A Medical Device Daily

A 51-year-old breast cancer patient from Switzerland has become the first person in the world to be treated using Gated RapidArc, which makes it possible to monitor patient breathing and compensate for tumor motion while quickly delivering radiotherapy during a continuous rotation around the patient.

This development from Varian Medical Systems (Palo Alto, California) enables the use of RapidArc radiotherapy technology in combination with respiratory gating – a process of turning the beam on and off in synchrony with the patient's breathing. This technique increases the precision of treatment delivery by compensating for tumor motion.

The treatment took place at the Istituto Oncologico della Svizzera Italiana (IOSI; Bellinzona, Switzerland) radiation oncology unit, a public comprehensive cancer center serving 330,000 inhabitants in southern Switzerland, and part of Ente Ospedaliero Cantonale at San Giovanni Hospital.

Giorgia Nicolini, MD, medical physicist at IOSI, said, “This is a very fast and straightforward procedure for the patient, who doesn't speak the local language, Italian, but in any case has found it very easy to follow instructions for gating. She has been fully co-operative and the part of the treatment time taken up by breathing management is decreasing after the first sessions. She also appreciates having to spend less time on the treatment couch.“

The hospital has used breath-hold gating as part of the treatment procedure for all left breast cancer patients since 2005 to better spare the heart and lung from exposure during radiotherapy treatment. Prior to Gated RapidArc, conventional seven-field gated IMRT treatments would have taken 15 minutes to deliver. Using two-arc Gated RapidArc, the treatment is concluded in around four minutes.

Nicolini said clinicians at IOSI compared RapidArc and IMRT treatment plans for the patient and decided RapidArc offered the better opportunity to spare nearby organs from exposure and target the tumor.

“The use of two partial arcs enables us to shape a better dose distribution and do a better job of sparing the opposite breast,“ said Antonella Richetti, MD, head of the IOSI Radiation Oncology Department. In addition, RapidArc enabled the dose to be delivered using fewer than half the dose monitor units needed for an equivalent conventional seven-field IMRT treatment.

“We are now using Gated RapidArc to treat all left-sided breast cancer patients when there is a need to include the supraclavicolar and/or internal mammary chain lymph nodes, or when chest wall anatomy will affect the dose to organs we want to protect,“ said Nicolini. “We are also planning to use the technique for lung and other thoracic and abdominal tumors when suitable.“ Gated RapidArc is a standard feature on the new TrueBeam system and is available as an option or upgrade on the Trilogy and Clinac iX accelerators from Varian.

Lab21 adds HIV diagnostic test to portfolio

Lab21 (Cambridge, UK), a specialist in personalized medicine, reported the addition of a new diagnostic test for HIV to its portfolio of companion diagnostic services.

Lab21 will be the first commercial reference laboratory in the UK to provide a companion diagnostic service for the HIV drug, Celsentri, which is marketed by ViiV Healthcare who are currently supporting the provision of this genotypic tropism testing to the UK NHS.

Lab21 will offer the HIV service from its UK operation with immediate effect and will be able to receive samples from all parts of the world. In the longer term the company also plans to offer the test as part of its comprehensive HIV service at its U.S. facility in Greenville, South Carolina.

The HIV diagnostic is a genotypic test which determines the sequence of a specific region of the virus, the V3 loop. This information helps to determine the specific cell type the strain of HIV will infect and replicate. As individual drugs are only effective against specific strains of HIV, this allows clinicians to identify the most effective treatment, improving patient care, and reducing costs

“This new technology has been developed in the HIV field over the past few years and we have now introduced the protocols into the Lab21 service labs to provide a fully validated, fast turnaround assay. The addition of this service to Lab21's portfolio means that we can offer a fully comprehensive menu of tests for HIV clinicians to use including viral load and resistance analysis, CD4 counts and serology,“ said Berwyn Clarke, CSO of Lab21.

AeroScout deploys temperature gauge

AeroScout (Redwood City, California) said that the GasthuisZusters Antwerpen (GZA) Hospital Group (Belgium) has implemented AeroScout's Temperature Monitoring solution across its three hospitals. GZA Hospital Group is using the Wi-Fi RFID solution to monitor and manage the temperature in refrigerators that contain critical items, such as pharmaceuticals and blood. The company claims the project represents one of the largest Wi-Fi temperature monitoring deployments in Europe and delivers quality of care and regulatory compliance benefits to GZA Hospital Group.

The solution was deployed by PHI DATA, a Brussels-based solutions integrator operating in Belgium, the Netherlands and Luxembourg, with expertise in automatic identification, data collection, localization and monitoring. For the GZA Hospital Group implementation, the AeroScout Temperature Monitoring solution leveraged the healthcare organization's existing Aruba wireless infrastructure.

During the rollout, PHI DATA mounted small AeroScout Wi-Fi Tags in refrigerators containing temperature-sensitive items such as medicine, blood and food. The team implemented AeroScout's Temperature Monitoring solution by leveraging GZA Hospital Group's existing Aruba WLAN infrastructure – avoiding the need to deploy and maintain a separate sensor network. The end-user software, AeroScout MobileView, was configured to automatically monitor refrigerators and send alerts if temperatures deviate from specified ranges to prevent spoilage of items and help ensure quality of care.

AeroScout makes unified asset visibility solutions.