C-RAD at James Cook

The James Cook University Hospital in Middlesbrough is a designated major trauma centre and provides all its specialties from one site which is unique for a hospital of its size. James Cook provides a wide range of district general hospital services and specialist services such as neurosciences, renal medicine, spinal injuries, major trauma, cardiothoracic, vascular surgery and cancer services, including radiotherapy.

Pictured recently at the hospital during applications training in the radiotherapy department on the newly installed C-RAD HD optical patient monitoring system are (from left): C-RAD applications specialists Beatrice Akrinrimisi and Peter Hundlinger with James Cook Medical Physics Expert Andrew Greenhalgh, Vertec Scientific product specialist Michael Davis, Therapeutic Radiographer Sophie Burns, Student Therapeutic Radiographer Aaron Singleton, Radiotherapy Clinical Lead Claire Huntley, Senior Therapeutic Radiographer Andrew Jepson and Superintendent Radiographer Catherine Wilson.

C-RAD systems are designed to monitor the precise patient position so that dose can be accurately delivered. The RT unit already had a C-RAD single camera system with both motion monitoring and respiratory gating but as part of an update the C-RAD specialists implemented the work flow facility.

The new Catalyst HD features a three camera overview of the patient during treatment for a 360 degree view (one ceiling mounted camera can be seen in the picture at left.) This arrangement has many benefits, including at bigger surface covered where at least two cameras will always have full view of the patient with 200 frames per second, no matter what the linac gantry angle. Inter-fractional motion detection permits maximum dose delivery within the target area with posture or positioning errors corrected immediately. Patient movements trigger alarms and linac beam hold while respiratory gating comes with baseline monitoring, breath hold, DIBH, all supported by audio visual coaching with patient control, a very useful tool.

New to the RT unit was a transition from voluntary gating to surface guided DIBH with visual coaching which gives a better reproducibility and overall higher accuracy of the treatment compared to voluntary DIBH.

According to Claire Huntley, “The James Cook always aims to give the best radiotherapy treatment – this new system will help us deliver it.”