60 seconds with… Jupiter 2 and the radiotherapy physics team
We chatted to the team – who call KGV basement at St Bartholomew's their home – about their new Linac machine, which costs more than £1.5 million and will deliver cutting-edge care to around 5,000 cancer patients in its lifetime.
What’s a Linac machine?
Linac stands for linear accelerator. Our medical linear accelerators deliver high energy x-rays or electrons to a specific area of the body. The radiation is most commonly used to treat cancerous tumours, but it’s also used with some benign conditions.
The success of the treatment is based around delivering a large radiation dose with a high degree of accuracy to the tumour, whilst sparing as much as possible the surrounding normal tissues.
What’s the new machine replacing?
The original Linac in this bunker (shielded room for radiotherapy treatments) was installed when our department was new, 10 years ago. Jupiter, as it was called (each of the machines are named after planets), was still delivering quality treatments, but 10 years is a long time in radiotherapy technology.
Older machines tend to have more downtime as parts age. The latest machines are better than ever at positioning the patient and delivering radiation with millimetre accuracy.
What’s new about Jupiter 2?
The latest Linac – nicknamed Jupiter 2 – is capable of delivering radiation at rates up to four times faster than our older machines.
This – alongside a more efficient workflow – can reduce appointment times for patients whose treatment involves delivering a large dose of radiation in each session.
Linacs are also capable of advanced imaging techniques, which we use to accurately position the patient before treatment – such as long-length on treatment CT-type imaging and even imaging synchronised with a patient’s breathing – so, in reality, the time saving is spent here instead.
How long does it take to install?
It takes about a month after the removal of the old machine to prepare the room and electrics to receive the new Linac.
It’s lowered in pieces through a hatch in the square and assembled on site in less than 10 days, which is amazing when you consider the complexity of the machine.
It takes about a week for the manufacturer to demonstrate that the equipment meets their specifications and then we get our hands on it in the physics department.
The ‘commissioning’, as we call it, takes a little less than three months for a machine of this type and involves a large number of measurements to ensure the radiation is delivered accurately and to characterise the generated x-rays.
The data we collect forms a beam model in a computer (treatment planning system), used to design these highly complex patient treatments, so it’s worth taking the time to get it right.
Each Linac will likely treat around 5,000 patients in its lifetime, which means the quality of the data is key to curing cancer and avoiding radiation damage.
How is Jupiter 2 maintained?
We have a small team of two specialist Linac engineers who provide routine monthly servicing and front line maintenance.
They are the first port of call every time we have a breakdown on one of our radiotherapy machines and are responsible for getting them up and running as quickly as possible (they were recently awarded star of the month for their dedication in keeping our service running).
In addition, we have a full manufacturer service three times a year and our physicists perform routine monthly quality assurance procedures over several days /month for each machine.
There is a lot to test!
What’s the reaction been to the new machine?
The staff love these machines as they are quick and easy to use and offer the best standard of care for our patients.
Patients have already noticed that the treatments seem to take less time, which means a lot when your treatment involves as many as 30 individual sessions!
The new machine delivers the highest standard of care available in radiotherapy, which we hope translates to improved patient comfort and experience and better outcomes.
For more information, please contact Ondree Severn, head of physical dosimetry.