By: Norma Lee MacLeod
After two years of surgeries and chemotherapy to treat stage four colon cancer, Todd Dowser moved to radiation therapy this spring and got a glimpse of the future.
He signed up for a clinical trial testing Varian’s new HyperSight imaging solution integrated with the Ethos therapy system. The difference was remarkable.
With the imaging technology traditionally integrated into radiation treatment systems, Dowser had to hold his breath repeatedly while the equipment captured images of his tumors. The Ethos system with HyperSight imaging took six seconds. “I know when I was lying there, I was thinking, well this is a lot quicker,” said Dowser. “I didn’t have an issue holding my breath, but I could certainly expect that for some older people, or people who have lung issues, this machine would be night and day.”
The Ethos system and its new imaging technology has the potential to transform radiation treatment worldwide. The imaging system takes high-quality, fast (6 seconds) images of the patient’s body, precisely capturing the location of the tumor and surrounding tissues right before treatment. Artificial intelligence (AI) reads the new images and recalculates a radiation plan based on the target and healthy structures as they appear that day, as opposed to how they appeared on planning images taken before the start of treatment. Ultimately, it’s hoped the accuracy of the images gathered in real time will mean tumors receive fewer, larger doses of radiation with less damage to healthy tissue.
“For a patient living in Yarmouth, we may be able to complete that treatment course in four or five sessions instead of 20,” said Dr. James Robar, Chief of Medical Physics for Nova Scotia Health. “How can you deliver four or five instead of 20? The key will be adaptive radiotherapy which Ethos plus HyperSight does at improved levels of resolution.”
The QEII Health Sciences Centre is the first place in the world to test the Ethos with HyperSight technology. “We wanted to be first, and we wanted to pioneer this in concert with our excellent partner, Varian,” said Dr. Robar. For Nova Scotians, “it means you’re among the first to receive the best care in the world.”
Ethos with HyperSight technology is currently under review by Health Canada and is now in use in more than ten sites worldwide. Dr. Robar is co-chair of an international consortium focusing on HyperSight technology. “Because I co-chair this consortium, I have an almost real time view of what’s going on in terms of the use of this technology and the results are quite incredible.”
The opportunity to work with Dr. Robar and the most advanced equipment in the world means Nova Scotia is attracting top talent. “We hired two superstar medical physicists already as a result of this project,” said Dr. Robar. He just put out ad for three more. “There’s a global shortage of board-certified medical physicists and the response to this ad was resounding.”
Dr. Robar says this couldn’t have happened without the help of the Nova Scotia Health Innovation Hub. “We only had our core group of medical physicists here. We just didn’t have the bandwidth for a project of this magnitude. It’s a lot more than just buying the machine.”
“The vision for this was Varian’s and Dr. Robar’s,” said Margaret Palmeter, Senior Director of Business Development for the Nova Scotia Health Innovation Hub. “The figuring out how we do it, how we bring it forward was the Health Innovation Hub and they knew they needed us to do that.”
The Health Innovation Hub works with industry, government, and the fundraising community to advance new technologies and treatments. The QEII Foundation’s $100 million We Are campaign, which is Atlantic Canada’s largest healthcare fundraising campaign, is a critical support and partner in this initiative. The broad expertise of the Health Innovation Hub team pulled all the players together to make a successful pitch to get the upgraded Ethos unit while international competitors were hot on their heels competing to get the technology first.
“It can be done here. You don’t have to be in San Diego or Palo Alto. You don’t have to be in Zurich or Seoul. You can do world leading innovation here in the province of Nova Scotia and that’s what we firmly believe at the Health Innovation Hub,” said Palmeter.
Eric Fisher, Manager of Business Development with the Health Innovation Hub, says because Ethos is an adaptive intelligence solution. There was a huge level of due diligence that went into understanding the requirements both to install and operate the system. “We were working at the pace of industry, which is something that I think only the Innovation Hub could do in terms of moving mountains internally and with our partners to get this done in time,” said Fisher. “Once the technology has Health Canada approval we will be flying out of the gate. The world leaders in radiation therapy will be watching and learning from Nova Scotia.”
Mia Furlong, Innovation Manager at the Nova Scotia Health Innovation Hub, acted as project manager. “It was only possible because all the stakeholders were so invested in getting this new state of the art advancement in image quality, precision, and speed. All the stakeholders had the same mission and vision of providing this top-notch patient care in Nova Scotia.”
In a year, three older treatment units at the QEII are due for replacement. “Everything that we learn in the initial months of using Ethos with HyperSight will inform what we do when we replace equipment in the clinic,” said Dr. Robar. He envisions the most advanced radiation treatment in the world being widely available to Nova Scotians. “Can you imagine giving a very large number of patients access to this technology? I think that’s the huge promise that is on the very near horizon here.”
Todd Dowser’s experience with HyperSight was an evaluation of the imaging technology. Despite his health challenges, he was happy to be part of the clinical trial testing the technology. “Medical advances are important to everybody. If I can give back in any way, I am more than happy to.”
