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Research and Technology

Savannah Oncology Center, a radiation oncology facility opened in 1988 by radiation oncologist Dr. Morris Geffen, brings some of the world’s most advanced radiation technologies to the LCRP. In return, Dr. Geffen and his partners, Dr. John Pablo and  Dr. Quillin Davis, are able to apply their expertise at our premier cancer center. As a show site for Siemens, one of the leading manufacturers of radiology and radiation equipment, the facility receives some of the most advanced tools in radiology. In fact, Savannah Oncology Center was one of the first clinical facilities in the world to receive a four-dimensional (3D + time) CT scanner used in radiation treatment planning, as well as two four-dimensional radiation treatment systems.

The level of accuracy provided by these systems has been a benefit to physicians and patients as they prepare for treatment. For example, head and neck cancers are some of the most difficult to treat because of the large number of glands, organs and tissues found in that area of the body. The combination of the sophisticated radiation therapy devices, intense treatment planning, and knowledgeable physicians, physicist and technicians are required to minimize and prevent damage to healthy glands, organs and tissues.

The first device, the SOMATOM Sensation Open, enables oncologists to select and plan the best possible treatment. It provides the precise imaging oncologists need to understand the scope of a patient’s cancer. The second device, the ONCOR Linear Accelerator with MVision Cone Beam CT imaging system, is an image-guided radiation therapy (IGRT) system used to deliver treatment. It ensures that radiation is applied to the entire tumor and limits exposure of the surrounding healthy tissue. Both machines work with four-dimensional precision (3D + the dimension of time).

What adds to the power of these systems is their ability to work together to eliminate the guesswork that occurs when a plan is translated into treatment. They take into account the fact that our bodies are always in motion—the tumor and internal organs shift between treatments and the patient’s own breathing can change the location of the tumor. Despite this motion, treatment planning, in most facilities, is based on a single three-dimensional “snapshot” of the tumor created by CT. But the SOMATOM Sensation Open, using a 90-second scan, effectively creates a “four-dimensional” image, a motion picture that includes the movement caused by breathing over time. Equipped with this knowledge, the radiation oncology team can create a precise plan that specifies how much radiation each area of the tumor will get.

When it’s time to act on the treatment plan, usually several days after the original CT scan, the patient and the tumor must be properly oriented in accordance with the plan. This is done immediately before treatment. The system creates these images in under three minutes, which helps minimize the time you have to wait on the treatment table.

The Savannah Oncology Center, offers many of the latest advances in radiation therapy including:

• Intensity modulated radiation therapy (IMRT): IMRT allows the physician to target the specific area of the tumor and deliver concentrated radiation to the tumor volume, while reducing the radiation delivered to surrounding normal tissue. Savannah Oncology was one of the leaders in the early adoption of IMRT technology.
• Image-guided radiation therapy (IGRT): IGRT supplements IMRT to create cutting-edge radiation treatment delivery. The technologies work together to increase accuracy in radiation treatment delivered by compensating for breathing and daily internal organ changes. Daily imaging on the actual treatment machine, coupled with sophisticated treatment planning software and pre-treatment imaging studies, allows for highly specific localization of the patient's tumor prior to each radiation treatment. This helps to compensate for motion due to breathing and daily internal organ changes to maximize the accuracy of treatment each day.
• Four-dimensional 40-slice wide-bore imaging: The most advanced CT scanner available allows images to be taken at multiple split-second time intervals to track tumor and organ motion through the respiratory cycle. These images can then be used for IGRT.
• High- and low-dose rate brachytherapy: Temporary or permanent implantable radiation sources allow radiation treatment to be delivered directly to the tumor. This is used in breast, prostate and lung tumors.
• MVision and Cone Beam CT Imaging by Siemens: Using MVision technology, these treatment machines and 4D CT scanner work together for IMRT and IGRT to analyze patient position and generate the adjustments required to deliver precision radiation therapy. Using "beam's eye view" data during treatment, it is the first production system of its kind in the United States.

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