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Case studies

Simulating radiation therapy using virtual reality

Creating a safe environment for training clinicians and enhancing treatment accuracy

Case study

The challenge

Radiation therapy is a complex process used for treating solid cancers, in which professionals must be able to understand the spatial relationships in the patient anatomy. Due to the high risks involved in radiotherapy, clinical training is fundamental to ensure safety. However, training in the clinic itself with patients is potentially risk-prone and can create anxiety for the patients.

Virtual reality (VR) systems provide a solution to these issues. Through a 3D immersive view of the treatment room, radiographers, students and other clinical staff can interact with fully articulated, life-size visualisations of the treatment machines. In this safe environment, trainees can simulate clinical situations and explore the effects of mistreatments without the associated risks to real patients. Simulations are fundamental to learn about dosimetry and the effects of radiation on the patient's organs. Real-life patient data can be loaded onto the VR system to achieve a greater understanding of clinical scenarios by visualisation of the dose delivery to the diseased organs and seeing how the non-involved tissues should be spared. The importance of absolute precision can be visualised in a manner not possible in the actual clinical treatment rooms.

However, the leading VR technology available to the radiotherapy community only displays static anatomical images and does not consider the patient's natural movements such as breathing. Furthermore, it has only recently started to account for other real-life variables, such as machine calibration and instrument fluctuations. These issues have prevented VR systems fully replacing live-patient training.

The solution

Through NPL's medical imaging accelerator for industry programme, funded through the Industrial Strategy Challenge Fund, NPL worked with Vertual Ltd. This UK company develops quality-control devices and models to understand the uncertainties associated with real clinical settings and incorporate them into Vertual's VR systems. A thorough study of the patient's movement in real-life allowed realistic motion and variation in the clinical environment to be reproduced in the VR treatment room. With these improvements, trainees can gain an increased understanding of the impact of motion on the dosimetry for the patient. In addition, by increasing the understanding of instrumentation uncertainty, it is possible to appreciate the importance of repeated measurements in the dosimetry associated with radiation therapy treatment.

The impact

Vertual's VR system (VERT) is currently used by universities and teaching hospitals across the UK and 30 other countries worldwide for training students and support specialists continue their professional development. VERT allows experimenting with new technologies before implementing them on patients, as well as understanding the implications of instrument variation.

The improved product developed in partnership with NPL will expand the current commercial uses of VERT, with possible applications in the patient-clinician relationship domain. Professionals may use VR to simulate with precision the patient's anatomical structure, which the patient can then visualise before proceeding with treatment. This has the potential to increase patients' confidence and trust in radiation therapy, enable them to understand how treatments will impact their organs and provides greater clarity about radiotherapy procedures.

About the customer

Vertual Ltd is the leading provider of virtual reality training systems in radiation therapy. Their virtual reality system VERT is used to train radiographers and physicists in universities and teaching hospitals in 32 countries across the world, with new customers choosing to use the VERT training system every year.

The company was formed in 2007 by three founder members as a spin-off company from a joint research project involving the University of Hull and East Yorkshire Hospital Trust. The VERT system was commercialised the following year and research and development on this product, along with new virtual reality training products, continues to be their focus.

Their aim is to create a range of virtual reality training solutions for both the healthcare sector and other sectors that require hands-on technical training in a safe simulated environment.

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