Elekta AB acquires Resonant Medical Inc.
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Mutual referencing™:
Clarity's unique, proprietary and patented Mutual Referencing™ technology is central to achieving an unprecedented level of speed and accuracy in patient positioning. It allows for acquisition of 3D ultrasound data in the identical and global coordinate systems of both the CT-Sim and treatment rooms. The ultrasound volume generated at the time of treatment planning serves as reference to calculate subsequent displacements. This enables accurate intramodality (i.e. ultrasound at planning, and to ultrasound at treatment) tumor position verification and localization as well as fast and accurate patient alignment.
Other ultrasound IGRT solutions use crossmodality comparisons; they compare ultrasound to CT volumes (which can vary by as much as 40%), with the ultrasound volume being closer to the true anatomical volume. Not only does this step up throughput on the accelerator; it also requires the radiation therapist to make a subjective judgment call on how best to align different volumes from two different modalities at every fraction. The Clarity system eliminates this burden by automatically comparing ultrasound volumes to ultrasound volumes and by providing the necessary information to correct for the calculated displacement.
Physicists
Clarity addresses the needs of the physicist with rapid calibration procedures, implicit image registration, and seamless connectivity. The result is hassle-free, practical ultrasound IGRT.
Calibration and QA:
Accurate image reconstruction depends on precise system calibration relative to the CT simulation room and treatment room coordinate system. The Clarity Tracking System uses sensors attached to a 3D ultrasound probe to generate 3D ultrasound data about the region of interest.
The Clarity software uses the calibration process to determine the transformations (translations and rotations) required to convert a given point in the ultrasound image into the 3D coordinates defined by the CT-Sim origin and treatment room isocentre.
Clarity features a quick and simple calibration protocol using the Clarity Calibration Phantom and its sophisticated, yet easy-to-use, Calibration Caddy. Both the CT-Sim and treatment rooms and the 3D ultrasound probe are calibrated on the day of system installation, with only periodic future verifications being required.
Should a QA test fail, recalibration takes only minutes.
Daily quality assurance checks can easily be integrated into the accelerator quality assurance routine. Absolute (i.e., calibration with room coordinate system) and relative (i.e., displacement calculation) verifications take only minutes with the help of the Clarity Calibration Phantom, and they provide the confidence to proceed with daily treatment.
Read publications relating to calibration.
Implicit Registration™
Clarity U/S Sim exploits the benefits of ultrasound by combining its superior soft tissue imaging capabilities with other imaging modalities such as CT. Its unique Implicit Registration™ technology facilitates accurate and automated image registration “fusion”, thereby providing additional comprehensive anatomical information from both imaging modalities. For example, the Implicit Registration™ of CT-Sim and U/S Sim can help better define the extent of the prostatic apex. 
Multimodality image fusion is becoming a hallmark of leading cancer centers Implicit Registration™ of CT and 3D ultrasound data provides reliable means of increasing the quality of target definition, thereby improving the accuracy of the treatment plan and enabling confident delivery of conformal therapy.
Clarity integrates seamlessly with CT-Sim, virtual simulation and other systems already in place in cancer centers using DICOM data exchange of pertinent treatment information.
Connectivity1:
Clarity exchanges data through industry standard protocols such as DICOM and secure-SSL queries.
CT images, contours, and plans can be imported from CT-Sim or VSIM consoles in DICOM format. The 3D ultrasound volume may be reconstructed with the same origin and slice offset as the CT series for export back to the CT-Sim and image fusion, if desired. Exporting the ultrasound series in the DICOM CT format ensures compatibility with all commonly used CT-Sim products.
Bidirectional exchange of images and contours is possible with industry standard treatment planning systems. Additionally, DICOM RT plans may be imported from the treatment planning system for isocentre definition and for MLC shape overlays in the treatment room.
A treatment fraction verification image is automatically generated and forwarded to the record & verify system for easy review and approval by the physician.
1 Note: some connectivity may require additional licenses or functionality on the third party DICOM peer.