BrainLab, Varian build radiosurgery hybrid

Best-of-breed technologies from BrainLab and Varian Medical Systems have been combined to form what the companies are calling the most powerful and advanced radiosurgery system on the market.

Introduced Sept. 17 at the Congress of Neurological Surgeons in San Diego, the Novalis Tx is part of each company's portfolio.

This is the latest development from a collaboration that goes back to 1996, when Varian and BrainLab combined their technologies to create the Novalis line of radiosurgery products. Novalis Tx stands out for its flexibility, not only among the Novalis line, but also compared with competitors' systems.

"We like to think of this as the sharpest, most precise, and most versatile scalpel in neurosurgery," Dow Wilson, president of Varian oncology systems, told DI SCAN.

Novalis Tx stands to outperform two other high-priced radiosurgery units, the Gamma Knife and Cyber Knife, according to Wilson. Industry estimates put prices for these products between $2.5 million and $4 million, depending on configurations.

A price has not yet been set for Novalis Tx, which will begin shipping by the end of October.

"It has been released for production," said Joseph Doyle, CFO and COO of BrainLab. "It will take three to four weeks to put one together."

Unlike other radiosurgery products currently on the market, Novalis Tx is not limited to a 6 million electron volt (MEV) energy level, according to Doyle. Rather, it can dispense beams at either 6 MEV or at least 10 MEV. The higher energy allows for treating deep-seated tumors while effectively sparing surrounding healthy tissue.

"If you are treating the prostate of a large patient, you will see higher energy being used because of having to penetrate deeper tissue," he said. "Typically, for treating the brain, 6 MEV is used."

The ability to deliver the highest dose rates in the industry, dynamic beam shaping, and frameless patient positioning translates into more rapid, effective, and comfortable treatments, according to Varian.

Physicians will be able to treat more patients per day than with any other radiosurgery system on the market, Doyle said.

Novalis Tx addresses the widest range of conditions of any commercial radiosurgery device, according to the companies. These include malignant and benign lesions, brain metastases, arteriovascular malformations, and neurological conditions such as trigeminal neuralgia (tic douloureaux) and acoustic schwannoma.

The hybrid is composed of Varian's Trilogy Tx linear accelerator and new HD120 multileaf collimator. Recently cleared by the FDA, the collimator allows ultrafine beam shaping. Reducing the width of the beam-shaping central leaves from the previous standard of 5 mm to 2.5 mm increases precision.

"It means we can really target the smallest of structures for radiosurgery," Wilson said. "It makes (the Novalis Tx) the most precise device on the market for delivering radiation to tumors."

Precise targeting is assisted by a comprehensive image guidance system configurable with Varian's OnBoard Imager, which allows 2D radiographic and fluoroscopic imaging, or BrainLab's room-mounted x-ray imaging system for real-time imaging and motion management. Coupled with BrainLab's 6D robotic couch, this system can offer fast and accurate patient setup and positioning, according to the companies. BrainLab also contributed its iPLAN treatment planning software, which is complemented by Varian's Eclipse treatment planning and ARIA information management software.