Stereotactic radiosurgery
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Stereotactic Radiosurgery. By Angela Powers, RN. Objectives. Describe the trend of Stereotactic Radiosurgery. Describe/evaluate hardware/software utilized. Describe/evaluate information systems used. Assess role of the nurse informaticist. Examine legal and ethical issues involved.

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Stereotactic Radiosurgery

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Stereotactic radiosurgery

Stereotactic Radiosurgery

By Angela Powers, RN


Objectives

Objectives

  • Describe the trend of Stereotactic Radiosurgery.

  • Describe/evaluate hardware/software utilized.

  • Describe/evaluate information systems used.

  • Assess role of the nurse informaticist.

  • Examine legal and ethical issues involved.

  • Discuss advantages/disadvantages from nursing perspective.


Stereotactic radiosurgery1

Stereotactic Radiosurgery:

  • Treats brain disorders with a single, high dose of radiation.

  • Works the same as other radiation therapies.

  • Doesn't remove tumor, but distorts it's DNA.

  • Causes tumors to lose ability to reproduce.

    (International Radiosurgery Association, 2010)


Procedure

Procedure:

(Mongia, 2009)


Hardware

Hardware

  • MRI

  • Linear Accelerator

  • Collimator

  • Patient Docking Device

  • Target Verification Device


Linac

LINAC

  • Short for Linear Accelerator.

  • Produces radiation needed in SRT procedures.

  • Operated by a Radiation Therapist.

  • Dosage calculated by a Radiation Oncologist.

  • Beam exits through the rotating Gantry.

  • Beams are shaped by the Collimator.

(Montagno & Sabbatini, 1997)


Software

Software

  • Three dimensional software for treatment planning.

  • Dose delivery software.


Stereotactic radiosurgery

  • NovalisTX:

(Jefferson Radiation Oncology, 2010)


Usability

Usability

  • Ease of Use

  • Ease of Learning

  • Satisfaction with Using

  • Efficiency of Use

  • Error Tolerance

  • Fit of System to the Task


Varian oncoview picture archiving and communication system pacs

Varian OncoView Picture Archiving and Communication System (PACS)

  • Collects, stores and distributes diagnostic images.

  • Digitalizes CT, MRI and X-ray results.

  • Enables ease of image sharing.

  • Enables collaborative approach to treatment.

  • Reduces data filing and retrieval times.

  • Saves time and money.

  • Reduces liability caused by errors and loss.

(Varian Medical Systems, 2010)


Varian oncoview pacs system review

Varian OncoView PACS System Review

  • Radiology Information System

  • Used by all members of team.

  • Enables digitalization of image results.

  • Generally part of Local Area Network.

  • HL7 and ANSI Data Standards.

  • Necessary for use of SRS.


Advantages of srs

Advantages of SRS

  • Simpler Process

  • Shorter surgery times

  • Shorter patient recovery times

  • Less invasive

  • Fewer side effects vs. brain surgery.

  • Ability to reach deeper brain tissue.


Disadvantages of srs

Disadvantages of SRS

  • High cost of purchase and use

  • Risk of neurological injury

  • Risk of mechanical inaccuracy

  • Potential necessity of multiple visits


Ethical legal issues

Ethical/Legal Issues

  • Not available to everyone

  • Malpractice suits


Required informatics competencies and role of nurse informaticist

Required Informatics Competencies and Role of Nurse Informaticist

  • Technical competencies - Modifier level

  • Utility competencies - Modifier level

  • Leadership competencies - User level


Functions and responsibilities of informatics nurses in srs

Functions and Responsibilities of Informatics Nurses in SRS

  • Technical capacities

  • Utility capacities

  • Leadership capacities

(Kaminski, 2009)


In summary

In Summary:

  • Often outpatient procedure for brain surgery

  • High dose radiation distorts tumor DNA

  • Improved outcomes for many conditions

  • Reduced surgery and recovery time

  • Multidisciplinary team involved in planning, implementation.


References

References:

  • About.com. (nd). PACS – What is PACS? Retrieved October 25, 2010, from: http://healthcareers.about.com/od/p/f/PACS.htm.

  • De AraujoMontagno, & E., Sabbatini, R. (1997). Radiosurgery. Retrieved October 15th, 2010 from: http://www.cerebromente.org.br/n02/tecnologia/radiocirurg_i.htm.

  • HL7 International. (2010). ANSI Approved Standards. Health Level Seven International. Retrieved October 25, 2010, from: http://www.hl7.org/implement/standards/ansiapproved.cfm

  • International Radiosurgery Association. (2010). Stereotactic Radiosurgery Overview. International Radiosurgery Association.Retrieved on September 19, 2010, from: http://www.irsa.org/radiosurgery.html.


References continued

References, Continued

  • Jefferson Radiation Oncology. (2010). Novalis TX. Retrieved October 9, 2010, from: http://www.jeffradonc.com/page.php?pID=21.

  • Johns Hopkins Radiosurgery. (nd). Stereotactic Radiosurgery. Johns Hopkins Medicine. Retrieved October 9, 2010, from: http://www.radonc.jhmi.edu/radiosurgery/treatmentoptions/stereotacticradiosurgery.html#WhatDevicesAreUsed.

  • Kaminski, J. (2009). Nursing Informatics Competencies: Self-Assessment. Nursing-Informatics.com. Retrieved November 15, 2010, from: : http://www.nursing-informatics.com/niassess/index.html.


References continued1

References, Continued

  • McGonigle, D. & Mastrian, K. (2009). Nursing Informatics and the Foundation of Knowledge. Sudbury, MA. Jones and Bartlett Publishers.

  • Medical News Today. (Sept, 2008). Non-Invasive Radiosurgery With Novalis TX platform Rolling Out Worldwide. Medical News Today. Retrieved on September 19, 2010, from: http://www.medicalnewstoday.com/articles/122391.php

  • Mongia, S. (2009). Gamma Knife Surgery. Retrieved on October 1, 2010, from gammaknifeonline: http://www.gammaknifeonline.in/.


References continued2

References, Continued

  • Radiologyinfo.org. (2010). Stereotactic Radiosurgery and Stereotactic Body Radiotherapy (SBRT). Retrieved on October 1, 2010, from radiologyinfo.org: http://www.radiologyinfo.org/en/info.cfm?pg=stereotactic.

  • Schnell, M., Bova, F., Larson, D. A., Leavitt. D. D., Lutz, W. R., Podgorsak, E. B., Wu, A. (1995). Stereotactic Radiosurgery: Report of Task Group 42 Radiation Therapy Committee. College Park, MD. American Institute of Physics. Retrieved October 9, 2010, from : http://www.aapm.org/pubs/reports/rpt_54.pdf.


References continued3

References, Continued.

  • Varian Medical Systems. (2010). TrueBeamSTx: Frequently Asked Questions. Retrieved October 9, 2010, from: http://www.variantruebeam.com/truebeamstx/faq.html


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