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Radiation oncologists focus on digital technologies

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IMRT leads surge in capital equipment purchases Increasing budgets are allowing the rapid adoption of advanced therapeutic techniques, according to a study released March 10 by IMV Medical Information Division.

IMRT leads surge in capital equipment purchases

Increasing budgets are allowing the rapid adoption of advanced therapeutic techniques, according to a study released March 10 by IMV Medical Information Division. Intensity-modulated radiotherapy is at the forefront of those techniques. The IMV survey found that 38% of sites performing radiation therapy applied IMRT in 2003, up from 4% in 1998. Other technologies for planning and therapy are also being embraced, as well as electronic networks, whose acceptance signals a waning reliance on film-based x-rays for treatment planning.

To support the introduction into clinical use of these digital technologies, budgets are surging. IMV estimates the average capital equipment budget for radiation oncology this year will be $980,000-up 34% from last year. The percentage of sites with budgets in excess of $1.5 million increased from 9% in 1996 to 18% this year.

Much of the growth in IMRT usage has come over the past three years. Use of this technology among sites grew from 4% to 10% between 1998 and 2000, then jumped more than 9% on average in each of the next three years. And IMRT still has a lot of room to grow, according to Lorna Young, senior director of market research at IMV, which is based in Des Plaines, IL.

"If people follow through on their intentions, it could double over the next three years," she said.

Questions about future equipment purchases, which appear on all IMV surveys, indicate only interest in acquiring new technology-not definite plans to do so, Young said. At the very least, however, the interest in IMRT shown by respondents puts this technology at the top of the list of equipment to be purchased.

Also on that list are two planning technologies that promise to increase the precision of radiotherapy: inverse planning and 3D treatment planning. Therapeutic technologies accompanying IMRT on the list are conformal radiotherapy, intraoperative radiation therapy, stereotactic radiosurgery, and prostate seed implantation. Some of these technologies are being taken up at a much slower rate than IMRT. Growth in the number of sites performing prostate preplanning for seed implantation, for example, is showing signs of flattening out, Young said.

In addition to their adoption of clinical techniques, sites are increasing their use of electronic networks to send and receive digital images such as CT and MR scans. In 2003, IMV found that 62% of radiation oncology sites used electronic networks, compared with 24% in 1998. The networks are replacing x-ray film, Young said.

"The digital world is finally making some headway into radiation oncology, which until lately has been largely film-based," she said. "In so doing, manufacturers have been able to start taking advantage of what CT and MR can contribute to planning."

The 2003 edition of the Radiation Oncology Census Database profiles 1642 sites-more than 80% of the 2009 facilities identified as performing external-beam radiation therapy treatments in the U.S. The database can be licensed by qualified subscribers and includes site-specific information such as equipment utilization by manufacturer, radioactive agent utilization by type, prostate seed utilization by supplier, and planned purchases. IMV licenses its data to companies seeking a comprehensive analysis of the radiation oncology market, and compares nationwide trends with its four prior census surveys conducted since 1996.

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