uniform low transmission and small linear penumbra
• Sharp dose gradients reduce unwanted dose, enabling dose escalation
• Easy attach and release mechanism
• Largest treatment aperture of 12 cm x 14 cm with interdigitation
7. • Switching on theTREATMENT CONTROL SYSTEM
To switch onTCS.
1 Set the mains isolator for the digital accelerator to ON.
2 Make sure that the coolant system is on (chiller system).
3 UPS supply is ON state
4 Temperature and humidity level maintained in treatment room
5 Switch on theTCS monitor.
6 Press the reset and power button on the BMDM
7 Make sure that the console start window appears,
8 system test on the database andTCS are completed
9
8. 1 Logon to “Integrity” then system is ready for logon in clinical as well as
For service mode , by selecting “username” & “password” it will redirect
To the screen mode with closed state.
WhenTCS switch on then the digital accelerator is in closed state
9. 1 Simultaneously MOSAIQ system is also booted and XVI SYSTEM & IVIEWGT SYSTEM is
also turned to on state,
2 And application for all three i.e. mosaiq , xvi, iviewgt is also launched with authorized “
username” and “password”.
3 Mosaiq console iviewgt console xvi console
10. 1 IMAGEVERIFICATION INVERSA HD (EKELTA)
Image verification inVERSA HD can be done in 2 modalities
i.e XVI (x-rays volume imaging) & IVIEWGT (electronic portal imaging device)
• XVI (x-rays volume imaging):
it’s a cone beam computed tomography acquired by the arms situated 90’ to gantry head along
with image detector on opposite side.
• kV source and kV imaging panel at 90º to treatment line
• used for three imaging modes: planar, fluoro, CBCT
• mounted on arms that are motorized to varying degrees.
11. • XVI console: Comprises of
• Contranst& brightness adjusting pannel.
• Patients details
• Treatment site
• Field ( SITE DRR)
• Images ( series of accquired images with dates)
• Inhibits
• Kv acquisition mode
12. IviewGT: EPID ( electronic portal imaging device)
electronic system for radiotherapy imaging i.e. captures portal images which it displays for
viewing and stores for later reference & comparison
FUNTIONS:
• Image detection: by means of scintillator plate attached to an amorphous silicon
detector
• Image acquisition: detector transmit the images via. Digital cable to computer frame
grabber.
• Image processing: systems offers range of option for superimposed graphics, multiple
exposure and selectively enlarged images through high speed analysis
• Image display: high resolution tft monitor for display
13. iviewGT console: like XVI console IVIEW GT Comprises of
• Contranst& brightness adjusting pannel.
• Patients details
• Treatment site
• Field ( SITE DRR)
• Images ( series of accquired images with dates)
• Inhibits
• Mv acquisition mode
14. DAILY CHEKUPS AND TROUBLE SHOOTS:
The temperature and humidity level maintained in treatment machine
room.
Machine warmup process with all energy’s along with all safety
interlock’s (inhibits).
Daily laser and iviewGT checkups & alignments test has been perform
with QA phantom (quasar penta-guide)
Daily log files of machine warmups and all major inhibits has been noted.
