Jefferson Hospitals uses VMAT and Monte Carlo technology for accurate and fast radiation therapy

The Radiation Oncology Department at Thomas Jefferson University Hospitals is now treating cancer patients using a state-of-the-art VMAT technology based on the most accurate dose calculation algorithm that dramatically shortens treatment delivery time.

VMAT (Volumetric Modulated Arc Therapy) is a new generation arc therapy technique that establishes new standards for treatment speed and dose conformity. Using Elekta's VMAT, Jefferson doctors can deploy single or multiple radiation beams sweeping in uninterrupted arc(s) around the patient, thus shortening treatment from the conventional eight to 12 minutes to as few as two minutes.

Radiation dose planning is performed using Monaco, a Monte Carlo treatment planning system featuring biological modeling, constrained optimization, and sensitivity analysis. Monte Carlo algorithm is widely considered the most accurate dose calculation, and is often used as a gold standard for evaluating other dose calculation algorithms.

"VMAT provides the radiation oncologist with the greatest freedom of choice regarding how the optimal dose will be delivered," said Adam Dicker, MD, PhD, Chairman and Professor of Radiation Oncology. "This is achieved through a unique team approach with internationally renowned medical physicists and physicians to apply digital control to all treatment parameters simultaneously to manipulate the radiation dose and the imaging dose. With the combination of VMAT and Monte Carlo, our patients receive fast daily treatments that maximize dose to cancer and minimize exposure to surrounding healthy tissues."

"VMAT has the potential to take a treatment that would occur over eight weeks and reduce it to two to three weeks, said Timothy Showalter, MD, Assistant Professor of Radiation Oncology, and an expert in image-guided therapy of prostate cancer.

Three-dimensional volume imaging technology integrated into the treatment planning system increases the precision of VMAT. This enables doctors to visualize the tumor target at the time of treatment and to guide the radiation just prior to delivering the beam.

"With the combination of VMAT and Monaco, clinicians have added benefits such as simultaneous optimization of multiple non-coplanar arcs, which allows the greatest flexibility in dose delivery," said Amy Harrison, MS, Medical Physics Clinical Supervisor. "Monte Carlo dose engine allows continuous arc calculation rather than being limited to approximations with discrete gantry positions. Biologically-based optimization, which enables better target dose conformity and normal tissue sparing, is a next-generation technology now available in our clinic supported by powerful Monte Carlo techniques."