Ethos Adaptive Radiation Therapy

It is well known that radiation therapy works by damaging the DNA structure of cancer cells. When the DNA structure is damaged, the cancer cells won’t be able to grow or divide, and eventually, they die. With each session, radiation therapy shrinks the tumour and destroys cancer cells. 

Now, there are a few changes that happen throughout the course of treatment. The patient will experience temporal changes in the anatomy, such as tumour shrinkage, weight loss, and internal motion. It is important to pay attention to these changes and alter the treatment accordingly, as these may contribute to less precise radiation delivery and more damage to nearby tissue otherwise.

To address these changes properly and ensure that the radiation therapy is delivered precisely, our specialists opt for something called “adaptive treatment.” During adaptive treatment, our radiation oncologists study the anatomical changes before every session and alter the radiation treatment accordingly. 

While this is necessary to reduce damage to the surrounding tissues, this procedure is time-consuming, and the patients are made to wait on the treatment couch until all changes are thoroughly captured, and appropriate alterations are made to the already prepared treatment plan. This has two Challenges : firstly, long waiting periods can cause inconvenience to patients, and secondly, it can increase the waiting periods for other patients whose sessions are scheduled.

India’s first Radiotherapy Platform with Adaptive Intelligence

At HCG, we have always strived to make care not just safe and effective, but also comfortable. To augment the benefits of adaptive treatment and help the patient receive the best care while being comfortable, HCG has introduced India’s first Ethos Adaptive Radiation Therapy Platform by Varian. 

Ethos’ Adaptive Intelligence solution amalgamates artificial intelligence with traditional adaptive treatment to create contours and devise and deliver adaptive treatment within just 15 minutes. This way, the patient does not have to wait for long periods, and they can comfortably complete their radiation therapy without any serious side effects. 

The adaptive treatment platform of Ethos is extremely intuitive and insightful. The information is always presented in an easy-to-understand manner; this helps the radiation oncologists make well-informed clinical decisions, and patients receive the best quality radiation treatment.

With Ethos Adaptive Radiation Therapy, we can treat breast cancer, cervical cancer, prostate cancer, and head and neck cancer.

Features of Ethos Adaptive Radiation Therapy

Multiple advanced features make Ethos Adaptive Radiation Therapy superior to its other linear accelerator counterparts. The following are the key features of the Ethos Adaptive Radiation Therapy platform:

Superior Visibility: This platform facilitates multi-modal diagnostic imaging, wherein scans like magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), and cone beam computed tomography (CBCT) are performed for more accurate data on tumour parameters. By facilitating an up-to-date view of the patient’s anatomy, Ethos helps clinicians make clinical decisions with confidence. 

Efficient Workflow: The Ethos Adaptive Radiation Therapy platform offers a streamlined workflow for initial treatment planning, treatment management, on-couch adaptation, and treatment monitoring.

• Ethos captures iCBCT images of the anatomical features of the patient during each session; the advanced algorithms of the iCBCT platform support noise reduction and produce higher-quality images, which are important for better treatment planning. 
• Ethos produces high-quality images using imaging modalities like MRI, PET, CT, and CBCT, which support more accurate treatment planning. 
• The simplified AI-driven data provided by the Ethos system on 3D radiation dose prediction for targets and organs at risk supports well-informed decision making.
• It also evaluates the original treatment plans to provide the technologists with valuable treatment planning insights. 

Simplified AI-driven Decision Making: At the time of initial planning, the Ethos platform generates multiple personalised treatment plans depicting the possible radiation dose distributions. The radiation technologist may either go with the original plan or the plan generated by Ethos (adapted) based on the treatment goals set for the patient. Ethos supports personalised treatment through:

• The delivery of insightful data in a structured manner.
• The Adaptive Intelligence feature of the Ethos that intuitively guides the technologists throughout the adaptive therapy process.
• In-sync treatment planning and treatment management programmes
• A highly optimised workflow that delivers radiation safely and quickly
• Treatment delivery on a unique platform that supports flexible and comfortable patient positioning and overall enhanced patient satisfaction

Robust Quality Assurance: The Ethos system facilitates robust quality assurance protocols, which help to enhance treatment efficacy and patient safety, and increase treatment confidence.

• The Ethos system allows technologists to perform independent adaptive plan QA without hampering the treatment workflow.
• This system uses the same QA algorithms for initial planning and adaptive planning to ensure consistency in the workflow.

Working of Ethos Adaptive Radiation Therapy

Ethos Adaptive Radiation Therapy primarily aims at targeting the tumour more precisely, reducing the dose to surrounding healthy tissues, and, lastly, improving the quality of overall treatment results.

The Ethos Adaptive Radiation Therapy combines artificial intelligence with adaptive therapy in order to capture and scan fine-grained images and determine the kind, size, and location of tumours and accordingly plan the treatment. The patient’s age, state of health, and normal movement of organs and tissue in the treatment area are all taken into account by the platform before the treatment. 

At the beginning of the treatment planning process, the Ethos Adaptive Radiation Therapy platform generates multiple personalised plans quickly that illustrate plausible radiation dose delivery. The clinician chooses the plan—original or adaptive—each day that best helps them achieve the treatment goals. The following are the ways that Ethos directs the radiation therapy process:

• The entire adaptive therapeutic process is governed by the intuitive Adaptive Intelligence feature.
• Treatment planning and administration are closely monitored to ensure better treatment efficacy.
• The workflow is designed to proceed smoothly and safely from one phase to the next upon the radiation oncologist/technologist’s approval.

During each session, the Ethos platform adjusts the radiation delivery to the patient’s unique anatomy. Every time, the radiation is precisely directed to the tumour location with the help of real-time optimisations.

In the case of other radiotherapy platforms, adaptive treatment planning is done manually, and this optimisation takes more than 40 minutes. However, in the case of the Ethos Radiation Therapy platform, doctors can efficiently plan and administer the adaptive treatment in a 15-minute time slot with the help of its Adaptive Intelligence feature.

What makes Ethos Adaptive Radiation Therapy different?

Ethos Adaptive Radiation Therapy is far superior and more patient friendly as compared to its other linac counterparts. 

During each session of the treatment, the radiation dose is adjusted to the patient’s specific anatomy. These real-time optimisations help in precisely targeting the tumour and completing each session in less time. This way, Ethos puts the patient at the centre of the care.

As there are no manual calculations involved, we can avoid errors and unnecessary delays in the treatment. 

Ethos is relatively silent in comparison to other radiation platforms, and this contributes to enhanced patient comfort during the treatment.

Advantages of Ethos Adaptive Radiation Therapy

More Precise Radiation Delivery: The Adaptive Intelligence solution employed by Ethos supports more precise imaging and treatment planning, and thereby enhances the accuracy of radiation delivery. This also helps minimise damage to the surrounding healthy tissues. 

Personalised Treatment Plans: The Ethos Adaptive Radiation Therapy platform effectively maps out the anatomy, diligently catches the anatomical changes, and accordingly optimises the treatment regimen through its superior AI-driven treatment planning and contouring capabilities. This helps us deliver personalised treatment to all patients, who are undergoing radiation treatment with the Ethos platform. 

Quicker Sessions: The Ethos Adaptive Radiation Therapy platform helps us deliver radiation therapy at a faster rate. Through this technology, the entire session, from start to finish, may take up to 15 minutes only.

Overall better Treatment Results: Through enhanced precision and personalisation, the Ethos Adaptive Radiation Therapy platform delivers better treatment results to patients and supports effective management of their condition.

Comfortable Treatment Sessions: The Ethos Adaptive Radiation Therapy platform is built with a large bore, silent motors, an integrated camera system, and an intercom system to deliver a positive experience in a comfortable and safe setting. It also makes the treatment more comfortable by reducing the overall treatment session time.

Safer Radiation Delivery: With its patient-centric design, the Ethos Adaptive Radiation Therapy platform supports enhanced patient safety throughout the session. 

Fewer Treatment-related Complications: By targeting the tumour more precisely and reducing damage to healthy tissues nearby, the Ethos Adaptive Radiation Therapy platform helps reduce the risk of severe treatment-related complications for patients. 

Frequently Asked Questions