‘The outcome from planned to delivery is fantastic‘

Interview with Aaron A. Kempenich

Patient QA on Radixact with Synchrony

Altru Cancer Center uses the Delta4 HexaMotion platform when performing QA on the Accuray Radixact with Synchrony. Aaron A. Kempenich describes the QA process, workflow, and the outcomes from planned to delivered.

Aaron A. Kempenich, MSc, DABR, RSO is a medical physicist and Radiation Safety Officer at the Altru Cancer Center in Grand Forks, ND.

‘Nothing can beat it‘

On the border of North Dakota and Minnesota lies the city of Grand Forks. Here resides Medical Physicist Aaron A. Kempenich, giving his all to make sure cancer patients get the best and safest treatment at the Altru Cancer Clinic. Altru Cancer Clinic is our second stop on a digital journey that lets us meet with Delta4 users across the world!

We have met with Aaron A. Kempenich, Medical Physicist and Radiation Safety Officer at the Altru Cancer Center in Grand Forks. Aaron and his six colleagues treat around 40 patients a day using two linac vaults; one with Accuray Tomo Hi-ART and one with Accuray Radixact with Synchrony. We asked Aaron about his job as a medical physicist, the patient QA process and workflow, and what one shouldn´t miss when visiting Grand Forks and North Dakota.

Describe your patient QA process and workflow

For patient QA on the Radixact with Synchrony, the Delta4 Phantom+ with the Delta4 HexaMotion is made for it. I have the phantom moving like the patient´s breathing motion and can adjust the breathing to be a realistic breathing pattern; Erratic for the anxious people, deep and slow as our many typical farming type men around here, or somewhere between. While this is happening, I have the machine track and deliver the dose prescribed by the oncologist to the tumor in that patient. The Delta4 Phantom+ with Delta4 Hexamotion helps me feel assured that my machine can deliver the dose that is promised to the patient, that it is done safely, and I get fantastic results from it.

Describe the outcomes from planned to delivery?

The outcome from planned to delivery is fantastic. With the Accuray Radixact with Synchrony in coordination with the Delta4 motion QA solution, I can see the plan that was created and approved by the doctor. I can deliver the QA plan on the systems and analyze it. The results I have gotten have a 4-sigma precision: 99.999% at 1 mm/1% – while it is in motion using the Radixact Synchrony and Delta4 Phantom+ with Hexamotion. Nothing can beat it!

What features were important when considering the QA solution?

Letting the machine with the phantom move realistically- be it a respiratory cycle of a patient´s breathing, or even a prostate system where it’s random omni-static placement, I can only do it with Delta4 Hexamotion and Delta4 Phantom+. No other system has that capability and without it, I would be unable to safely deliver the treatment to the patients.

No other system has that capability and without it, I would be unable to safely deliver the treatment to the patients.

What are the best features of Delta4?

The best features are the simplicity of the software, the fast and simple setup, and the lack of wires. The wireless communication is a unique feature that I find great. We also have wonderful support from the ScandiDos team. I can call the physicists or the technicians and they know me by the first name and answer quickly. They dutifully search for solutions, as I would, and I appreciate that.

How long does it take to QA a plan?

In a plan QA, it depends on the complexity of the plan. But outside the time of the treatment itself, using the Delta4 motion QA solution is really short since the setup only takes about 5 minutes. After set up, I can run the QAs of various patients in a row, and the time per patient, other than the treatment time, would be about 3 to 4 minutes.

What’s your clinic’s relationship with ScandiDos?

Our relationship with Scandidos is new as this is the first Delta4 system that we had when we went clinical in November 2020. However, the relationship became intimate and close as the Altru Cancer Center was the second site in the world, and the first non-academic site in the world, to use the Radixact Synchrony on a patient. The first site was in Wisconsin at the teaching university Froedtert Hospital. With the Delta4 motion QA solution, I felt secure and safe to be able to deliver my treatment to the patient. I threw a whole bunch of wild variables in it, using the Delta4 features and it delivered accurate, pure results as I expected.

What do you like best about your job as a medical physicist?

As corny as it may be, is that I get to help people. I want to deliver the best treatments, I want to make sure they are delivered appropriately, and that the patient gets what they need. I treat each patient as it be my wife or my daughters. If I wouldn’t deliver treatment to my wife or my daughters, I would not deliver a single plan to any patient at all.

Did you face any work challenges due to the pandemic and how did you adapt?

The pandemic, as around the world, was an interesting time. While a lot of places in the economy around the world slowed down and shut down, our population actually increased. I was working 5,6, 7 days a week – continually just trying to keep up with all the patients we had come and get treatment.

What do you think a visitor should not miss when visiting Grand Fork?

Grand Forks is known for many things. Historically it was a trading point but now it is popular due to the cold long winters that enable winter sports; Curling, oh I love to curl- and eg hockey. Another wonderful thing in Grand Forks is the University of North Dakota where I did my undergrad and graduate schooling. There is also the North Dakota Museum of Art, which is a shining stone in this pond of North Dakota that brings us culture from around the world. Special to this area are the sunrises and sunsets that are parallel to none other than the sunrises and sunsets of maybe Santa Fe. It’s a 360-degree sunset that people brag about forever. Also, as sweet as our sunsets are, the honey around here is really something extra. I know a humble honey farmer whose honey is worth more than gold per ounce, so I dare to say we might have the best honey in the world.

Animation of the Delta4 Motion QA Solution.

Your ideal solution for Motion management QA

Delta4 HexaMotion is a motion platform that recreates the movement of the tumor in six dimensions and independently simulates patient breathing motion. Together with Delta4 Phantom+, it ensures tumor control in moving targets and answers the vital questions:

  • Am I hitting the target?
  • What do I gain with tumor tracking or gating?

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