Piedmont Hospital radiation therapist Rob Gordon removes the device that keeps patient Abdul Adeola's head still and properly aligned during treatment. The hospital's Trilogy radiosurgery system uses precise images that allow doctors to treat tumors in hard-to-reach parts of the body.
"Inoperable" is a word that brain tumor patients at Piedmont Hospital in Atlanta are hearing a lot less these days, thanks to a new radiosurgery system called Trilogy.
Piedmont Hospital is only the fourth facility in the country to have this image-guided radiation therapy system, which allows doctors to choose the most effective treatment modality and deliver it from one machine in a single room.
When the risks are too great, other illnesses are present or a patient is too old for conventional surgery, doctors at Piedmont are turning to stereotactic radiosurgery. Using focused beams of radiation to destroy malignant and non-malignant tumors, the treatment painlessly shrinks or eliminates tumors and abnormalities.
Physicians can deliver higher doses of radiation more precisely and with fewer treatment sessions than with previous technology. The Trilogy system also allows doctors to treat tumors in places that were previously inaccessible or in critical areas such as the brain, spinal cord, liver or lungs.
The system can shape radiation beams to match the shape of the tumor (avoiding surrounding healthy tissue). Its robotic imaging system guides treatment with sub-millimeter accuracy because it can automatically track tumor movements in real time and adjust accordingly.
Trilogy is even more powerful than Piedmont's Leksell Gamma Knife 4C. The Gamma Knife is not a knife at all, but a device that uses highly focused beams of gamma radiation to perform bloodless surgery for previously untreatable, deep-seated tumors; vascular malformations; and functional disorders in the brain.
Piedmont is the only facility in Atlanta and one of about 20 in the nation to have the newest Gamma Knife model and upgraded software. The hospital has used Gamma Knife technology for more than 15 years.
When it comes to the latest in medical technologies, Georgia hospitals often are at the forefront.
Long-distance training
Recently, an Emory surgeon
conducted one of the world's
first telerobotic surgical training
sessions from his of.ce in Atlanta.
Dr. C. Daniel Smith, chief
of the division of general and GI
surgery in the Emory University
School of Medicine, operated an
RP-7 wireless remote presence
robot - located thousands of
miles away in a surgery training
center in Europe - to train
two surgeons from Venezuela.
Telerobotics, which allows
surgeons to be in two places at
once, has opened new possibilities
for training doctors around
the world.
"This has incredible implications for teaching surgeons, especially if we can have experts remain home in their own hospitals instead of traveling, while still able to provide training resources in remote locations," Smith said.
At the MCG Children's Medical Center in Augusta, pediatric surgeon Walt Pipkin, an expert in advanced laproscopic and thoracoscopic procedures, is operating through "peepholes," thanks to a specialized, hightech endosuite environment.
"Minimally invasive surgery [which replaces large incisions] is rapidly becoming the surgery of choice, both for families and surgeons, when it is appropriate," Pipkin said. Patients heal faster, with less pain, scarring and risk of infection.
Located in the new Center for Minimally Invasive Surgery for Children, the endosuite has equipment mounted to the ceiling and operated by a central computer. Tiny telescopes are used to view the inside of the abdomen and chest.
The telescopes are connected to monitors that allow surgeons to see interior structures at a larger and clearer size. The monitors are mobile so that no matter where surgeons move, they have a comfortable view to guide them easily and safely during surgery.
Radiation therapy
Meanwhile, doctors at MCG
Health System's Georgia Radiation
Therapy Center are using
SmartBeam Intensity Modulated
Radiation Therapy to treat
cancerous tumors. It works like a
global positioning system for the
body, precisely targeting tumors
and delivering focused X-ray
radiation beams.
"The goal of radiation therapy is to provide the maximum dose to the tumor, while mitigating the effect on normal cells. IMRT allows us to do this, focusing radiation on the tumor site and sparing healthy tissue," said Dr. Chris Sheils, a radiation oncologist. "As a result, patients experience few, if any, side effects from the treatments."
The IMRT machine can revolve 360 degrees around the patient to find the best beam placement and can treat tumors as small as a pencil tip.
Emory University School of Medicine recently installed Georgia's only 9.4 Tesla magnetic resonance imaging machine for biomedical research. The device can provide images of areas with diameters as small as one-tenth of a millimeter, about the size of a human hair.
Only about 20 of these powerful MRI machines are in use around the world. MRI systems surround the patient with a powerful magnetic field, which, in conjunction with radio waves, results in signals and then creates visual images of body composition.
The power of an MRI machine is calculated based on the strength of its magnetic field, measured in units of Tesla. Machines with more Tesla offer better image resolution. Clinical MRI machines typically operate using 1.5 Tesla.
.We can measure a lot of things with this magnet,. said Shella Keilholz, Ph.D., assistant professor of biomedical engineering. "We can look at structure. We can look at blood flow. We can see volume, amounts of oxygenation, and water distribution. We can make maps of the principal directions of diffusion, and that tells us what the microstructure in the brain is like."
The MRI machine lets researchers conduct diverse investigations without harming research subjects.
WellStar Cobb Hospital has four new surgical suites equipped with the latest high definition video and camera systems. One has a total digital integration system that allows surgeons to send live images to colleagues via teleconference for educational purposes or consultation. The system makes it possible to save images and record the surgery for patient files or for post-surgery discussions with the patient.
"The difference with the high-definition video capability is a tremendous advantage to both surgeon and patient because it allows the visualization of the internal organs to be crisp and clear during surgery," said Martha Stratton, executive director of surgical services at WellStar Cobb Hospital.