CyberKnife centre performs its first simulated therapy using PseudoPatient treatment verification

NSH CyberKnife Cancer Center at the Neuro Spinal Hospital in Dubai has conducted its first simulated therapy for multiple brain cavernomas using PseudoPatient, RTsafe’s patient-specific quality assurance process. This represents the first application of PseudoPatient in the Gulf region.

The hospital is said to be the first in the UAE to use the CyberKnife system by Accuray, a non-invasive robotic radiotherapy treatment for tumours and other conditions that can be an alternative to surgery or for patients who have inoperable or surgically complex tumours. PseudoPatient is an anatomically faithful model of the patient’s head which, along with RTsafe’s dosimetric evaluation services, enables medical physicists and clinicians to verify the entire treatment plan before the patient is exposed to radiation.

RTsafe founder and chief scientific officer Evangelos Pappas said: “We are delighted that the Neuro Spinal Hospital, a distinguished institution that seeks to become the premier neurosciences, neurological, spinal and orthopaedics healthcare provider in the region, shares our belief in the concept of assuring patient safety and treatment efficiency through human-like simulation of the stereotactic radiosurgery [SRS] process.”

The simulation was carried out ahead of NSH’s patient treatment using the CyberKnife radiosurgery system that integrates robotic technology, small radiation beams and image guidance principles to achieve submillimetre stereotactic accuracy. The machine was acquired as part of the ongoing efforts by the hospital to increase patient safety and treatment quality.

A case study of pre- treatment verification with the PseudoPatient in robotic SRS of multiple brain cavernomas was presented by NSH chief medical physicist Dr Christos Antypas at the MEFOMP Conference in May. The study showed that PseudoPatient, based on actual patient anatomy, has proven to be a valuable tool for pre-treatment verification in robotic CyberKnife SRS treatments and could improve treatment efficiency and patient safety.

The PseudoPatient treatment verification process begins with the construction of a 3D-printed phantom based on the patient’s CT scan, accurately reproducing the bone anatomy. The phantom is then filled with a polymer gel, developed by RTsafe, that acts as both a soft tissue equivalent material and a 3D dosimeter. The end-to-end radiosurgery procedure is performed just as it would be on the patient. The irradiated phantom is then MRI scanned and changes in the gel’s magnetic properties reveal the treated areas. RTsafe then provides a comprehensive quantitative and qualitative report to assist the clinical team in either verifying the treatment plan or making adjustments to it.

Picture: RTsafe’s PseudoPatient (lower left) verifies radiotherapy in a safe environment.

Published on page 13 of the August 2023 issue of RAD Magazine.