What is TrueBeam?
The main principle of radiation oncology systems is to control tumor growth by zeroing in high energy radiation on it while sparing the surrounding vital organs. High dose of high energy radiation kills tumor cells and prevents them from proliferating. Since tumor cells divide more rapidly than healthy cells, radiotherapy can successfully treat a number of tumor types. Even if some surrounding healthy tissues get affected by radiation, they can easily recover because of the recovery mechanism they possess, unlike tumor cells.
Truebeam STX device combines many treatment platforms on the same device and is recognized as the last point that may be achieved in technology in this entirely-digital world.
Which treatment techniques can be applied with TrueBeam?
Several complex techniques can now be applied with the same instrument thanks to instruments like TrueBeam and TrueBeam Stx. It is possible to reach any site in the body easily with photon and electron energies at different levels. In particular, it enables to synchronize the dose administered in radiotherapy of moving organs like the pancreas, lung, prostate and breast. The primary treatment techniques performed with TrueBeam and TrueBeam Stx are listed below:
Intensity Modulated Radiation Therapy (IMRT):
IMRT is a radiation therapy technique developed after 3DCRT treatment. It ensures that maximum dose is delivered to tumors close to vital structures, while sparing the surrounding healthy tissue significantly. In this technique, intensity of the beam is changed by creating small areas inside the beam area, and high intensity radiation doses can be delivered to the tumor. This ensures that tumor cells are killed and the surrounding critical organs are spared by sending low-intensity or less radiation.
Image Guided Radiation Therapy (IGRT):
IGRT is not a radiation therapy application technique, but a method for confirming the treatment technique and area during each radiation therapy session which must be applied with high accuracy like IMRT. For this reason, the improved IGRT method is a procedure where treatment areas are checked via anatomic imaging methods like two and three dimensional kilovoltage or tomography applied in the treatment room during the therapy.
Volumetric Modulated Arc Therapy (VMAT):
VMAT is a rotational IMRT technique. In this therapy, Clinac delivers radiation as it turns around the patient while the multileaf collimators move. The dose rate changes throughout the radiation period. For this reason, IMAT is an intensity modulated treatment technique performed with more than one arc angles, and treatment period is quite shorter compared to other techniques according to the site of treatment.
Stereotactic Radiosurgery (SRS):
Stereotactic radiosurgery is described as the delivery of a high-dose radiation in a single session or more sessions on small tumors or sick sites in the body with complete accuracy and minimal effect on surrounding healthy tissues. Care is taken to the positioning of the tumor and the patient, guided by highly-advanced precise and accurate imaging. Thus, very high radiation doses can be delivered to the tumor site, protecting healthy tissues. It is a non-invasive treatment model.
Stereotactic radiosurgery is used to treat regularly-bordered and small tumors. This method is rather used for benign or malignant tumors localized in the brain, brain metastases, spinal cord tumors and metastases. In radiosurgery procedures performed with CyberKnife, only plastic masks are used to maintain patient immobility. Therefore, the patient remains immobile during the delivery of radiation.
Radiosurgery is an alternative method to surgery when conventional surgery is difficult or not recommended for the patient if there are vital structures like a lens, brainstem or artery close to the tumor. Generally performed in a single session or a few sessions, radiosurgery may have effects on some tumors as precise as surgical operation on that site.
Stereotactic Body Radiotherapy (SBRT):
In this type of treatment, tumors in any part of the body are treated using less number of sessions, smaller areas and higher doses. Briefly defined, stereotactic radiosurgery on sites other than brain and the spinal cord is called stereotactic body radiotherapy. Due to localization, tumors are inclined to move for various reasons such as respiration, organ movement, and are thus hard to stabilize. Identification of tumor movement and consideration of such movement in high-dose stereotactic therapy are factors in precisely delivering the required dose on the tumor. For instance, a tumor localized in the lung will move with respiration, respiration-induced movement of the tumor must be monitored during treatment. Stereotactic body radiotherapy is used to treat small and isolated tumors; and is frequently used in tumors localized notably in the lungs, liver, adrenal gland, prostate and pancreas.
This method that does not often require an invasive procedure constitutes an alternative option to surgery and radiotherapy in many small tumors and different diseases.
Total and Half Body Photon Irradiation
Total Body Electron Irradiation
How does the TrueBeam function?
Truebeam rotates around the patient and delivers the planned radiation dose to the patient at angles that have been determined previously at the planning stage. Combining imaging, device-specific RapidArc technology and real time tumor monitoring in the same instrument, it sends beams at high accuracy and precision to the target tumors. With the help of respiration monitoring system and 3-dimensional tomographic imaging systems, the clinician is provided with information about the monitored site during the treatment.