Medical physicist Anath Ravi (left) and radiation oncologist Dr. Eric Leung review imaging from the MR-Brachytherapy Suite. (Photography by Kevin Van Paassen)
Treating cervical and other gynecological cancers used to require an uncomfortable procedure and overnight stay at the hospital. Now, with the help of an innovative imaging and operating suite at Sunnybrook, some patients can receive treatment in hours rather than days – all with minimal discomfort.
Sunnybrook’s specialized MRI-Brachytherapy Suite combines the power of magnetic resonance imaging (MRI) with an operating room and radiation bunker. In this space, doctors can pinpoint tumours and place a radiation source directly into cancerous tissue, while using MRI to observe the treatment “in real time,” says Sunnybrook radiation oncologist Dr. Eric Leung.
The entire procedure, known as gynecological interstitial brachytherapy, can be performed in adjoining rooms, rather than transporting a patient between imaging and operating suites across the hospital. This has turned a lengthy treatment, which previously took up to 48 hours, into an outpatient procedure that is quicker and less painful.
During a gynecological interstitial brachytherapy, MRI is used to guide the placement of a tube-shaped applicator and around 20 thin needles that deliver large doses of radiation to the vagina, cervix or uterus while avoiding healthy, sensitive tissue.
Prior to the suite, patients would have to wait for a few hours – awake – with the applicator inserted, which many people found uncomfortable or painful. They were also awake for the applicator removal.
“Importantly, the treatment can now be done while a patient is under anesthesia,” Dr. Leung says.
Sunnybrook’s efforts to improve the treatment haven’t stopped there. Ananth Ravi, PhD, lead brachytherapy medical physicist, is testing new electromagnet technology to guide needle placement and increase precision during the procedure.
“Our brachytherapy team is excited by this leap forward in the evolution of our program,” Ravi says. “The efforts of our team and the introduction of innovative technologies enable us to deliver not just effective, but [also] truly compassionate, patient-centred care.”