The next generation in radiation treatment technology is now at the Lankenau Hospital Cancer Center where radiation oncologists have implemented Image Guided Radiation Therapy or IGRT to target cancerous tumors with real time pretreatment verification, allowing even greater precision than ever before. Lankenau is the first suburban Philadelphia hospital to offer this cutting-edge technology.

"With IGRT we are better able to tailor radiation treatments to each patient's needs," said Albert S. DeNittis, MD, Lankenau chief of Radiation Oncology. "For the patient, the benefits are more accurate treatment, allowing for dose escalation, and the potential for better outcomes."

IGRT with the On-Board Imager integrates real-time tumor tracking, the ability to adjust patient positioning when necessary, and the precision of intensity modulated radiation therapy (IMRT). IMRT, an advanced form of radiotherapy offered at Lankenau for the last four years, shapes the radiation beam to match the tumor's dimensions so a high dose of radiation can be delivered directly to the malignancy without harming surrounding normal tissue.

"A combination of imaging techniques on the On-Board Imager, including high-resolution, three-dimensional CT images and fluoroscopic moving images complements IMRT by improving the accuracy of the radiation delivered," explained Dr. DeNittis. "The Imager's software can also suggest changes to align the patient more precisely with the treatment beam."

The IGRT system is also equipped with additional tools to enhance our treatment delivery, such as the respiratory gating system. Here's how it works. Patients are positioned on a couch and just before treatment begins, an x-ray system moves around the body to gather images that pinpoint the exact tumor location. This precise targeting is especially effective for treating tumors around the lung and abdomen, where the patient's natural breathing movements can alter radiation dosing. It also allows the patient to relax and breathe naturally, reducing stress and anxiety.

 "We know that tumors can move-both during a radiation treatment and from one treatment to another-as a result of normal action like digestion and breathing," Dr. DeNittis said. "Any change in position could mean the tumor may not receive the full radiation dose, or normal tissues may receive more radiation than they should."

With the respiratory-gating system, patients can receive IMRT to areas such as the lung, pancreas, stomach, rectum and breast. Prior to this technology IMRT was being used primarily for cancers of the prostate and head and neck.

This new technology is the latest development in the evolution of radiation therapy from a diagnostic tool to an integral part of the treatment process, according to Dr. DeNittis.

Prior to the development of image-guided radiation therapy, radiation oncologists had to account for variations in patient positioning and respiratory motion by treating a relatively large margin of healthy tissue around a tumor, increasing the risk of complications and causing them to use lower, less effective doses of radiation.

"With the degree of precision that these systems bring to treatment, we are confident that we are hitting the target tumor and minimizing the effect on nearby healthy tissue," Dr. DeNittis said. "Image-guided radiation therapy is making it possible for more patients to receive advanced treatments with great precision and safety because of a suite of tools that give us effective and efficient management of all patient data."

And through the Main Line Health Community Clinical Oncology Program at Lankenau Hospital, patients continue to have the opportunity to enroll in nationally sponsored clinical trials. The Main Line Health CCOP is ranked third nationally among CCOPs in the number of patients enrolled in radiation therapy oncology group clinical trials.

To reach the Radiation Oncology Center, please call 610-645-2433.

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