(June 18, 2015) Dutch hospital acquires 1,000th Agility, Elekta’s radiotherapy beam-shaping technology for treating cancer

LEEUWARDEN, Netherlands, June 18 – Radiotherapy Institute Friesland (RIF) in the Netherlands recently accepted delivery of a new Elekta Synergy® linear accelerator for cancer treatment, equipped with Elekta’s 1,000th Agility™ multileaf collimator (MLC). Agility is the world’s fastest MLC, enabling physicians to dramatically reduce treatment times for patients.

“Two of our five linacs are already equipped with Agility,” says Annerie Slot, MD, a radiation oncologist and executive director at RIF, which will begin using its latest Elekta Synergy in September. “We value the narrow 0.5 cm width of the Agility leaves, which is especially beneficial in shaping the radiation beams for small targets in stereotactic treatments. The high leaf speed enables us to deliver volumetric modulated arc therapy [VMAT] in a shorter time, particularly in the stereotactic treatments we deliver. The shorter treatment time not only improves patient comfort, but it also helps reduce the possible intra-fractional change in the tumor’s position.”

First Agility user helped develop MLC
Participating with other clinical sites, St. James’s University Hospital (Leeds, England) and Elekta collaborated on the development of Agility in a research program that began in 2009. Physicians at the hospital marked their third year of clinical Agility use in April 2015, benefiting from the MLC’s capabilities in both Elekta Synergy and Versa HD™ treatment systems.

“We tested the first working prototype in 2010 and went clinical on April 1, 2012, making St. James’s the world’s first center to use Agility,” says Vivian Cosgrove, PhD, head of radiotherapy physics. “In August 2012, we used Agility for the first time with VMAT delivery in a stereotactic body radiation therapy [SBRT] case.”

Dr. Cosgrove says the treatment delivery speeds attributable to Agility and High Dose Rate mode on Versa HD have been incredible.

“Having Agility and High Dose Rate mode in both our Versa HD linear accelerators means we can take full advantage of rapid beam delivery techniques such as VMAT,” Dr. Cosgrove notes. “We use High Dose Rate mode VMAT on every patient treated on the Versa HD systems, including prostate and lung treatments and bi-lateral head-and-neck treatments. 

“Our prostate patients are treated in 10 minute slots or six patients per hour,” he notes. A lung SBRT case is accomplished in a 20-minute slot. With this delivery efficiency we typically treat 45 to 55 patients per day on each Versa HD, but occasionally, we treat as many as 60 patients in a 10-hour day.

“We are really delighted with Agility,” he adds. “The MLC has proven to be very reliable and has enabled us to deliver very fast, very efficient treatments with an extremely low leakage of less than 0.5 percent across the entire field. And we continue to expand treatment sites, now including bi-lateral head-and-neck.”

During 2016-2019, St. James’s will be replacing the standard MLCs on eight of its 10 Elekta linacs with Agility.

“The technical advancements in Agility represent Elekta’s research and development leadership and also the fruits of our collaborations with many clinical customers,” says Todd Powell, who will soon assume the role of Elekta’s Executive Vice President, Comprehensive Oncology Solutions. “The success of Agility demonstrates that such technology is exactly what hospitals need to address the growing incidence of cancer worldwide.”