Froedtert Hospital & Medical College of Wisconsin Actively Treating Patients with CMS' FOCUS ``Solid IMRT''.

Business Editors & Health/Medical Writers

ST. LOUIS--(BW HealthWire)--Feb. 20, 2002

Physicians at Froedtert & Medical College Cancer Center in Milwaukee, Wisconsin have treated eight head & neck cancer patients with Intensity Modulated Radiation Therapy (IMRT) using solid modulators (a.k.a. compensator-based IMRT or "solid IMRT") in the past four months. The Cancer Center uses the FOCUS(R) IMRT treatment planning system and ".decimal" compensator feature, offered by Computerized Medical Systems, Inc. (CMS). The ".decimal" compensators, milled from brass to the highest quality achievable, are produced by Southeastern Radiation Products, Inc. of Orlando, Florida. Compensator-based IMRT using FOCUS incorporates the ease and speed of FOCUS IMRT planning, with the unrivaled spatial resolution of ".decimal" compensators.

Medical Physicist, Paul Jursinic, Ph.D., assistant professor of radiation oncology at the Medical College of Wisconsin, spearheaded the commissioning and implementation of solid IMRT at the Cancer Center. He began by commissioning the FOCUS 3D algorithms, convolution and superposition, then commissioned the ".decimal" compensator program for conventional compensators. Dr. Jursinic subsequently attended CMS' IMRT training class in St. Louis to master the software component of IMRT planning.

The Cancer Center team has initially concentrated on head & neck cancers using solid IMRT because the superior spatial resolution of compensators lends itself to smaller complex targets and critical structures. They have achieved their desired prescriptions to the primary target and lymph nodes, while sparing the spinal cord. They have accomplished this using only 5 beams per IMRT plan.

The team also reports greater clinical efficiency with solid IMRT. "One of the benefits of compensator IMRT is that these treatments can be carried out in a 15-minute time slot, which is the same length of time needed for a normal 3D plan," says Dr. Jursinic. "The therapists do have to enter the room to exchange compensators and rotate the gantry for every beam, but this takes approximately 30 seconds per compensator."

The team also uses IMRT plans with MLC-based delivery and reports delivery times with compensator-based IMRT, which are two to three times faster. According to Dr. Jursinic, "The portion of our IMRT treatment delivery with compensator-modulated plans continues to grow, due to our greater planning experience and to the significant savings in delivery time." He says, "There is also a reduction in the total monitor units delivered, with solid IMRT requiring on average threefold fewer monitor units per plan to achieve the same prescription."

The quality assurance (QA) necessary for IMRT plans can be very rigorous. Dr. Jursinic carries out extensive QA procedures for each IMRT modulator. His work has been greatly facilitated by the availability of the FOCUS IMRT QA tools and the use of the "Profiler" (Sun Nuclear, Inc.), a diode array tool and associated analysis software. These tools allow efficient and integrated comparisons of measured dose with calculated dose output by the FOCUS system.

Ben Nelms, Ph.D., Director of Physics and Research at CMS, says, "Paul Jursinic and the staff of the Froedtert & Medical College Cancer Center have been excellent clinical partners with CMS, especially in our endeavors to offer compensator-based IMRT. They are using the software to its potential, not just with planning tools, but also with the integrated QA tools we've built into FOCUS. It's very gratifying to see all of Paul's hard work, and our hard work here at CMS, manifest itself as state-of-the-art patient care."

Computerized Medical Systems, Inc. manufactures, markets and supports FOCUS 3-D Treatment Planning Systems, including FOCUS IMRT, Focal PC-based applications, including FocalEase(TM), (a physician's desktop contouring package), FocalFusion(TM) (a multimodality automated image fusion/registration tool), and FocalVue(TM) (a desktop physician's review workstation application), as well as DynaScan, a Dosimetry system for beam data collection. Offices are located worldwide. Our headquarters are in St. Louis, Missouri with regional offices in Tokyo and Osaka, Japan, Hong Kong, China, and a new European regional office in Frieburg, Germany.

CMS is the worldwide market share leader in radiation treatment planning systems with more than 1,000 FOCUS 3-D systems installed to date more 3-D RTP installations than any other manufacturer. Sale of FOCUS IMRT has surpassed 150 units.

For further information on CMS, please visit the CMS Website at http://www.cms-stl.com or call CMS at 800/878-4267 or 314/993-0003.