Technology and Techniques*

*Consult your physician to determine the appropriate treatment technique and location

Linear Accelerators are the primary piece of treatment equipment used in every Coastal Radiation Oncology Treatment Center. Linear accelerators, or “linacs,” deliver non-invasive external beam radiation therapy by producing high energy x-rays or electrons that destroy cancer cells while sparing the surrounding normal tissue.

Gamma Knife®

Gamma Knife® is a noninvasive form of radio surgery recognized worldwide as the preferred treatment for specific types of lesions, tumors, or conditions that affect the brain.  The Gamma Knife® uses computerized data from CT scans, MRIs or others imaging tests to identify the areas within the brain that will be treated with the multiple beams of gamma radiation. Gamma Knife® can treat deep within the brain, close to nerves, arteries, or other vital structure, as well as multiple locations in the brain often in a single session.  Additionally, Gamma Knife® is an excellent option for patient whose medical conditions might make the physical trauma traditional surgery impossible or risky.

Intensity Modulate Radiation Therapy (IMRT)

Intensity Modulate Radiation Therapy (IMRT) is an advanced form of noninvasive radiation therapy that utilizes computer-guided x-rays to precisely target and destroy cancer cells while avoiding healthy tissue. The use of high-speed computers and special imaging devices ensures our team is able to control the intensity and size of a radiation beam and adjust it hundreds of times throughout a single treatment. This results in a beam of radiation that can be shaped around a cancerous tumor to avoid healthy tissue. Additionally, the intensity of the beam can be blocked, filtered, and adjusted to most effectively radiate a tumor and destroy a cancer cell’s DNA—preventing a tumor from growing and spreading. To learn the exact location of a cancerous tumor and to precisely target a tumor using IMRT, a variety of diagnostic three-dimensional computer tomographic (3DCT) scans and/or magnetic resonance images (MRI) are collected. Depending on a tumor’s location and the sensitivity of surrounding tissue, a positioning device may be used to help a patient stay perfectly still while undergoing treatment. Sometimes, tiny gold seeds are implanted in or near a tumor to help our treatment team identify it clearly on imaging devices and to ensure the most effective treatment. IMRT is commonly used to treat prostate cancer, head and neck cancer, and cancers of the central nervous system. These sensitive areas require the utmost precision so IMRT is often an optimal treatment option. IMRT may also be used in treating some cases of breast, thyroid, lung, gastrointestinal, and gynecologic cancers.

Image-Guided Radiation Therapy (IGRT)

Image-Guided Radiation Therapy (IGRT) is an advanced form of radiation therapy that uses 2D, 3D and 4D imaging technology to pinpoint the precise shape and location of a cancerous tumor and accurately deliver radiation beams to its location.  Using special imaging technology, IGRT allows our physicians and treatment specialists to view or “image” a tumor before, during, and after treatment.  By imaging the tumor prior to the delivery of every radiation treatment, miniscule adjustments can be made to the radiation beams to precisely target the tumor, which may move or change shape and size during the course of treatment which helps to avoid the surrounding healthy tissue. IGRT is most commonly used in conjunction with IMRT to treat tumors in areas of the body that move regularly (i.e. lungs).

Stereotactic Body Radiation Therapy (SBRT)

Stereotactic Body Radiation Therapy (SBRT), also known as Stereotactic Ablative Radiotherapy (SABR) is a type of external beam radiation therapy that can be completed in one to five days rather than over several weeks and is best for very small tumors.  This highly focused, specialized type of external beam radiation therapy gives an intense dose of radiation concentrated on well-defined tumors. Stereotactic radiation relies on detailed imaging, computerized three-dimensional treatment planning to deliver precise radiation doses with extreme accuracy.  SBRT/SRS uses these specialized scans to pinpoint exactly where within the body the tumor target is located. These techniques allow our doctors to give a high dose of radiation to the tumor in a short amount of time.  SBRT delivers the right amount of radiation to the cancer in a shorter amount of time than traditional treatments. Plus the treatment is delivered with extreme accuracy, minimizing the effect on nearby organs. However, SBRT is only suitable for small, well-defined tumors that can be seen on imaging such as CT or MR scans. As a result, this approach is not suitable for all situations. The amount of radiation that may be safely delivered may be limited if the cancer is located close to a sensitive normal structure, such as the spinal cord or bowel.

Stereotactic Radiosurgery (SRS)

Stereotactic radiosurgery (SRS) is a type of external beam radiation therapy that can be completed in one to five days rather than over several weeks and are best for very small tumors.  SRS refers to single or several stereotactic radiation treatments of the brain or spine delivered by a team including a radiation oncologist and a neurosurgeon. A customized stabilizer may be required to keep the body perfectly still during treatment. Stereotactic radiation relies on detailed imaging, computerized three-dimensional treatment planning to deliver precise radiation doses with extreme accuracy.  The advantage of SRS is that it delivers the right amount of radiation to the cancer in a shorter amount of time than traditional treatments. Plus the treatment is delivered with extreme accuracy, minimizing the effect on nearby organs. However, SRS is only suitable for small, well-defined tumors that can be seen on imaging such as CT or MR scans. As a result, this approach is not suitable for all situations. The amount of radiation that may be safely delivered may be limited if the cancer is located close to a sensitive normal structure, such as the spinal cord or bowel.

Volumetric Arc Therapy (VMAT)
Volumetric Arc Therapy (VMAT) is an advanced form of intensity modulated radiation therapy (IMRT).  With a 360° rotation of the gantry on the linear accelerator (or multi-arc treatment), a precisely-sculpted 3-D dose is distributed. VMAT is generally able to deliver the dose to the entire tumor in a single 360° rotation around the patient, which can take as little as just two minutes. Conventional IMRT without VMAT usually requires the machine to rotate around the patient several times or to make repeated stops and starts to treat the tumor from different angles.
TomoTherapy®
TomoTherapy® system is an all-in-one system that lets your treatment team scan and treat with a single piece of equipment that physically revolves around you. TomoTherapy® is the only radiation therapy system designed on a CT scanner foundation.  Daily imaging before each treatment allows your clinician to adjust treatment for even the smallest changes in the size, shape, and location of tumors. TomoTherapy® provides highly precise targeting and attacking of cancer cells. Advanced image-guided, Intensity Modulated Radiation Therapy (IMRT) delivered from 360 degrees around you. Radiation is delivered via thousands of little “beamlets” coming from all angles. The flexibility and function of TomoTherapy increases control in delivering radiation where it needs to be while minimizing damage to surrounding healthy tissues and organs. It can be adapted at any point to best deliver treatment, ensuring the right dosage in the right place at the right time. Thus ensuring your doctor is able to effectively treat hard-to-reach and complex tumors.
HDR Brachytherapy

High-dose-rate Brachytherapy (HDR) is a dependable and highly developed form of internal radiation therapy delivered through catheters to the exact site of a cancerous tumor.  The procedure is typically repeated over several treatments to quickly de3vlier a high dose of radiation to the tumor.  Compared to low-dose-rate radioactive (LDR) that are implanted for extended periods of time, the higher doses used in HDR brachytherapy deliver equivalent radiation in just a few minutes by inserting and then removing the radioactive material.  HDR brachytherapy may be used as the only treatment or it may be combined in a treatment plan with external radiation therapy. HDR treatment is often faster than other types of treatment, and can be performed on an outpatient basis. Most importantly, the precision and limited exposure to healthy tissue HDR provides translates to excellent success rates for certain types of cancers.

Superficial Radiation Treatment
Superficial Radiation Treatment (SRT) is a non-invasive treatment option for skin cancer. SRT is a logical choice for primary lesions that otherwise require difficult or extensive surgery of sensitive structures in the head and neck regions such as the fold in the nose, eyelids, lips, corner of mouth, and the lining of the ear, where surgery would result in a poor cosmetic outcome. SRT does not require anesthetics or skin grafting, and the cosmetic results are excellent compared to other treatments. The SRT systems used at Coastal Radiation Oncology deliver fast and accurate treatments, which maximize therapeutic benefit while minimizing effects to the surrounding area.
Deep Inspiration Breath Hold (DIBH)

Deep inspiration breath hold (DIBH) is a specialized technique that delivers radiotherapy as patients hold their breath. DIBH is designed to help reduce any incidental radiation to the heart. For patients with cancer of the left breast, one of the main concerns during the radiotherapy treatment is the proximity of the heart to the treatment area. Our internal anatomy and the position of the breast tissue that requires treatment means heart tissue may potentially receive some of the radiation dose. Years after treatment, incidental doses of radiation may cause some heart related problems. The DIBH technique is helpful ensuring that the breast/chest wall area receives the full prescribed dose of radiation while reducing exposure of the heart.

Our Commitment to Safety

Coastal Radiation Oncology is proud to have some of the nation’s leading American Board of Radiology certified medical physicists working at our centers. Our medical physics staff ensures that all of our advanced technologies work properly, reliably and safely. In addition to maintaining the safety of our equipment, our expert medical physicists also work closely with our team of radiation therapy experts to ensure that every treatment is safe and custom tailored to the needs of each patient.

At Coastal Radiation Oncology, we hold ourselves to a level of safety that adheres to or goes beyond industry standards to give our patients the best possible treatment and peace of mind.

To learn more about industry safety standards, please visit the websites for the American Society for Radiation Oncology (ASTRO) or the American College of Radiation Oncology (ACRO)