C-RAD’s SGRT and Elekta’s Versa HD: A Seamless Workflow

Oklahoma Cancer Specialists and Research Institute (OCSRI) offers Tulsa and surrounding areas the most comprehensive cancer care as a physician-owned group practice with more than 20 blood and cancer specialty physicians and 200 nurses and associates. OCSRI was formed in 2016 as a partnership between St. John Health System and Tulsa Cancer Institute.

Justin Silkwood joined Tulsa Cancer Institute one month prior to the formation of OCSRI. Previously, he received his MS in Medical Physics from Louisiana State University in 2013 and attended Mary Bird Perkins Cancer Center’s residency program in Baton Rouge, LA from 2013-2015.

What radiation oncology equipment does OCSRI utilize with C-RAD?

We have the Elekta Versa HD™ linear accelerators (linacs) and C-RAD’s Catalyst⁺ HD as a seamless workflow to treat people with cancer in two of our locations, Tulsa and Bartlesville, Oklahoma.

How has C-RAD’s SGRT improved treatment delivery on Elekta’s Versa HD?

I like to think of taking a snapshot with C-RAD’s Catalyst⁺ HD by the three ceiling-mounted cameras in the linac room as a robotic assistant whose main job is to keep a constant, sharp eye on the patient, one that watches for patient motion non-stop and faithfully reports back to the team any changes in position.

How do you use the system for SRS treatments?

For SRS treatments, to truly see if a patient has moved outside of tolerance limits, you need technology like C-RAD’s surface guided tracking. And it’s simple: after the cone beam is done, you line up the patient, reset your reference and now C-RAD’s on it. The system is watching the patient for you and can tell you if the patient is moving out of position. For example, if a patient coughs while in treatment position, the assistance of Catalyst⁺ HD helps us know when it happened and how to get the patient back in the correct position for safe, accurate treatment.

For which cases is Catalyst⁺ HD used the most?

We utilize C-RAD for lung patients and our head-and-neck and SBRT patients. We also use it for breast patients with deep inspiration breath holds (DIBH). Surface guidance comes in quite handy in a whole lot of different cases. In the Bartlesville cancer center, the care team will do most of their initial patient setup with C-RAD.

How does Catalyst⁺ HD help in the DIBH cases?

C-RAD has a feature called in-room visualization which bathes the vault in a gentle green light when the patient breathes within the treatment window. This visual cue is easy to understand and enables the patient to take an active role in their treatment. They feel very empowered. The care team doesn’t have to stress them by constantly giving them instructions in real time and it holds the beam automatically whenever the patient is not in the green zone, which is also very helpful. The entire workflow is much more efficient with that initial setup, so it’s very nice for the care team and patient.