raystation brochure ver3web

Adding A new dimension to treAtment plAnning for rAdiAtion therApy

RayseaRch laboRatoRies2 RaystatioN

introdUCing rAystAtion

Optimize gantry, couch and

collimators for conventional 3D-CRT

Fast automated contouring of

multiple regions simultaneously

with model-based segmentation

Ultrafast multi-purpose optimization

engine

Track delivered dose using deformable

dose accumulation

Highly intuitive IMRT planning with

unique multi-criteria optimization

Versatile VMAT optimization for any

linear accelerator

Proven IMRT optimization using

direct machine parameter

optimization

RayseaRch laboRatoRies 3RaystatioN

Comprehensive framework for

four-dimensional adaptive radiation

therapy

IMPT optimization accounting for

range and position uncertainties

Works with Windows PC’s on flexible network

infrastructure with true floating

licenses

Powerful and fully supported scripting

tools to automate and customize workflow

Efficient workflow using latest GUI

design techniques

Electron dose calculation using

Monte Carlo

Proton dose calculation using

Monte Carlo


InTRODUCInG RAySTATIOnA brand new treatment planning system for radiation therapy, created from well proven algorithms. Built on a 4D platform, Ray-Station brings unique functionality that you won’t find in any other treatment planning system. This comprehensive system handles 3D-CRT, IMRT, VMAT, proton therapy and 4D adaptive radiation therapy, for any treatment machine. It also contains all relevant advanced image processing tools such as automated segmentation and deformable registration and handles all imag-ing modalities. In brief: RayStation contains everything a state-of-the-art facility would need for treatment planning in one soft-ware platform. However, RayStation can also be packaged and licensed in a modular fashion to fit the needs of any radiation oncology clinic.

RaySearch’s goal is to further optimize the treatment planning process for radiation therapy, looking for tools to make the soft-ware safer, faster and better, while maintaining ease of use. The modern user interface is carefully designed to present only relevant and intelligible options and properties, while minimizing the effort for the user to complete any workflow.

The core of the system is the well tested ORBIT software frame-work. This world leading optimization platform has been in clinical use as the underlying engine in various systems for more than a decade at over 1,800 clinics worldwide.Throughout, RayStation and the ORBIT framework are based on sound mathematical and physical properties. No corners have been cut in the design of the computational algorithms. This strong foundation makes it possible to combine all delivery techniques and all types of optimization functions. This also enables RayStation to quickly adapt to new developments in the delivery hardware such as VMAT.

ADVAnCInG TREATMEnT PLAnnInG FOR THE BEnEFIT OF ALL PLAyERSPhysicians can combine, compare and evaluate different treat-ment modalities on a single integrated RayStation system. They can also conveniently compare multiple plans. With multicriteria optimization (MCO) for IMRT, the radiation oncologist can even balance between different treatment tradeoffs instantly.

Hospital management will find that the modular and open design of RayStation makes it possible to find the perfect combinations of capabilities without getting stuck with time-consuming transfers between systems. RayStation is also very flexible in terms of hardware requirements. It can be implemented as a stand-alone workstation on ordinary PC’s, or on a network infrastructure with virtualized database, application servers and thin clients. The license model supports floating licenses to ensure cost effective installations.

RayStation is also the perfect vehicle for research purposes. Its built-in research interface and Python scripting tools are designed to allow customization by direct interaction with core algorithms. Finally, physicists will find the commissioning and quality assurance tools simplified and straight forward. With transparent modeling, the commissioning process is highly automated, but still allows the physicists to control how the beam is characterized.

CLInICALLy VALIDATED In nORTH AMERICA AnD EUROPEThe first patient treatment with RayStation was carried out at the Massachusetts General Hospital Radiation Oncology Department in Boston and the first European patient was treated at RISO, The Radiotherapeutic Institute in Deventer, the Netherlands.

“RayStation is an entirely new system with a lot of interesting features and a modern workflow. We have validated the system thoroughly and are very happy with the accuracy and the quality of the plans generated. The system is fast and easy to use and gives us the possibility to create high quality IMRT plans”, says Rik Westendorp, medical physicist at RISO.

ADDInG A nEW DIMEnSIOn TO TREATMEnT PLAnnInG – SEE FOR yOURSELF! RaySearch’s foundation rests on innovation, and our commit-ment is always to deliver performance above the standard for our industry. We are constantly pushing the limits and Ray-Station is a big leap forward. RayStation is not only a new genera-tion, it takes treatment planning to a whole new level.

On the following pages, you will see some examples of the unique versatility of the RayStation system. To further explore what RayStation can do for you and your clinic please contact us for a demonstration.

mAking the Complex simple


proven imrt optimizAtion

RAySEARCH’S PROVEn VMAT treatment planning algorithm is the most flexible solution available today, allowing clinicians to create single or multiple-arc plans for Elekta, Varian and Siemens linear accelerators. By constraining the algorithm to use constant dose rate, it can even be used to optimize plans for VMAT delivery with linear accelerators that have not been upgraded for VMAT. By direct and simultaneous optimization of all available VMAT treat-ment parameters, such as dose rate and MLC leaf positions, while ensuring the fulfillment of accelerator constraints, such as maxi-mum leaf speed, treatment plans with outstanding quality can be achieved. The advantage of the direct machine parameter optimization approach is that the plan remains feasible and deliverable throughout the optimization process, thus eliminating any quality-degrading post- processing step.

SOFTWARE FOR OPTIMIzATIOn of IMRT was the starting point of RaySearch. The first IMRT product was released in 2001 as a plug-in module to Philips Pinnacle3 treatment planning system and since 2004 RaySearch’s IMRT solutions also exist in Nucle-tron’s treatment planning system Oncentra. The proven IMRT technology from RaySearch provides clinicians in over 1,800 radiation therapy centers around the world, with state-of-the-art tools to design high quality IMRT treatment plans.

The RayStation IMRT optimization module is the result of over two decades of advanced development and fine tuning. The clinical requirements on a treatment plan are specified by defining any feasible combination of dose volume and radio-biological objectives and constraints. Thanks to direct optimiza-tion of step-and-shoot segments, i.e. the aperture shape and weight of each segment, the delivery time can be significantly reduced without compromising the treatment quality. As the optimizer is aware of the physical limitations of the linear accelerator during the optimization process, it is able to make more effective comprom ises and can thereby reduce the number of required segments by as much as fifty percent. Furthermore, since the plan is always deliverable during optimization with no need for post processing, there will be fewer re-runs which in turn leads to a faster planning procedure.

versAtile vmAt optimizAtion


optimizing 3d-Crt

mUltiCriteriA optimizAtion

rAdiobiologiCAl optimizAtion

THE RAySTATIOn 3D-CRT optimization module brings inverse planning to con-ventional radiation therapy. It enables the clinician to simultaneously optimize all available degrees of freedom in three-dimensional conformal treatments: beam weights, aperture shapes, as well as collimator-, gantry-, couch- and wedge angles. The clinician can select any subset of parameters to be opti-mized while the others stay fixed according to the beam setup. With 3D-CRT optimization, a vast space of alternative beam configurations can be explored quickly and an optimal plan is produced within minutes.This makes it easy for the planner to achieve excellent plan quality with a high level of consistency.

THE MULTICRITERIA OPTIMIzATIOn (MCO) functionality in RayStation aims at making the treatment planning procedure more intuitive and time-efficient as well as providing tools for exploring the inherent trade-offs present in the treatment plans. MCO eliminates the need for importance weights in the objective function and the time-consuming iterative adjustments of these weights. Instead of having to perform a series of optimization runs to find the appropriate balance between different objectives, the user can explore the solution space in real time. With RayStation, this very powerful feature is now available for the first time in a commercial treatment planning system.

The MCO planning procedure is carried out in the following way: based on the specified clinical criteria, a set of so-called Pareto plans are automatically generated. These plans are used as input to an interactive navigation tool where the planner or physician can manipulate sliders in real time to assess the impact of dose adjustments to relevant regions of interest. This enables clinical decisions during plan creation, which dramatically speeds up the planning process. The MCO functionality has been enhanced by the findings from a research collaboration on MCO with Massachusetts General Hospital.

USInG RADIOBIOLOGICAL RESPOnSE MODELS brings the planning process closer to the original intent of the planner, i.e. to create the plan that has the highest probability of curing the patient while minimizing the risks of compli-cations to the surrounding healthy tissue. The system may also be asked to maximize tumor control probability while keeping the risk of complications below certain levels. Furthermore, the radiobiological objectives and con-straints can be combined with physical requirements on the dose distribution such as maximum dose or dose uniformity. The results can always be assessed with traditional tools such as DVHs to understand the implications of a solution. RayStation contains all relevant radiobiological models, including models for tissue repair and tumor growth. This makes it possible to evaluate the effects of different fractionation schedules as well as effects of unforeseen interruptions in the treatment delivery.

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6

12

18time

of d

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Fractionation schedule


InTRODUCInG PROTOn PLAnnInG In RAySTATIOn Advanced treatment planning tools play a key role in today’s proton therapy. The RayStation proton therapy optimization module brings RaySearch’s proven technology into the field of proton treatment planning. The powerful optimization engine and the four-dimensional architecture of RayStation make it an ideal platform to meet the substantial requirements that advanced proton therapy puts on a treatment planning system.

RayStation is the perfect tool for creating photon/proton boost plans. The optimization of the boost can optionally be inde pendent of the base dose, or use it as pretreated dose.

COMPREHEnSIVE TOOL BOxThe proton module in RayStation supports a variety of proton treatment modalities and beam lines, such as pencil beam scanning (PBS), uniform scanning, and double and single scattering. The dose calculation is performed either with a Monte Carlo algorithm, or with a Fermi-Eyges-based pencil beam algorithm, both of which can be used within the optimization loop and for final dose calculation. For PBS, the optimization tools include IMPT, single field uniform dose and distal edge tracking. For passively-scattered proton therapy, modern tools help the user create clinical treatment plans and subsequent milling machine instructions in an efficient manner, including the fully automated creation of compensators and blocks with

the possibility of manual editing. A unique capability of Ray-Station is the possibility to create PBS treatment plans that are robust with respect to geometrical uncertainties, such as errors in patient positioning, and to patient-density uncertainties resulting from errors in CT interpretation. Robust optimization makes it possible to utilize the full potential of IMPT without sacrificing reliability of the resulting delivered dose.

InTRODUCInG PROTOn OPTIMIzATIOn In THE CLInICThe first RayStation user is one of the world’s most advanced proton therapy clinics – Westdeutsches Protonentherapiezen-trum Essen (WPE) in Germany. The WPE facility is designed around the adaptive therapy concept with infrastructure for daily patient imaging and automated transportation of immobi-lized patients. WPE selected RayStation for its unique ability to create robust and adaptive plans for treatment of moving tumors, such as lung sarcoma, with proton PBS.

“We were looking for a modern treatment planning solution with full support for adaptive therapies taking full advantage of the latest 4D imaging technology. In the end RaySearch was the only supplier that could live up to our demands. We feel that they share our vision of the future of radiation therapy so I must say it feels very rewarding to collaborate with them to break new ground in our field”, says Jonathan Farr, Chief Technical Physicist, WPE.

proton therApy optimizAtion


AdAptive rAdiAtion therApy

Deformable registration to deform delivered dose each fraction to the same geometry and compute accumulated delivered dose. Replanning using accumulated delivered

dose as background dose.

Treatment delivery and image acquisition.Changing patient geometry.

InTEGRATED TOOLS FOR ADAPTIVE THERAPyDuring the treatment course, the patient anatomy will change as the target and surrounding organs at risk move and deform, both from interfractional and intrafractional motion. RayStation was designed from the very beginning with a strong focus on handling these dynamic aspects of radiation therapy. By explicitly representing the time dimension throughout the domain model, RayStation provides the ultimate framework for planning and managing adaptive radiation therapy.

DEFORMABLE REGISTRATIOn & DOSE EVALUATIOnThe patient geometry is monitored by acquiring images of the patient in treatment position, for example by using cone-beam CT, during the treatment course. As the surface models of the regions of interest are propagated and adapted to the acquired data sets, a four-dimensional representation of the patient geometry can quickly be obtained. Dose can be calculated on any geometry and, by comparing with the dose distribution in the original treatment

plan, the system detects and makes the user aware of deviations that require action. The dose delivered in each fraction is mapped to a reference CT-dataset by deformable registration. Having a common frame of reference for the patient geometry makes it possible to correctly accumulate doses from different fractions.

TREATMEnT ADAPTATIOnThe system provides several ways to compensate for setup errors and organ motion. Based on matching bony structures, target cen-ter-of-mass, marker positions etc., simple offline or online couch corrections can be calculated. In addition, a wide range of adaptive offline or online replanning options are available that take into account the accumulated dose, observed deviations and predic-tion of future patient geometry. The replanning options range from simple adaptations such as adjustments of beam weights to com-plete replanning that involves reoptimization of the beam orienta-tions and intensity modulation.


PATIEnT DATA MAnAGEMEnTDICOM IMPORT/ExPORTRayStation’s data model is fully compatible with the DICOM standard, allowing the system to easily import and export any DICOM RT object. This includes multiple CT, MR and PET image series, 4D-CT, structure sets, doses and RT Plan and RT Ion treatment plans.

In addition, RayStation communicates with other data sources such as DICOM senders and receivers or DICOM archives, using either file transfer, DICOM storage service classes or DICOM query/retrieve.

rAystAtion – A Complete treAtment plAnning system

PLAn CREATIOn3D-CRTRayStation provides the user with a set of modern, interactive and user-friendly tools for forward planning of 3D-CRT and passive proton plans. The system automatically computes MLC or block apertures and jaw settings based on targets, avoidance regions and flexible margin tools. For passively-scattered proton plans, RayStation also determines the nozzle settings and extracts the optimal compensator shapes. The user can manually edit all computed settings and device geometries, as well as define shielding blocks. Tools for beam weighting are also provided.

DOSE CALCULATIOn/BEAM COMMISSIOnInGRayStation includes accurate and fast dose calculation services for any external photon beam treatment plan, using either the collapsed-cone convolution algorithm for high accuracy or the singular-value decomposition algorithm for instantaneous presentation. All dose c alculation algorithms support parallel execution on multiple cores or on GPUs. In order for the user to be able to commission and perform quality assurance of the clinical dose calculation, the system includes a graphical user interface giving the user complete control of the process.

IMAGE REGISTRATIOn/FUSIOnSeveral methods for rigid and deformable regi-stration are available using combinations of landmark, surface and gray level information. Deformable and rigid registrations can be used for showing fused images as refererence while contouring, and for mapping regions or points of interests between image sets. Available image fusion display techniques include: chess-board, vertical or horizontal split, color blends and spyglass.

EFFICIEnT COnTOURInG TOOLSThe system includes a comprehensive tool set for manual contouring such as polygon, freehand, paintbrush/2D roller-ball and local deformations (push-and-pull). Furthermore, RayStation contains a set of semi-automatic tools based on live threshold searching and specific functions for margin and bolus genera-tion. Finally, RayStation supports regions-of-interest (ROIs) with voxel-based triangulation, 3D visualization, protocol-based attributes, bifurcated and detached ROIs, and boolean algebra for combining ROIs. Templates can also be saved with or without the geometries included, which can then be recalled on future patients.

MODEL-BASED SEGMEnTATIOnMBS is a semi-automatic tool for delineation of regions-of-interest based on biomechanical and statistical information about organs. Volumetric images are segmented semi- automatically, utilizing a combination of grey-scale gradients and models with knowledge of how organs may change shape. With MBS, it is possible to delineate multiple regions of interest simultaneously, which increases throughput, accuracy and reproducibility.

PATIEnT MODELInG

Patient Data Management Patient Modeling Plan Creation


QA PREPARATIOnThe module for quality-assurance preparation allows the user to easily transfer the clinical plan to a phantom and recalculate dose, either beam-by-beam or for the entire plan. The out-put from the module is the dose distribution in DICOM format, a QA report and optionally a new treatment plan with collapsed gantry angles.

TREATMEnT ADAPTATIOn This is the control center for delivering and managing adaptive radiation therapy. The workspace is used for monitoring and replanning the treatment once it has commenced. It includes fraction-to-fraction evaluation, dose tracking, online and offline patient setup corrections and full adaptive replanning. A more detailed description of RayStation’s adaptive functionality is found on page 9.

Plan Optimization Plan Evaluation QA Preparation Treatment Adaptation

PLAn EVALUATIOnThis module is a comprehensive toolbox for evaluation and comparison of treatment plans and dose distributions. It also includes clinical approval, plan summation and dose computation on auxiliary image data sets. The user can select from a number of predefined layouts containing different combinations of dose displays, dose volume histograms and dose statistics.

PLAn OPTIMIzATIOnOptimization is our core. RaySearch’s software framework ORBIT contains an ultrafast multi-purpose optimization engine, that solves virtually any posed optimization problem within radiation therapy, using, when applic-able, direct and concurrent optimization of all degrees of freedom of the treatment unit. The optimization engine utilizes a sequential quadratic programming method to minimize or maximize a composite objective function while rigorously maintaining linear and non-linear constraints. Treatment techniques that can be optimized include: 3D-CRT, IMRT (step-and-shoot and sliding window), VMAT and PBS (IMPT or SFUD).

In addition to the traditional optimization procedure, RayStation also provides multi criteria optimization, MCO, which allows for real-time manipulation and evaluation of clinical trade-offs.

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... Day 30

REGULATORY NOTERayStation has regulatory approval in the US, Canada and the European Union. In the US and Canada, the newfeatures proton planning, electron planning and dose tracking are pending clearance, while they are cleared for clinical use, shown with the CE-mark, in the EU.

ABOUT RAYSEARCHRaySearch Laboratories is a medical technology company that develops advanced software solutions for improved radiation therapy of cancer. RaySearch’s products are mainly sold through license agreements with leading partners such as Philips, Nucletron, IBA Dosimetry, Varian, Accuray and Siemens. To date, 15 partner pro ducts have been launched and RaySearch’s software is used at some 1,800 clinics in more than 30 countries. In addition, RaySearch offers the proprietary treatment planning system RayStation directly to clinics. Ray Search was founded in 2000 as a spin-off from Karolinska Institutet in Stockholm and the company is listed in the Small Cap segment on NASDAQ OMX Stockholm. For more information about RaySearch, visit www.raysearchlabs.com.

CUSTOMER CONTACT:For further information regarding RayStation or to get a demonstration please contact one of our sales representa tives or send questions by e-mail on: [email protected]

SALES REPRESENTATIVES:

North AmericaDavid McPhail, VP of Sales RaySearch Americas Inc.Telephone: +1 877 778 [email protected]

ChinaFrank QianCEO, Kang Li Da Trading CorporationTelephone: +86 10 [email protected]

BeNeLuxAnnelies ZimmermannBusiness Director, RaySearch Belgium Sprl.Telephone: +32 2 213 83 [email protected]

South KoreaHeung Won, JangCEO, Oncology Total Solutions Co. Ltd.Telephone: +82 2 2024 [email protected]

ItalyGuido CatollaPresident, Tecnologie Avanzate T.A.Telephone: +39 11 6600101 [email protected]

Rest of the worldJohan LöfPresident and CEO, RaySearch Laboratories ABTelephone: +46 8 545 061 [email protected]

RaySearch Laboratories (publ) Sveavägen 25 111 34 Stockholm Tel +46 8 545 061 30 Fax +46 8 545 061 [email protected] www.raysearchlabs.com

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