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    Technologies & Features
  In the planning room…
IMPLICIT REGISTRATION™
  Full volumetric information
  Voxel-based contouring
  In the treatment room…
  MUTUAL REFERENCING™
  Beam’s-eye view
  Surface matching
  Performance and throughput
  Real-time feedback
of patient re-alignment
  Wireless couch tracking
   Core platform…
  Built-in QA
  Unique QA and calibration tools
  Real-time camera tilt
detection and interlock
  Advanced technologies
and features
  Reconstructed 3D ultrasound
  Assisted segmentation
  User-defined U/S acquisition parameters
  Complete integration
and communication
  Seamless integration
  Distributed system design
  DICOM data communication
  Combined patient data from multiple RESTITU U/S-GUIDE™ installations
  Rich data access
  Persistent data
  Report generator
  SQL-compatible database
  Central data server
  DVD patient data archival
  Leading-edge hardware
  Zero-footprint ergonomics
  Multiprocessor, multithreaded software engineering
  On-probe or on-screen scan controls
  Active infrared markers
  Expandability
  Multiple rooms
  Multiple anatomical sites

Resonant Medical develops, manufactures and commercializes 3D ultrasound adaptive radiotherapy products for cancer centers – with the goal to enable fundamental improvements to treatment planning, verification and delivery, for the advancement of patient care.


Clinical problems addressed
Resonant’s solution: RESTITU™
RESTITU™ in the planning room: U/S-SIM
RESTITU™ in the treatment room: U/S-GUIDE
RESTITU™ Workstation and Server
Hardware highlights

Clinical problems

Precise tumor localization and fast and accurate patient
positioning prior to each treatment fraction are crucial steps
in the effective treatment of tumors. Resonant Medical’s
products have been developed to address the fundamental
problem of organ motion and the issues associated with
comparing ultrasound to CT image modalities for motion measurement and patient repositioning. By addressing this fundamental problem, it also provides a new and unique
solution to lower resolution soft-tissue visualization on CT.

Resonant’s solution: the RESTITU™ platform

Resonant Medical’s products provide a robust and innovative solution to the problems of organ motion during the course of treatment and lower resolution soft-tissue visualization on CT.

At the time of treatment delivery, the RESTITU™ platform
helps implement treatment plans by accurately visualizing and successfully correcting for geometric changes in any organ identifiable by ultrasound imaging – making the best possible
use of IMRT technologies and increasing the confidence level required to plan and deliver today’s ever more conformal radiotherapy treatments.

Resonant’s system consists of RESTITU U/S-SIM™ in the
planning room, RESTITU U/S-GUIDE™ in the treatment room,
the RESTITU™ Workstation and unique QA and calibration tools. Our current lead product addresses prostate tumor visualization and patient re-alignment, and we are about to commercialize modules for other anatomical sites, such as head-and-neck, breast and cervix.

RESTITU™’s ergonomic hardware and high-performance software platform features significant technological advances in 3D ultrasound imaging technology, such as IMPLICIT REGISTRATION™ and MUTUAL REFERENCING™ – opening the door to a number of possible improvements in treatment planning and delivery.

Here is how RESTITU™ works: The radiation therapist acquires high-quality, reconstructed 3D ultrasound volumetric data – in a matter of seconds and with minimum effort. Then, with assisted segmentation, the volume of the targeted organ and structures-at-risk is quickly segmented. Organ displacement is accurately calculated to restore the target to its intended planned position. Patient alignment (target position, shape and size) is validated through a beam’s-eye view with MLC overlay. Powerful visualization tools on the RESTITU™ Workstation allow the physician to analyze volumetric information in 3D, and persistent data enables treatment progress monitoring.

 

From image acquisition to patient re-alignment
in only 90 seconds!

 

 

 

 

 

 

RESTITU™’s key advantages

While making position verification and patient positioning possible, without compromising throughput, RESTITU™ allows the medical team to:

• Improve soft-tissue organ definition
• Achieve multimodality image fusion
Segment target and structures-at-risk
• Communicate with existing systems (DICOM data exchange)
• Verify target position and re-align patient in 90 seconds
• Obtain full volumetric data at every session
• Achieve precise, accurate and reproducible results (high-performance software)
• Access and review patient data from any office
Generate reports
• Maintain complete records of all alignments
Upgrade to multiple anatomical sites, expand to multiple rooms

…and more

 

RESTITU™ in the planning room: U/S-SIM

RESTITU U/S-SIM™ is the 3D ultrasound system used in the CT-Sim room for target volume delineation and "positional reference volume" definition.

It allows radiation oncologists to achieve better target definition, thanks to ultrasound’s superior soft-tissue visualization and Resonant’s patented IMPLICIT REGISTRATION™ of treatment plan CT and 3D ultrasound data. By reducing subjectivity in the definition of both target volumes and organs-at-risk, RESTITU U/S-SIM™ has the potential to improve the quality of treatment plans.

Since the RESTITU™ system is also expandable to other anatomical sites, the future of ultrasound as an adjunct imaging modality is promising.

 

 

 

RESTITU™ in the treatment room: U/S-GUIDE

In the treatment room, RESTITU U/S-GUIDE™ makes tumor position verification and patient positioning possible without compromising throughput. Thanks to Resonant’s patented MUTUAL REFERENCING™ technology, it delivers robust and reproducible 3D ultrasound imaging, tumor position verification and patient re-alignment in only 90 seconds. RESTITU U/S-GUIDE™ greatly improves the physician’s confidence in treatment accuracy, while addressing patient throughput.


RESTITU U/S-GUIDE™ was specifically designed with the efficiency and comfort of the radiation therapist in mind. The radiation therapist will appreciate the intuitive touch screen interface, which guides them through the whole repositioning workflow, from patient scanning, to assisted segmentation, volume visualization and patient alignment. Many features illustrate this attention to the therapist’s efficiency at the time of treatment delivery, so that the therapist can focus on providing quality care – without being an ultrasound specialist.

For example, just to name a few, the image-acquisition phase provides the therapist with imaging presets and reference images from previous treatment days. The system makes it possible to repeat any step in the workflow rather than starting from the beginning. Most importantly, RESTITU™’s patient alignment feature provides automatic displacement calculation through our unique, patented MUTUAL REFERENCING™ technology, as well as patent-pending surface-matching algorithms. During this step, real-time feedback of the organ position in the three orthogonal planes and all beam’s-eye views provides further confidence in displacement corrections. The result – rapid, confident repositioning of the patient.

Medical physicists will also appreciate the attention to their specific concerns, as evidenced by the RESTITU™ system’s persistent calibration features and tools. The fixed design gives the medical physicist the confidence to allow continued use of the system with only periodic quality assurance tests. The unique tilt-detection interlock of the tracking system camera ensures that the system remains calibrated and alerts the team to any changes that would require recalibration. In the event recalibration is required, the system guides the medical physicist through the procedure in a matter of minutes.

Beam’s-eye view
Target views from the perspective of each beam – with MLC overlay – for optimal verification

Clear instructions
Clearly indicated displacement required for patient re-alignment

Real-time feedback
Real-time on-screen visualization and measurements during patient re-alignment

3D visualization
Generates volumetric information about target at time of treatment

RESTITU™ Workstation

RESTITU™ Workstation assists the physician by performing four major tasks, as well as many sub-tasks:

RESTITU™ Workstation defines reference target volumes.
It improves target definition and facilitates treatment planning – thanks to IMPLICIT REGISTRATION™ and the fusion of CT and 3D ultrasound images.
It permits the convenient review of patient data acquired during any previous treatment session.
It enables storage of and access to patient data.

 

Definition of reference target volumes

RESTITU™ Workstation allows the physician to review, refine and approve reference target volumes. The reference target volume is used as the basis for subsequent comparison on the RESTITU U/S-GUIDE™ through MUTUAL REFERENCING™.

Improved target definition

The Workstation allows IMPLICIT REGISTRATION™ and automatic fusion of CT and RESTITU™ U/S-SIM™ data for improved organ definition.

Review of patient data

RESTITU™ Workstation provides powerful, proprietary tools to access, visualize and analyze volumetric patient information in 3D acquired during any previous treatment session – from the convenience of any office in the cancer center.

The Workstation allows review of all images acquired at the RESTITU U/S-SIM™ or RESTITU U/S-GUIDE™ stages – individually or in 3D reconstruction mode, as well as statistical information, time-series and trend analyses.

Access to patient data

Conveniently access patient data acquired during any previous treatment session and stored on the RESTITU™ server.

Access to persistent patient data from the desktop – using RESTITU™’s secure, web-browser-based retrieval system – facilitates individual as well as multidisciplinary clinical and research collaborations.

Data is readily available to generate progress reports or for statistical analysis in research-friendly (CSV, XLS) or immutable formats (pdf). In addition, this data can be accessed and reviewed in multiple report formats from any office in your institution.

High-capacity storage or retrieval from archived data is possible, thereby providing a rich source of information for research or statistical purposes.

Fusion
Instant multimodality image fusion – CT, ultrasound – for better organ definition

 

Reference volume
Creation of the reference volume and position for subsequent comparison during treatment

 

Data server
Storage of all patient records, from all sessions

 

Data review
Tools to review, compare and analyze patient data over time


 

 

Hardware highlights

RESTITU™’s unique hardware – for high performance and quality

QA and calibration tools

Unlike other systems that require calibration on a per-patient basis, RESTITU™ features a unique fixed design which ensures persistent calibration from one day to the next. Periodic calibration verification is made simple with a custom RESTITU™ Calibration Phantom and RESTITU™ Calibration Caddy.

Tracking system

Ceiling-mounted with robust hardware and fitted with a tilt detector. This unique interlock of the tracking camera ensures that the system remains calibrated and alerts to any changes that would require recalibration.

Wireless couch position indicator

Provides current patient position information to the RESTITU™ system – to allow for real-time feedback while patient is being repositioned. Wireless design ensures minimal obstructions for patient and therapist alike.

3D ultrasound probe

Features an active infrared emitter array to ensure more accurate spatial reconstruction of the ultrasound pixels in relation to the room’s global coordinate system.

 

 

Resonant currently has several patents pending for its proprietary technology.