Radiotherapy Simulation Systems

 Radiotherapy Simulation Systems

Scope of this Product Comparison
This Product Comparison covers radiographic/fluoroscopic (R/F) and computed tomography (CT)
radiotherapy simulation systems. Chart A covers stand-alone radiotherapy simulators with radiographic/
fluoroscopic (R/F) imaging capability; some models also offer CT simulation. Chart B covers CT-based simulation
systems consisting of hardware and software used in conjunction with CT scanners. (See the Product Comparison
titled Scanning Systems, CT, Full-Body for more information on CT scanners.)

Purpose
A radiotherapy simulation system replicates the motions of a
radiotherapy treatment unit (see the Product Comparison titled Linear
Accelerators; Radiotherapy Units, Cobalt) to delineate (by radiographic,
fluoroscopic, or CT imaging) the tumor site and volume to be treated. The
two principal goals of radiation therapy simulation and planning are to
define the tumor volume (the region of the actual tumor and the
surrounding tissues that are considered to be at risk) and develop a
treatment technique that delivers a homogeneous dose of radiation to the
tumor while minimizing the dose to surrounding normal tissues. A
radiotherapy simulation system can localize the tumor and accurately
duplicate patient positioning for the specific radiotherapy treatment unit.
Combining technologies from both therapeutic and diagnostic radiology, a simulation system mimics the
movements of a linear accelerator. However, instead of emitting high-energy radiation, the system provides x-ray
imaging to determine, document, and externally mark the area to be treated. Once the potential field of
irradiation is established, areas or organs to be excluded from radiation treatment can be delineated. Some
simulators can also be used for planning brachytherapy treatment (see the Product Comparison titled
Brachytherapy Systems, Remote Afterloading).
Before the first treatment, the patient’s position is verified on the
radiotherapy unit itself with port films or electronic portal images.
Although they reveal only vague outlines of tissue densities, port UMDNS Information
films are adequate for comparison with the simulation films to
This Product Comparison covers the following
ensure exact replication of positioning, field size, and direction of device terms and product codes as listed in ECRI
the beam. Port films are taken at least weekly to document the Institute’s Universal Medical Device
Nomenclature System™ (UMDNS™):
accuracy of the prescribed radiation treatment.
Radiotherapy Simulation Systems [13-280]
CT-based simulation systems use a CT scanner with specialized Radiotherapy Simulation Systems, Computed
Tomography-Based [20-548]
hardware and software for radiotherapy simulation and treatment Radiotherapy Simulation Systems,
field delineation. Usually, the scanner is networked to a treatment Radiographic/Fluoroscopic-Based [20-547]
planning workstation. These systems are also called virtual

5200 Butler Pike, Plymouth Meeting, PA 19462-1298, USA  Tel +1 (610) 825-6000  Fax +1 (610) 834-1275  Web www.ecri.org  E-mail hpcs@ecri.org
Radiotherapy Simulation Systems

simulators because they allow patient marking without necessitating the generation of a treatment plan. In CT-
based simulation, the tumor is delineated on CT slices, the target volume is determined using a treatment
planning computer, and the treatment field is selected. The CT-based simulation system is then used to mark the
patient for radiation treatment; thus, imaging, treatment planning, treatment field delineation, and patient
marking can be accomplished in a single session. CT-based systems are also used for verification of tumor
margins and surrounding anatomy, posttreatment tracking of tumor regression, and 3-dimensional (3-D) image
analysis for multileaf collimators and conformal radiotherapy.

Principles of operation
Radiotherapy simulators
Radiotherapy simulators rotate 360° around a patient to define a tumor volume and navigate it to the
isocenter—the specified point of rotation that remains constant throughout treatment simulation. Isocenter
heights typically range from 120 to 127 cm. Most simulators use a Class II laser system to demarcate the isocenter.
Once the tumor volume has been delineated and positioned at the isocenter, it can be irradiated from any angle,
and irradiation of healthy organs can be avoided.
Localizing the tumor volume during simulation requires replicating certain mechanical and design features of
a typical radiotherapy unit and conventional radiographic and/or fluoroscopic equipment. The simulator must be
able to mimic basic motions and readouts of treatment units, avoid collisions while still allowing 360° rotation,
incorporate imaging systems, and maintain certain mechanical tolerances.
The simulator is composed of an x-ray system and a mechanical system and is capable of six major motions:
gantry rotation, focus-to-axis distance (FAD) adjustment, collimator rotation, image intensifier translation (lateral,
longitudinal, and radial), table translation (vertical, longitudinal, and lateral), and table rotation (around the
isocenter and pedestal).

The x-ray system

The x-ray system consists of the x-ray generator, the x-ray tube, and the image intensifier. The x-ray generator
modifies incoming voltage and current (mA) to provide the x-ray tube with the power needed to produce an x-
ray beam. Three-phase generators are used with simulators; they offer a number of advantages over single-phase
generators including higher tube currents at very short exposure times, nearly constant potential, and higher
effective kVp.
The size of the focal spot (the target point on the face of the anode), anode angle, exposure rating, and rotation
speed should also be considered. In treatment simulation, small focal spots are preferred because they enhance
details and minimize the width of the image of the treatment area. Because the imaged x-ray field for most
simulators is 45 to 50 cm2, a 12° to 15° anode angle is adequate; a 12° anode angle effectively covers a 40 cm 2 field,
and a 15° angle covers a 50 cm2 field with an increase in asymmetric magnification of the image-defining lines.
Some manufacturers offer biangle tubes, which are tubes with two adjustable anode angles.
A 23 or 30 cm image intensifier is usually adequate for simulators with fluoroscopy, although larger sizes are
available. Fluoroscopic images are usually displayed on the TV monitor and can be stored on videotape or film
using a cine or photospot camera mounted on the image intensifier or stored digitally. Instead of an image
intensifier, solid-state flat-panel detectors have also been incorporated into imaging systems for simulating
radiotherapy treatments.
The image intensifier usually has a cassette attached to its top surface to hold radiographic film. The maximum
allowable film size can differ among manufacturers; however, 35 × 43 cm (14 × 17 in) film is most often used for
simulation. A radiation grid, which consists of a series of lead-foil strips that absorb scatter radiation, is
commonly located in front of the cassette. Grid ratio, defined as the ratio of the height of the lead strips to the

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distance between them, expresses the grid’s ability to remove scatter radiation. Average grid ratios are 8:1, 10:1,
and 12:1; grids with high ratios provide maximum contrast. A focused grid (which has angled lead strips) is most
often used.
A tray assembly with shielding trays (also called shadow or block trays) is available for most simulators and is
located below the collimator. Custom-shaped lead blocks are placed in the trays to prevent the x-ray beam from
irradiating excluded parts of the treatment field. These trays should be adjustable to match the focus-to-tray
distances for all simulated therapy units.

The mechanical system

The simulator’s mechanical system includes the collimator,
gantry, table, and controls. The collimator is located in the x-
ray tube housing and consists of adjustable lead or metal
diaphragms (most of which are motorized) that block the x-
ray beam, thereby limiting and shaping the treatment field to
avoid irradiating healthy areas. Collimator rotation of at least
90° should be available to facilitate simulation of half-blocked
fields for field matching of the therapy units. Collimator
rotation ranges from ±50° to 360°. Raising or lowering the
collimator assembly varies the source-to-axis distance (SAD),
which is the distance from the focal spot of the x-ray tube to
the isocenter; this is also referred to as FAD. A SAD range of
50 to 150 cm is typical for most simulators.
Located in the collimator assembly, field-defining wires
delineate the treatment area. Two pairs of wires, 0.5 mm in
diameter, can be moved to define rectangular field sizes from
3 × 3 cm to 45 × 45 cm. The wires must be able to simulate the maximum treatment field size (40 × 40 cm at 100 cm
SAD) for all treatment units. Most simulators exceed this maximum by 5 to 10 cm at 100 cm SAD, thereby
providing a conveniently visible margin around the largest treatment field.
Some simulators provide completely independent motion of the x and y axes of the collimators and field-
defining wires, allowing simulation of asymmetric and half-blocked fields. This independent motion also helps
reduce scatter radiation during fluoroscopic scanning of the lateral edges of the x-ray field. In some units,
independent field-wire movement is controlled and displayed by a microcomputer.
The gantry, which is usually floor or wall mounted with a stable motorized mechanism for rotation, supports
the x-ray tube, collimator, field-defining wires, and image intensifier in proper alignment with the central axis of
the x-ray beam and the gantry’s axis of rotation. A 360° gantry rotation is available for SADs of up to 100 cm;
SADs exceeding 100 cm usually require a floor pit or a higher isocenter. Some systems provide automatic
stopping at several user-selectable SADs, as well as at certain preset angles such as 0°, 90°, 180°, and 270°.
Matching the gantry angle scale of the simulator with that of the treatment unit should be discussed with the
manufacturer before purchasing the simulator. Gantry rotation speeds are usually variable to permit either fine
adjustment or rapid changing from the anteroposterior (beam-up orientation) or posteroanterior (inverted beam)
ports of the isocentric point. At beam-up orientation, the focus-to-tabletop distance must be great enough to
accommodate the maximum source-to-skin distance (SSD), which is 100 cm.
The simulator table or couch is usually motorized and has two variable speeds in all motions except for
rotation around the pedestal. Lateral, longitudinal, and vertical motorized motions can be controlled from both
the simulator and the remote control room. The couch is mounted so that it rotates and moves vertically around
the isocenter. Tabletops range from 45 to 51 cm wide and 219 to 274 cm long, remain horizontal as the patient is
positioned, and should rise to or above the isocenter to provide a 100 cm SSD when the beam is directed upward.

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Radiotherapy Simulation Systems

Simulator tables that require a deep pit in the floor can usually be lowered to facilitate patient access; however,
the presence of the image intensifier under the table can limit the minimum table height. If the table is supported
on wheels, special railing and flooring may be necessary to ensure stability.
The patient couch should be identical to that of the radiotherapy treatment unit to guarantee proper
positioning of the patient for treatment. Couch accessories, such as armrests or headrests, should also be similar
to those of the treatment unit. In addition, the table must be radiolucent so that it does not degrade the images
produced.
An isocentric chair that is compatible with existing simulators has been developed for radiotherapy simulation
and treatment in the upright position. The chair is positioned under the gantry arm, between the image intensifier
and the x-ray head; after the gantry is rotated to the lateral position, the base of the chair is locked into place to
produce a stable platform. A laser located on the ceiling can be used to verify the chair’s isocenter. Mediastinal
tumors and head and neck tumors and lesions can be more effectively imaged and treated in the upright position;
both treatment and simulation in the anteroposterior-posteroanterior, opposed lateral, and multiple oblique field
orientations are possible with this chair design. One manufacturer currently offers an isocentric chair as an
option.
Controls for table movement, gantry rotation, SAD adjustment, collimator rotation and diaphragm adjustment,
field-defining wire adjustment, and image intensifier translation should be located in the simulator room. A
ceiling-mounted pendant that allows easy tableside access to these local controls is generally provided in the
simulator room. Controls for the x-ray generator should be located in a separate remote control room (adjacent to
the simulator room), along with a control console duplicating the local controls and including controls for SAD,
gantry angle, and field size. Both the local and remote control devices usually provide digital readouts.
Anticollision devices are used to safeguard equipment and protect the patient from injury. Without these
devices, collisions are likely between the collimator assembly and the patient or tabletop; between the image
intensifier and the patient, tabletop, or floor; and between the x-ray tube housing and the floor. A mechanical
touchbar/microswitch or an electronic position sensor combined with a microprocessor is commonly used as an
anticollision device; both prevent resumption of simulator motion following a possible collision and require the
operator in the simulator room to override the anticollision mechanism. Some units rely on warning lights
activated by an impending collision. Regardless of the system, emergency stop switches should be strategically
placed in both the simulator room and the remote control room.

CT-based simulation systems

CT simulation allows 3-D viewing and planning along with verification images that can be compared with
portal images. CT simulation requires a physical CT scan of the patient followed by virtual simulation, for which
the patient is not required. The goal of CT simulation is to achieve the accuracy of conventional treatment
simulation with the added benefit of 3-D visualization. The advantages of CT simulation over conventional
simulation include the need for only one planning session visit for the patient, volume markup without the
patient present, and minimal patient waiting time.
CT simulators can be standard CT systems with a modified table or specifically configured CT systems with a
large bore. CT simulation can also be performed using a conventional radiotherapy simulator modified by adding
a computer for image reconstruction and data storage and, depending on the manufacturer, by replacing the
image intensifier with a solid-state detector. CT data is used to localize the target volume and reconstruct images
from a beam’s-eye view, which allows patient anatomy to be viewed from the perspective of the radiation source.
However, the performance of a modified simulator will not be comparable to the performance of a CT-based
simulation system; scan times, reconstruction times, and contrast resolution are improved by using a CT scanner.
The hardware and software used for CT-based simulation varies by manufacturer. The laser marking system
uses Class II diode or helium-neon (He-Ne) lasers. Lasers can be installed as a set on the walls and ceiling of the
room or on a gantry.

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Because radiation therapy is administered with the patient on a flat treatment couch, CT scanning is performed
with the patient lying in the treatment position on a flat couch top or removable flat pad insert. (The curved
tabletop used for diagnostic imaging alters the position of internal anatomy in relation to external anatomic
landmarks.) Acquired CT data is transferred via a network to the treatment planning system. Other image data,
such as from positron emission tomography (PET), can be combined with the CT data. The planning workstation
is used to localize the tumor, delineate the target volume, and calculate coordinates to mark the patient’s skin for
radiotherapy. The simulator controls the laser marking system, which indicates where to mark the skin
intersection of the target volume center. Beam’s-eye-view images can be displayed and printed to visualize the
planned treatment beam in relation to anatomy. Digitally reconstructed radiographs (DRRs)—maps representing
beam attenuation along rays drawn from the radiation source—are comparable to simulator films and are
generated at various beam orientations to verify or modify patient positioning, collimator angles, beam width,
SAD, and gantry positioning during treatment.
For electronic transfer of simulation data, the CT-based simulation system can be networked to the treatment
planning system, record-and-verify and digital portal imaging systems, and the linear accelerator using Ethernet
connections and compliance with the Digital Imaging and Communications in Medicine for Radiotherapy
(DICOM RT) Standard. DICOM RT standardizes the way radiotherapy data is transferred from one piece of
equipment to another and among multivendor devices.
For more information, see the following Product Comparisons:
 Radiotherapy Treatment Planning Systems
 Radiotherapy Record and Verify Systems; Portal Digital Imaging Systems
 Linear Accelerators; Radiotherapy Units, Cobalt

Reported problems
Common problems previously included the misalignment of the collimator caused by the weight of the beam
block assembly wearing on the bearings of the x-ray tube housing.
Additionally, inadequate support could cause tabletop deflection when weight greatly exceeding that of the
average patient was applied to the table. Because tabletop deflection can result in inaccurate radiographic
imaging and, hence, inaccurate patient positioning, purchasers should ensure that all tables are installed with
proper support and stabilizing devices.
While computers are used more extensively in radiotherapy, human error remains a possibility. Therefore,
quality assurance procedures remain extremely important.

Purchase considerations
ECRI Institute recommendations
Included in the accompanying comparison charts are ECRI Institute’s recommendations for minimum
performance requirements for R/F and CT radiotherapy simulation systems.
The most important consideration for R/F simulation systems is the ability to position the patient with respect
to the beam in such a way that radiotherapy is simulated as close as possible to the patient. Therefore, the system
should have a SAD ranging from 80 to 150 cm and a source-to-image distance (SID) ranging from 80 to 200 cm
and the gantry should be able to rotate ±150° above and ±180° below a 100 cm SAD. The patient table should be
capable of a wide range of translations (at least 70 cm vertically, ±20 cm laterally, and 100 cm longitudinally) and
rotations (360° pedestal rotation and ±95° isocenter rotation) to allow for proper patient positioning. Also, the
simulator should be capable of ±90° collimator rotations and image intensifier translations of ±20 cm laterally, ±20
cm longitudinally, and 60 cm radially.

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Radiotherapy Simulation Systems

A three-phase x-ray generator is preferred because it allows higher tube currents at very short exposure times,
nearly constant potential, and higher effective kVp. The generator should be capable of radiographic output of 40
to 150 kV, 10 to 800 mA, and up to 1,000 mAs and fluoroscopic output of 40 to 125 kV and up to 20 mA. To
enhance details and minimize the image width of the treatment area, smaller focal spot sizes of 0.6 mm or 1 mm
are preferred. A simulator with an image x-ray field of 45 cm2 at a 100 cm SAD, a 12° anode angle, and a 23 cm
image intensifier with a coverage area of 70 cm2 meets minimum recommendations.
The standard system components for a CT-based radiotherapy simulation system should include the CT
gantry, laser alignment, control console, and workstation. If the CT scanner is not included, then the system
should be capable of interfacing with any DICOM-compatible CT scanner.
There are a number of important CT specifications that purchasers should consider. The scanner should have a
large bore diameter of 70 to 80 cm, a 60 cm maximum field of view, and multislice capability with 0.5, 1, 2, 4, 5,
and 10 mm slice widths. Also, the scanner should have an axial spatial resolution of 10 lp/mm at a 50%
modulation transfer factor and a low-contrast resolution of 4 mm at 0.3% at 2 rads, as well as noise levels of 0.3%
at 3 rads. The system should be able to reconstruct 20 images per second, digitally reconstruct radiographs in less
than 1 second, and instantaneously reconstruct with beam’s-eye-view.
The laser marking system should be configured with three moving diode lasers capable of 635 nm wavelengths
and should have a positioning accuracy within ±0.5 mm and a less than 1.5 mm projected beam pattern; the
system should also produce less than 1 mW power output.
Other important considerations are networking and system interfacing, specifically Transmission Control
Protocol/Internet Protocol Ethernet connections and the ability to interface with any DICOM RT-compatible
radiotherapy treatment planning system.

Other considerations
The radiotherapy simulation suite should include a shielded room for the simulator and x-ray generator, as
well as separate control and treatment planning rooms. The control room, which houses the generator control
panel and the simulator remote controls, should be separated from the simulator room by a large lead- or plate-
glass window. The treatment planning room houses the computer and its peripherals, which should be
compatible with the simulator system.
The installation of some radiotherapy simulation systems may require the use of a pit. The pit—a recessed
portion of the floor—provides both an anchor for the base of the simulator and a conduit for cables and wiring.
Systems that require a pit for operation should have an appropriately planned simulation suite.
Modifying a conventional radiotherapy simulator to perform CT simulation can cost from $250,000 to $300,000,
and adding hardware and software to an existing CT scanner can cost from $160,000 to more than $200,000.
Purchasing a new CT-based simulation system can cost from $400,000 to more than $1,600,000. Buyers should
consider the number of CT simulations that will be performed to determine whether the purchase of a CT scanner
dedicated to simulation is justifiable. If a CT-based simulation package is considered for an existing CT scanner,
buyers should evaluate the potential for conflicts with room use for diagnostic imaging procedures.
With the advances in radiotherapy treatment planning, any hospital currently looking to advance their
radiotherapy services will need a radiotherapy simulation dedicated CT scanner. CT simulation is necessary for
intensity-modulated radiotherapy (IMRT), which allows a high dose of radiation to be delivered to a tumor while
minimizing irradiation of surrounding healthy tissue.

Environmental considerations
As a result of increasing concerns over the environment and the conservation of resources, many
manufacturers have adopted green shipping and production methods, as well as features that improve the energy
efficiency of their products or make them more recyclable. In addition, healthcare facilities and device

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 Radiotherapy Simulation Systems

manufacturers have begun to adopt green initiatives that promote building designs and work practices that
reduce waste and encourage the use of recycled materials.
Some companies are moving to reduce lead and other toxic substances in radiology suites. Tungsten and
plastics can replace select lead parts during manufacturing. In addition, components made from recyclable
materials and systems manufactured in green plants are desirable. A number of manufacturers are redesigning
key system components such as x-ray tubes to reduce energy consumption.
End-of-life costs need to be considered as well. Facilities should look for manufacturers who offer take-back
programs on entire imaging systems or their components. If a supplier does not offer such an arrangement, the
hospital must absorb the costs of disposing of the system according to local environmental protection laws when
it is replaced.

Stage of development
Radiotherapy units have been available since the early 1960s; however, the simulator was not established as an
essential therapeutic tool until the early 1970s, when the linear accelerator—the chief mode of external-beam
radiation therapy—was introduced. CT simulation was introduced in the early 1990s and was frequently used to
complement conventional radiotherapy simulation. However, ongoing developments in radiotherapy, such as
IMRT, multileaf collimators, and conformal therapy, along with the increasing emphasis on digital imaging and
networking different imaging modalities, have stimulated growth in the use of CT simulation. CT is now the
primary modality used for simulation.

Bibliography
Aird EG, Conway J. CT simulation for radiotherapy treatment planning. Br J Radiol 2002 Dec;75(900):937-49.
Barrett A, Dobbs J, Morris S, et al. Practical radiotherapy planning. 4th ed. New York: Oxford University Press; 2009.
Cho PS, Lindsley KL, Douglas JG, et al. Digital radiotherapy simulator. Comput Med Imaging Graph 1998 Jan-
Feb;22(1):1-7.
Hendee WR, Ibbott GS, Hendee EG. Radiation therapy physics. 3rd ed. Hoboken, (NJ): Wiley-Liss; 2004.
Jani SK, ed. CT simulation for radiotherapy. Madison (WI): Medical Physics Publishing; 1993.
Miller RW, Raubitschek AA, Harrington FS, et al. An isocentric chair for the simulation and treatment of radiation
therapy patients. Int J Radiat Oncol Biol Phys 1991 Jul;21(2):469-73.
Nagata Y, Nishidai T, Abe M, et al. CT simulator: a new 3-D planning and simulating system for radiotherapy:
part 2. Clinical application. Int J Radiat Oncol Biol Phys 1990 Mar;18(3):505-13.
Nishidai T, Nagata Y, Takahashi M, et al. CT simulator: a new 3-D planning and simulating system for
radiotherapy: part 1. Description of the system. Int J Radiat Oncol Biol Phys 1990 Mar;18(3):499-504.
Ragan DP, Tongming H, Mesina CF, et al. CT-based simulation with laser patient marking. In: 3-D radiation
treatment planning and conformal therapy: proceedings of an international symposium. Madison (WI):
Medical Physics Publishing; 1993.
Taylor J. Imaging in radiotherapy. London: Croom Helm; 1988.

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Supplier information
Chart A: R/F Radiotherapy Simulation Systems
HUESTIS MEDICAL
Huestis Medical [162412]
PO Box 718
Bristol, RI 02809-0718
Phone: (401) 253-5500, (800) 972-9222 Fax: (401) 253-7350
Internet: http://www.huestismedical.com
E-mail: sales@huestis.com

INVAP
INVAP SE [237889]
Avenida Cmte Luis Piedrabuena 4950
San Carlos de Bariloche R8403CPV
Argentina
Phone: 54 (2944) 409300 Fax: 54 (2944) 409339
Internet: http://www.invap.com.ar
E-mail: marketing@invap.com.ar

NUCLETRON
Nucletron Corp [106839]
8671 Robert Fulton Dr
Columbia, MD 21046
Phone: (410) 312-4100, (800) 336-2249 Fax: (410) 872-4199
Internet: http://www.nucletron.com
E-mail: info@us.nucletron.com

Nucletron Asia Pacific (HK) Ltd [186598]

Room 1005 Tower II Silvercord 30 Canton Road Tsim Sha Tsui
Kowloon
People's Republic of China
Phone: 852 23112683 Fax: 852 23113672
Internet: http://www.nucletron.com
E-mail: general@nucletron.com.hk

Nucletron SA [361441]
Avenida de Castilla 2 Parque Empresarial San Fernando Edificio Francia Planta 2a Esc A
San Fernando de Henares E-28830
Spain
Phone: 34 (918) 250068 Fax: 34 (918) 250069
Internet: http://www.nucletron.com
E-mail: info@es.nucletron.com

Nucletron SAS [361435]

Parc d'Entreprises Val d'Europe Office No 113 4 Boulevard Michael Faraday
Matne la Valle F-77716
France
Phone: 33 (1) 60428868 Fax: 33 (1) 60428785
Internet: http://www.nucletron.com
E-mail: info@fr.nucletron.com

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 Radiotherapy Simulation Systems

SHINVA
Shinva Medical Instruments Co [452207]
Shinva Medical Scientific Zone Zibo New & High Tech Zone
Zibo City 255086
People's Republic of China
Phone: 86 (533) 3587719 Fax: 86 (533) 3587722
Internet: http://www.shinva.com
E-mail: sales@shinva.com

VARIAN ONCOLOGY
Varian Medical Systems Deutschland GmbH [161079]
Alsfelder Strasse 6
Darmstadt D-64289
Germany
Phone: 49 (6151) 73130 Fax: 49 (6151) 703273
Internet: http://www.varianinc.com
E-mail: de.info@varianinc.com

Varian Medical Systems Inc [363973]

3100 Hansen Way
Palo Alto, CA 94304-1129
Phone: (650) 213-8000 Fax: (650) 213-8200
Internet: http://www.varian.com
E-mail: custcare@varian.com

Varian Medical Systems International AG [363212]

Chollerstrasse 38 Postfach
Zug CH-6303
Switzerland
Phone: 41 (41) 7498844 Fax: 41 (41) 7403340
Internet: http://www.varian.com
E-mail: info.europe@ch.varian.com

Varian Technologies Japan [407331]

8/Fl Sumitomo Shibaura Building 4-16-36 Shibaura Minato-ku
Toyko 108-0023
Japan
Phone: 81 (3) 52321239 Fax: 81 (3) 52321244
Internet: http://www.varianjapan.com
E-mail: masami.uchida@varianinc.com

Chart B: CT Simulation Systems

GE HEALTHCARE
GE Healthcare (Hong Kong) [401905]
Room 1102 11/Fl The Lee Gardens 33 Hysan Road
Causeway Bay
People's Republic of China
Phone: 852 21006300 Fax: 852 27831878
Internet: http://www.gehealthcare.com

GE Healthcare USA [439946]

3000 N Grandview Blvd

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Radiotherapy Simulation Systems

Waukesha, WI 53188
Phone: (262) 544-3011, (800) 643-6439 Fax: (262) 544-3384
Internet: http://www.gehealthcare.com

GE Healthcare Spain SA [401910]

Avenida de Europa 22 Parque Empresarial de la Moraleja
Alcobendas (Madrid) E-28108
Spain
Phone: 34 (91) 6632500 Fax: 34 (91) 6632503
Internet: http://www.gehealthcare.com
E-mail: vpinfo@med.ge.com

GE Healthcare France [171319]

11 avenue Morane Saulnier
Velizy Cedex F-78457
France
Phone: 33 (6) 07453493 Fax: 33 (1) 34495202
Internet: http://www.gehealthcare.com
E-mail: xavier.drianne@med.ge.com

PHILIPS
Philips Argentina SA Dept Sistemas Medicos [415453]
Vedia 3892 Cassila 3479
Capital Federal 1429
Argentina
Phone: 54 (11) 45467699 Fax: 55 (11) 45467697
Internet: http://www.medical.philips.com
E-mail: lorenzo.vallerga@philips.com

Philips Healthcare North America [453551]

3000 Minuteman Rd
Andover, MA 01810-1099
Phone: (978) 687-1501, (800) 229-6417
Internet: http://www.healthcare.philips.com
E-mail: medical@philips.com

Philips Healthcare Australasia [453552]

65 Epping Road
North Ryde 2113
Australia
Phone: (800) 251-4000 Fax: 61 (2) 99470240
Internet: http://www.medical.philips.com
E-mail: healthcare.au@philips.com

Philips Medizinische Systeme Austria GmbH [415444]

Triester Strasse 64
Wien A-1100
Austria
Phone: 43 (1) 601012541 Fax: 46 (1) 601011319
Internet: http://www.medical.philips.com
E-mail: pms.austria@philips.com

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 Radiotherapy Simulation Systems

SIEMENS ONCOLOGY
Siemens AG Siemens Health Services [401832]
Hartmannstrasse 16
Erlangen D-91052
Germany
Phone: 49 (9131) 840 Fax: 49 (9131) 842379
Internet: http://www.siemensmedical.com

Siemens Medical Solutions USA Inc Oncology Care Systems Group [399203]
4040 Nelson Ave
Concord, CA 94520-1200
Phone: (925) 246-8200, (888) 826-9702 Fax: (925) 246-8284
Internet: http://www.siemensmedical.com/oncology
E-mail: info@smsocs.com

Siemens Medical Solutions (South Africa) [307478]

300 Jamadel Avenue Halfway House
Midrand 1685
South Africa
Phone: 27 (11) 6522000 Fax: 27 (11) 6522711
Internet: http://www.siemens.co.za
E-mail: uptimeservicesrsa.za@siemens.com

Siemens Healthcare Diagnostics Pte Ltd [452080]

The Siemens Center 60 Macpherson Road
Singapore 348615
Republic of Singapore
Phone: 65 62640900 Fax: 65 62640900
Internet: http://www.medical.siemens.com

TOSHIBA
Toshiba America Medical Systems Inc [101894]
2441 Michelle Dr
Tustin, CA 92780
Phone: (714) 730-5000, (800) 421-1968 Fax: (714) 734-0362
Internet: http://www.medical.toshiba.com
E-mail: info@tams.com

Toshiba Medical Systems Corp Div Toshiba Corp [140664]

1385 Shimoishigami
Otawara-shi 324-8550
Japan
Phone: 81 (287) 266211 Fax: 81 (287) 266050
Internet: http://www.toshiba-medical.co.jp
E-mail: info@tams.com

Toshiba Medical (Australia) Pty Ltd [373230]

12-24 Talavera Road
North Ryde 2113
Australia
Phone: 61 (2) 98878003 Fax: 61 (2) 98874866

Internet: http://www.medical.toshiba.com.au

©2010 ECRI Institute. All Rights Reserved. 11

Radiotherapy Simulation Systems

E-mail: intouch@toshiba-tap.com

Toshiba Medical Systems Europe bv [160817]

Zilverstraat 1
Zoetermeer NL-2718 RP
The Netherlands
Phone: 31 (79) 3689222 Fax: 31 (79) 3689090
Internet: http://www.toshiba-medical.eu
E-mail: tmsnl@tmse.nl

Note: The data in the charts derive from suppliers’ specifications and have not been verified through
independent testing by ECRI Institute or any other agency. Because test methods vary, different products’
specifications are not always comparable. Moreover, products and specifications are subject to frequent changes.
ECRI Institute is not responsible for the quality or validity of the information presented or for any adverse
consequences of acting on such information.
When reading the charts, keep in mind that, unless otherwise noted, the list price does not reflect supplier
discounts. And although we try to indicate which features and characteristics are standard and which are not,
some may be optional, at additional cost.
For those models whose prices were supplied to us in currencies other than U.S. dollars, we have also listed the
conversion to U.S. dollars to facilitate comparison among models. However, keep in mind that exchange rates change
often.

Need to know more?

For further information about the contents of this Product Comparison, contact the HPCS Hotline at +1 (610)
825-6000, ext. 5265; +1 (610) 834-1275 (fax); or hpcs@ecri.org (e-mail).

Last updated November 2010

12 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Policy Statement
The Healthcare Product Comparison System (HPCS) is published by ECRI Institute, a nonprofit organization.
HPCS provides comprehensive information to help healthcare professionals select and purchase diagnostic and
therapeutic capital equipment more effectively in support of improved patient care.
The information in Product Comparisons comes from a number of sources: medical and biomedical
engineering literature, correspondence and discussion with manufacturers and distributors, specifications from
product literature, and ECRI Institute’s Problem Reporting System. While these data are reviewed by qualified
health professionals, they have not been tested by ECRI Institute’s clinical and engineering personnel and are
largely unconfirmed. The Healthcare Product Comparison System and ECRI Institute are not responsible for the
quality or validity of information derived from outside sources or for any adverse consequences of acting on such
information.
The appearance or listing of any item, or the use of a photograph thereof, in the Healthcare Product Comparison
System does not constitute the endorsement or approval of the product’s quality, performance, or value, or of
claims made for it by the manufacturer. The information and photographs published in Product Comparisons
appear at no charge to manufacturers.
Many of the words or model descriptions appearing in the Healthcare Product Comparison System are
proprietary names (e.g., trademarks), even though no reference to this fact may be made. The appearance of any
name without designation as proprietary should not be regarded as a representation that is not the subject of
proprietary rights.
ECRI Institute respects and is impartial to all ethical medical device companies and practices. The Healthcare
Product Comparison System accepts no advertising and has no obligations to any commercial interests. ECRI
Institute and its employees accept no royalties, gifts, finder’s fees, or commissions from the medical device
industry, nor do they own stock in medical device companies. Employees engage in no private consulting work
for the medical device industry.

About ECRI Institute

ECRI Institute, a nonprofit organization, dedicates itself to bringing the discipline of applied scientific research
in healthcare to uncover the best approaches to improving patient care. As pioneers in this science for more than
40 years, ECRI Institute marries experience and independence with the objectivity of evidence-based research.
More than 5,000 healthcare organizations worldwide rely on ECRI Institute’s expertise in patient safety
improvement, risk and quality management, healthcare processes, devices, procedures, and drug technology.
ECRI Institute is one of only a handful of organizations designated as both a Collaborating Center of the World
Health Organization and an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and
Quality. For more information, visit http://www.ecri.org.

©2010 ECRI Institute. All Rights Reserved. 13

Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL ECRI INSTITUTE'S HUESTIS MEDICAL INVAP NUCLETRON

RECOMMENDED
SPECIFICATIONS1
R/F Simulation Systems Huestis*Cascade NT UNISIM Simulix Evolution
WHERE MARKETED Worldwide Worldwide Worldwide
FDA CLEARANCE Yes Not specified Yes
CE MARK (MDD) Yes Not specified Yes
SOURCE-TO-AXIS 80-150 85-165 @ 100 60-120 70-150
DISTANCE (SAD), cm
SOURCE-TO-IMAGE 80-200 94-184 with 22.8 cm II, 84- 72-185 200 AP, 225 lateral
DISTANCE (SID), cm 173 with 30.4 cm II
GANTRY ROTATION
Above 100 cm SAD,° ±150 ±150 ±135 ±165
Below 100 cm SAD,° ±180 ±185 ±185 ±190
Isocentric accuracy at 1 ±1 ±1 ±0.75 radius
100 cm SAD, mm
Motorized speed(s), 10 360 360, 22 Variable
°/min
Mounting Floor Freestanding floor Floor, pit required Floor, 10 cm deep pit
required
ISOCENTER HEIGHT, cm 126 130 126
COLLIMATOR ±90 ±95 ±100 ±180
ROTATION,°
IMAGE INTENSIFIER
Size, cm ≤23 30.4 standard 15 or 23 41 x 41
Area coverage, cm 70 x 70 70.4 x 70.4 with 30.4 II 57 x 60 90 x 90
Resolution, line 4.5 4.6 5 1.3
pairs/mm
Autobrightness Yes Yes Yes Yes
Movement
Lateral, cm ±20 ±20 ±17 ±17
Longitudinal, cm ±20 ±20 ±19 ±20
Radial, cm 60 50 53 60
PATIENT TABLE
Movement
Vertical, cm 70 66 53 104
Lateral, cm ±20 ±19 ±20 ±25
Longitudinal, cm 100 61 80 110
Rotation
Pedestal,° 360 Not specified 360 ±90
Isocenter,° ±95 ±90, not motorized ±145 ±100
Tabletop, L x W, cm 250 x 50 274 x 51 220 x 45 225 x 50
Minimum tabletop 64 70 80 64
height, cm
Max load capacity, kg Not specified Not specified 272 (600)
(lb)
X-RAY FIELD SIZE
Size at 100 cm SAD, cm 45 x 45 1 x 1 to 45 x 45 0 x 0 to 46 x 46 0 x 0 to 45 x 45
Independent x & y axes Yes Yes Yes Selectable
Motorized Yes Yes Yes Variable speed
Field lightbulb Yes 150 W 50 W halogen Quartz halogen

This is the first of three

pages covering the above
model(s). These
specifications continue onto
the next two pages.

14 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL ECRI INSTITUTE'S HUESTIS MEDICAL INVAP NUCLETRON

RECOMMENDED
SPECIFICATIONS1
R/F Simulation Systems Huestis*Cascade NT UNISIM Simulix Evolution
TREATMENT FIELD
DELINEATION
At 100 cm SAD, cm ≤45 x 45 2 x 2 to 45 x 45 0 x 0 to 45 x 45 0 x 0 to 45 x 45
Independent x & y axes Yes Yes Yes 8 cm crossover
Motorized Yes Yes 2 speeds Variable speed
X-RAY GENERATOR
Type Constant potential or high High-frequency, high-speed High frequency, 30 kHz High frequency, 50 kW
frequency starter
Phase 3 3 3 3
Radiographic output
kV range (steps) 40-150 (not specified) 50-125 (1) 40-120 (not specified) 40-150 (not specified)
mA range 10-800 25-600 50-400 10-630
Exposure time, sec 0.01-8 0.005-15 0.005-5 0.0001-10
mAs range ≤1,000 Low to medium; high Not specified 0.4-1,000
Fluoroscopic output
kV range 40-125 40-120 in 1 kVp steps 40-110 40-140
mA range ≤20 0.5-6, 20 1-15 0.5-20
X-RAY TUBE
Anode material Tungsten Tungsten-rhenium- Tungsten-rhenium- Molybdenum
molybdenum molybdenum
Anode angle,° 12 14 14 14
Anode speed, rpm 9,000 3,200, 10,000 2,850 for 50 Hz 10,000
Focal spot sizes, mm 0.6, 1 0.6, 1.2 0.6, 1.2 0.4, 0.8
Heat storage capacity, 500,000 400,000 Not specified 600,000
HU
Heat dissipation rate, 100,000 100,200 Not specified 140,000
HU/min
CASSETTE HOLDER
Sizes, cm (in) 35 x 43 (14 x 17) 35 x 43 (14 x 17) 35 x 43 (14 x 17) 35 x 43 (14 x 17)
Rotation,° 90 ±90 No 0
GRID RATIO Optional, user selectable Optional 8:1 Not specified 8:1
TREATMENT ROOM Table Table Wall monitor, infrared hand Dual tableside controls
CONTROL UNIT MOUNT control
SAFETY DEVICES
Anticollision Yes Yes Yes Yes, touch and logic
Emergency off switch Yes Yes Yes Yes
Warning lights Yes Yes Yes Yes
CT SIMULATION OPTION Optional No No Oncentra ConeBeam
Spatial resolution 1 mm Not specified NA <1.25 mm
Time per slice Acquisition in 1 min Not specified NA 45 or 90 sec
OPTIONAL 50-80 kW high-frequency None specified Civco tabletop inserts to
ACCESSORIES generators with high-speed match accelerator tables,
starter, 30.4 cm (12 in) II, accessory siderails, shadow
cassette adapter inserts, tray adapters, 3-chamber
additional block tray AEC, back-pointer laser,
assemblies, additional SimCassette, brachytherapy
lasers immobilization devices, and
integrated connectivity to
brachytherapy treatment
planning

This is the second of three

pages covering the above
model(s). These
specifications continue onto
the next page.

©2010 ECRI Institute. All Rights Reserved. 15

Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL ECRI INSTITUTE'S HUESTIS MEDICAL INVAP NUCLETRON

RECOMMENDED
SPECIFICATIONS1
R/F Simulation Systems Huestis*Cascade NT
SUGGESTED ROOM SIZE, 5.5 x 5.5 x 2.7 (18 x 18 x
L x W x H, m (ft) 8.9)
TOTAL SYSTEM WEIGHT, 2,268 (5,000)
kg (lb)
POWER REQUIREMENTS 380 VAC, 3-phase/480
VAC, 3-phase; 110 VAC,
machine control
PURCHASE
CONSIDERATIONS
List price Not specified
Warranty 2 years
Delivery time, ARO Not specified
Year first installed 1976
Number installed 266
Fiscal year Not specified
GREEN FEATURES None specified
OTHER SPECIFICATIONS Windows XP operating
system;
asymmetric/symmetric field
wires with full crossover;
LCD control display; SVGA
main display; built-in
calibration software; LAN
capability; carbon-fiber
tabletop; freestanding
design; customized blocking
trays match treatment units;
last-image hold; S-distortion
correction; simultaneous
local and remote motion
controls; 4 diode line lasers
and 2 grid trays (80 cm, 100
cm).
UMDNS CODE(S) 13280, 20547 13280, 20547
LAST UPDATED November 2010
Supplier Footnotes 1These recommendations
are the opinions of ECRI
Institute's technology
experts. ECRI Institute
assumes no liability for
decisions made based on
this data.
Model Footnotes
Data Footnotes
UNISIM Simulix Evolution
6 x 5.5 x 3 (19.7 x 18 x 9.8) 5 x 5 x 2.8 (16.4 x 16.4 x
9.2)
3,150 (7,000) Not specified
220 VAC, 50 Hz, 2 kVA; 3 x 120-480 VAC
380 VAC, 50 Hz, 41 kVA
$260,000 $500,000-650,000
1 year 1 year (includes glassware);
10 years (isocenter), 98%
uptime guarantee
Not specified Not specified
1995 2004
Not specified 32
Not specified Not specified
None specified None specified
Telecobalt therapy unit also Automatic load/unload,
available; ISO 9000 and setup memory; automatic
TGA (Australia) certified. stops at 0, 90, 180, and
270° rotations; in-room data
display; hard copy of all
parameters; simultaneous
multiple movements; patient
and machine protection
through extensive
anticollision logic; lead
blades track field-
delineating wires during
setup and II during
fluoroscopy; universal
compatibility with treatment
units; export or DICOM
print; CT extension
available; DICOM RT
import/export, RTP link and
DICOM print, automatic
treatment machine
configuration with plan
import or new patient, MLC
creation and validation with
drag-and-drop leaf
positioning, electronic
simulation and 4-image
merge, block library and
drawing capability. Meets
requirements of IEC, ISO
9001, and VDE. ETL listed.
13280, 20547 13280, 20547
November 2010 November 2010

16 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL NUCLETRON SHINVA SHINVA SHINVA

Simulix-HQ Radiotherapy Simulator SL-I Radiotherapy Simulator SL- Radiotherapy Simulator SL-
IC ID
WHERE MARKETED Worldwide Worldwide Worldwide Worldwide
FDA CLEARANCE Yes No No No
CE MARK (MDD) Yes Yes Yes Yes
SOURCE-TO-AXIS 70-150 70-120 70-120 70-120
DISTANCE (SAD), cm
SOURCE-TO-IMAGE 197 (0° 150 SAD), 215 85-165 85-165 85-165
DISTANCE (SID), cm (90°)
GANTRY ROTATION
Above 100 cm SAD,° ±165 ±135 ±135 ±135
Below 100 cm SAD,° ±190 ±185 ±185 ±185
Isocentric accuracy at ±0.75 radius ±1 ±1 ±1
100 cm SAD, mm
Motorized speed(s), Variable 36-360 36-360 36-360
°/min
Mounting Floor, 10 cm deep pit Floor Floor Floor
required
ISOCENTER HEIGHT, cm 126 125 125 125
COLLIMATOR ±180 ±100 ±100 ±100
ROTATION,°
IMAGE INTENSIFIER
Size, cm 38, 33; II 23 23 or 30 23 or 30 23 or 30
Area coverage, cm 72 x 72 with 13 in II 21 or 29 21 or 29 21 or 29
Resolution, line 1.1 for 12 in II 1.2/1.4/1.6 for types 1.2/1.4/1.6 for types 1.2/1.4/1.6 for types
pairs/mm
Autobrightness Yes Yes Yes Yes
Movement
Lateral, cm ±17 ±18 (23 cm II) or ±10 (30 ±18 (23 cm II) or ±10 (30 ±18 (23 cm II) or ±10 (30
cm II) cm II) cm II)
Longitudinal, cm ±20 ±18 (23 cm II) or ±10 (30 ±18 (23 cm II) or ±10 (30 ±18 (23 cm II) or ±10 (30
cm II) cm II) cm II)
Radial, cm 60 30 30 30
PATIENT TABLE
Movement
Vertical, cm 104 >35 >55 >55
Lateral, cm ±25 ±18 >±20 >±20
Longitudinal, cm 110 >75 >95 >95
Rotation
Pedestal,° ±90 ±100 >180 >180
Isocenter,° ±100 ±100 ±100 ±100
Tabletop, L x W, cm 225 x 50 240 x 55 240 x 55 240 x 55
Minimum tabletop 64 92 69 69
height, cm
Max load capacity, kg 272 (600) Chinese standard: under Chinese standard: under Chinese standard: under
(lb) 135 (297.6), table change 135 (297.6), table change 135 (297.6), table change
≤5 mm ≤5 mm ≤5 mm
X-RAY FIELD SIZE
Size at 100 cm SAD, cm 0 x 0 to 45 x 45 0 x 0 to 45 x 45 0 x 0 to 40 x 40 0 x 0 to 40 x 40
Independent x & y axes Selectable No No Yes
Motorized Variable speed Yes Yes Yes
Field lightbulb Quartz halogen 24 V halogen 24 V halogen 24 V halogen

This is the first of three

pages covering the above
model(s). These
specifications continue onto
the next two pages.

©2010 ECRI Institute. All Rights Reserved. 17

Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL NUCLETRON SHINVA SHINVA SHINVA

Simulix-HQ Radiotherapy Simulator SL-I Radiotherapy Simulator SL- Radiotherapy Simulator SL-
IC ID
TREATMENT FIELD
DELINEATION
At 100 cm SAD, cm 0 x 0 to 45 x 45 2 x 2 to 45 x 45 2 x 2 to 40 x 40 2 x 2 to 40 x 40
Independent x & y axes 8 cm crossover No Yes Yes
Motorized Variable speed Yes Yes Yes
X-RAY GENERATOR
Type High frequency, 50 kW Constant potential Constant potential Constant potential
Phase 3 3 3 3
Radiographic output
kV range (steps) 40-150 (not specified) 40-125 (not specified) 40-125 (not specified) 40-125 (not specified)
mA range 10-630 100-500 100-500 25-500
Exposure time, sec 0.0001-10 0.01-4 0.01-4 0.001-6.3
mAs range 0.4-1,000 Not specified Not specified Not specified
Fluoroscopic output
kV range 40-140 40-110 40-110 40-125
mA range 0.5-20 0.5-5 0.5-5 0.5-6
X-RAY TUBE
Anode material Molybdenum Tungsten-molybdenum Tungsten-molybdenum Tungsten-molybdenum
Anode angle,° 14 17.5 14 12
Anode speed, rpm 10,000 2,800 2,800 2,800
Focal spot sizes, mm 0.4, 0.8 0.6/1.6 0.6/1.5 0.6/1.2
Heat storage capacity, 600,000 80,000 200,000 350,000
HU
Heat dissipation rate, 140,000 Not specified 15,000 97,000
HU/min
CASSETTE HOLDER
Sizes, cm (in) 35 x 35 (14 x 14), 35 x 43 30.4 x 38.1 (12 x 15), 25.4 x 30.4 x 38.1 (12 x 15), 25.4 x 35 x 35 (14 x 14), 35 x 43
(14 x 17) 30.4 (10 x 12) 30.4 (10 x 12) (14 x 17)
Rotation,° ±90 0 0 0
GRID RATIO 6:1 10:1 10:1 10:1
TREATMENT ROOM Dual tableside controls Ceiling Ceiling Ceiling
CONTROL UNIT MOUNT
SAFETY DEVICES
Anticollision Yes, touch and logic Yes Yes Yes
Emergency off switch Yes Yes Yes Yes
Warning lights Yes Yes Yes Yes
CT SIMULATION OPTION CT extension No No No
Spatial resolution <1 mm NA NA NA
Time per slice 60 sec NA NA NA
OPTIONAL Civco tabletop inserts to None None None
ACCESSORIES match accelerator tables,
accessory siderails, shadow
tray adapters, 3-chamber
AEC, back-pointer laser,
SimCassette, brachytherapy
immobilization devices, and
integrated connectivity to
brachytherapy treatment
planning

This is the second of three

pages covering the above
model(s). These
specifications continue onto
the next page.

18 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL NUCLETRON SHINVA SHINVA SHINVA

Simulix-HQ Radiotherapy Simulator SL-I Radiotherapy Simulator SL- Radiotherapy Simulator SL-
IC ID
SUGGESTED ROOM SIZE, 5 x 5 x 2.8 (16.4 x 16.4 x 6 x 6 x 4.2 (19.7 x 19.7 x 6 x 6 x 4.2 (19.7 x 19.7 x 6 x 6 x 4.2 (19.7 x 19.7 x
L x W x H, m (ft) 9.2) 13.8), control room width 13.8), control room width 13.8), control room width
≥2.5 m (8.2 ft), equipment ≥2.5 m (8.2 ft), equipment ≥2.5 m (8.2 ft), equipment
room door width ≥1.5 m (4.9 room door width ≥1.5 m (4.9 room door width ≥1.5 m (4.9
ft) ft) ft)
TOTAL SYSTEM WEIGHT, Not specified 4,000 (8,820) 4,000 (8,820) 5,000 (11,023)
kg (lb)
POWER REQUIREMENTS 120-480 VAC 380±38 V/220±22 VAC, 50 380±38 V/220±22 VAC, 50 380±38 V/220±22 VAC, 50
Hz ±1 Hz, 50 kVA Hz ±1 Hz, 50 kVA Hz ±1 Hz, 50 kVA
PURCHASE
CONSIDERATIONS
List price $350,000-400,000 $100,000 $100,000 $100,000
Warranty 1 year (includes glassware); 1 year 1 year 1 year
10 years (isocenter), 98%
uptime guarantee
Delivery time, ARO Not specified >3 months >3 months >3 months
Year first installed 2001 1996 1996 1996
Number installed 90 474 474 474
Fiscal year Not specified Not specified Not specified Not specified
GREEN FEATURES None specified None specified None specified None specified
OTHER SPECIFICATIONS Automatic load/unload, None specified. None specified. None specified.
setup memory; automatic
stops at 0, 90, 180, and
270° rotations; in-room data
display; hard copy of all
parameters; simultaneous
multiple movements; patient
and machine protection
through extensive
anticollision logic; lead
blades track field-
delineating wires during
setup and II during
fluoroscopy; universal
compatibility with treatment
units; export or DICOM
print; CT extension
available. Meets
requirements of IEC, ISO
9001, and VDE. ETL listed.
UMDNS CODE(S) 13280, 20547 13280, 20547 13280, 20547 13280, 20547
LAST UPDATED November 2010 November 2010 November 2010 November 2010
Supplier Footnotes
Model Footnotes
Data Footnotes

©2010 ECRI Institute. All Rights Reserved. 19

Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL SHINVA VARIAN ONCOLOGY

Radiotherapy Simulator SL- Acuity iX
IE
WHERE MARKETED Worldwide Worldwide
FDA CLEARANCE No Yes
CE MARK (MDD) Yes Yes
SOURCE-TO-AXIS 70-120 100 fixed, cast gantry
DISTANCE (SAD), cm
SOURCE-TO-IMAGE 85-165 100-180
DISTANCE (SID), cm
GANTRY ROTATION
Above 100 cm SAD,° ±135 ±185
Below 100 cm SAD,° ±185 ±185
Isocentric accuracy at ±1 ≤1, diameter
100 cm SAD, mm
Motorized speed(s), 36-360 Variable ≤360
°/min
Mounting Floor Cast gantry
ISOCENTER HEIGHT, cm 125 123
COLLIMATOR ±100 ±185
ROTATION,°
IMAGE INTENSIFIER
Size, cm 23 or 30 40 x 30 amorphous silicon
imager
Area coverage, cm 21 or 29 39.7 x 29.8
Resolution, line 1.2/1.4/1.6 for types 1.3 fluoroscopy mode, 2.6
pairs/mm digital rad mode
Autobrightness Yes Yes
Movement
Lateral, cm ±18 (23 cm II) or ±10 (30 35 total travel
cm II)
Longitudinal, cm ±18 (23 cm II) or ±10 (30 40 total travel
cm II)
Radial, cm 30 75 total travel; vertical
PATIENT TABLE
Movement
Vertical, cm >55 63-169
Lateral, cm >±20 ±25
Longitudinal, cm >90 145.8
Rotation
Pedestal,° >180 None
Isocenter,° ±100 ±100
Tabletop, L x W, cm 240 x 59 200 x 53
Minimum tabletop 75 63
height, cm
Max load capacity, kg Chinese standard: under 227 (500)
(lb) 135 (297.6), table change
≤5 mm
X-RAY FIELD SIZE
Size at 100 cm SAD, cm 0 x 0 to 40 x 40 0.5 x 0.5 to 50 x 50
Independent x & y axes Yes Yes
Motorized Yes Yes
Field lightbulb 24 V halogen Yes

This is the first of three

pages covering the above
model(s). These
specifications continue onto
the next two pages.

20 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL SHINVA VARIAN ONCOLOGY

Radiotherapy Simulator SL- Acuity iX
IE
TREATMENT FIELD
DELINEATION
At 100 cm SAD, cm 2 x 2 to 40 x 40 0.5 x 0.5 to 44 x 44
Independent x & y axes Yes Yes
Motorized Yes Yes
X-RAY GENERATOR
Type Constant potential High frequency, 32 kW;
pulsed fluoro mode
Phase 3 3
Radiographic output
kV range (steps) 40-125 (not specified) 40-150 (1)
mA range 25-500 50-320
Exposure time, sec 0.001-6.3 4-250 msec, pulsed
mAs range Not specified 1-630
Fluoroscopic output
kV range 40-125 40-125 in 1 kV steps
mA range 0.5-6 1-20 in 1 mA steps
(continuous), 25-80 (pulsed)
X-RAY TUBE
Anode material Tungsten-molybdenum Tungsten-rhenium-
molybdenum graphite
Anode angle,° 12 14
Anode speed, rpm 2,800 3,000, 10,000 high
Focal spot sizes, mm 0.6/1.2 0.4, 0.8
Heat storage capacity, 350,000 2,000,000
HU
Heat dissipation rate, 97,000 140,000
HU/min
CASSETTE HOLDER
Sizes, cm (in) 35 x 35 (14 x 14), 35 x 43 43 x 35 (17 x 14)
(14 x 17)
Rotation,° 0 NA
GRID RATIO 10:1 8:1 parallel
TREATMENT ROOM Ceiling Table, 2 pendants
CONTROL UNIT MOUNT
SAFETY DEVICES
Anticollision Yes Software, hardware
Emergency off switch Yes Yes
Warning lights Yes Shown with icons in room
and console
CT SIMULATION OPTION No Cone-beam CT
Spatial resolution NA 4-7 lp/mm
Time per slice NA 45 sec for volume
acquisition, 15 cm volume
length, ~95 cm aperture
size, 0.5-10 mm
reconstruction width, 3
contiguous volumes ≤45 cm
total scan length

©2010 ECRI Institute. All Rights Reserved. 21

Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL SHINVA VARIAN ONCOLOGY

Radiotherapy Simulator SL- Acuity iX
IE

OPTIONAL None EXACT Couch, digital

ACCESSORIES shape projector, 80 cm
simulation mode, DICOM,
IRREG 2-D planning, 2D/2D
match for automated
verification, electron
applicators, couch
accessories, mounts for
other manufacturers'
equipment, laser alignment
system, laser backpointer,
SomaVision for 3-D
planning and viewing,
emergency back-up battery
downdrive
SUGGESTED ROOM SIZE, 6 x 6 x 4.2 (19.7 x 19.7 x 7.4 x 6 x 2.6 (24.3 x 19.7 x
L x W x H, m (ft) 13.8), control room width no 8.5)
less than 2.5 m (8.2 ft),
equipment room door width
no less than 1.5 m (4.9 ft)
TOTAL SYSTEM WEIGHT, 5,000 (11,023) 2,706 (5,966) with
kg (lb) baseframe and couch
POWER REQUIREMENTS 380±38 V/220±22 VAC, 50 400-480 VAC, 50/60 Hz,
Hz ±1 Hz, 50 kVA line to line, 3-phase, 100
kVA load
PURCHASE
CONSIDERATIONS
List price $100,000 Not specified
Warranty 1 year 1 year
Delivery time, ARO >3 months Not specified
Year first installed 1996 2002
Number installed 474 200, all models
Fiscal year Not specified Not specified
GREEN FEATURES None specified None specified

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model(s). These
specifications continue onto
the next page.

22 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Chart A: R/F Radiotherapy Simulation Systems

MODEL SHINVA VARIAN ONCOLOGY

Radiotherapy Simulator SL- Acuity iX
IE
OTHER SPECIFICATIONS None specified. EXACT IGRT couch; fully
carbon fiber, no movable
rails or gridded panels;
digital radiography output:
40-150 kVp, 25-100 mA, 4-
6,300 msec exposure time;
standard software features
of digital field wires for
image-driven simulation;
verification process
supported with active field
handling, digital image
enhancement; measuring
tools; cine image
acquisition; automatic and
delta go-to's; autosetups;
pair and track mode; ABC,
pulsed fluoro mode and
digital rad mode for higher
techniques and film-
equivalent image
acquisition, dual and quad
merge for larger field sizes;
software features include
image-controlled simulation,
cine mode, quad and dual
image merge, MLC creation
and display, postprocessing
filters, DICOM print, image
import export, window and
level, RT chart, match and
review, and automatic
storage of image and acuity
parameters; 600,000 HU
anode heat storage.
UMDNS CODE(S) 13280, 20547 13280, 20547
LAST UPDATED November 2010 November 2010
Supplier Footnotes
Model Footnotes
Data Footnotes

©2010 ECRI Institute. All Rights Reserved. 23

Radiotherapy Simulation Systems

Chart B: CT Simulation Systems

MODEL ECRI INSTITUTE'S GE HEALTHCARE PHILIPS PHILIPS

RECOMMENDED
SPECIFICATIONS1
CT Simulation Systems LightSpeed RT 16 CT AcQSim³ Brilliance CT Big Bore
Simulator Oncology Configuration
WHERE MARKETED Worldwide Worldwide Worldwide
FDA CLEARANCE Yes Yes Yes
CE MARK (MDD) Yes Yes Yes
SYSTEM COMPONENTS
Standard CT gantry, laser alignment, LightSpeed operating Workstation with virtual CT scanner gantry, console,
control console, workstation console, LightSpeed simulation software, image laser positioning system, flat
table/gantry, LightSpeed registration, DRRs, DCRs, table pad, digital filming
Matrix II detector, color printer, interface to modules, digitally
Advantage Workstation LAP or Gammex laser composited radiograph
VolumeShare, laser positioning systems; software, virtual simulation
alignment lights, high- absolute marking with software, color printer and
performance network kit, approved Philips scanners interface
Exact couch
Optional High-capacity bariatric table Pinnacle³ RTP and all Pinnacle³ RTP and all
Pinnacle options Pinnacle options
CT SCANNER Yes No Yes
Bore diameter, cm 70-80 80 Depends on scanner 85
Max FOV, cm 60 65 Depends on scanner 60
Slices 10 16 Depends on scanner 16
Slice widths, mm 0.5, 1, 2, 4, 5, 10 16 x 0.625, 1.25, 2.5, 3.75, Depends on scanner 0.75-12 axial mode, 0.56-
5, 10 7.5 spiral mode
Resolution
Axial spatial (50% MTF), 10 8.5 Depends on scanner Not specified
lp/mm
Low-contrast, mm @ % 4 @ 0.3 @ 2 5 @ 0.3 @ 1.33, 3 @ 0.3 @ Depends on scanner 4 @ 0.3%
@ ≤2.5 rads 3.72
Noise, % @ ≤2.5 rads 0.3 @ 3 0.32 ±0.03 @ 2.85 Depends on scanner 0.27
COMPATIBLE CT Any DICOM-compatible Any DICOM-compatible All DICOM CT scanners; Brilliance CT
SCANNERS scanner (if not included) scanner with 60 sec helical absolute marking: AcQSim
capability CT large bore, Ultra Z,
Brilliance big bore, PQ
2000, PQ 2000S, PQ 5000
PATIENT TABLE
L x W, cm (in) 170 (67) long scan range, Not specified Not specified
optional 200 (79) long
Max load capacity, kg 227 (500), ±2 mm table Not specified 204 (450)
(lb) extension positional
accuracy, optional 295 (650)
table
X-RAY
Generator, kW 60 53.2, optional 100 Not specified 60
Tube
Heat capacity, MHU 5 8 Not specified 8
Heat dissipation rate, 700,000 8 kW continuous Not specified 1,608 kHU/min
HU/min
Rotation rate, sec 0.5 0.5 Not specified Not specified
IMAGE
RECONSTRUCTION
Images/sec 20 6, optional 16 Not specified ≤10

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pages covering the above
model(s). These
specifications continue onto
the next two pages.

24 ©2010 ECRI Institute. All Rights Reserved.


Chart B: CT Simulation Systems
MODEL ECRI INSTITUTE'S GE HEALTHCARE
RECOMMENDED
SPECIFICATIONS1
CT Simulation Systems LightSpeed RT 16 CT
Simulator
LASER SYSTEM
Configuration 3 3 moving lasers (2 lateral
cross and 1 sagittal cross)
Laser type Diode Diode
Wavelength(s), nm 635 635
Power output, mW <1 <1
Positioning accuracy, <±0.5 <±0.5 @ 3 mm
mm
Projected beam pattern <1.5 <1.5 @ 3 mm
size, mm
RECONSTRUCTION TIME
Beam's-eye view Instantaneous Real time
DRRs <1 sec <1 sec
WORKSTATION
Hardware platform Dual Intel Xeon CPU
Memory, MB 2,084
Storage media MO disk, DVD, PACS 73 GB ULTRA SCSI 160
hard drives (2), CD-R
Hard-copy devices Any DICOM Any PostScript-compatible
paper printer, any DICOM-
print-compatible laser film
imager
Software features Clinical preference 3-D patient model with
isotropic voxels, interactive
4-port display, macro-
capable treatment template
protocols, treatment
machine library, interactive
DRRs, virtual fluoroscopy,
DRR anatomic mixing with
custom thresholding,
multiple DRR blending, auto
SSD calculation for all
fields, auto MLC and block
margining to multiple
structures, 3-D volume
expansion, auto
multimodality, 3-D image
fusion, Advantage
VolumeShare contains
SimMD, CT/MR fusion,
DICOM print filming, DICOM
RT import/export, optional
Advantage 4-D software,
prospective gating
©2010 ECRI Institute. All Rights Reserved.
Radiotherapy Simulation Systems
PHILIPS PHILIPS
AcQSim³ Brilliance CT Big Bore
Oncology Configuration
Direct interface to LAP or Direct interface to LAP CT-
Gammex laser systems, 1 4-3
moving overhead with 2
fixed side lasers or 3
moving laser options
Diode, CDR Class II Not specified
735 ±10 nm, visible red LAP CT-4-3
±1 through an 80 mm LAP CT-4-3
aperture at 200 mm
distance
0.1 mechanical, ±1 at LAP CT-4-3
isocenter at 4 mm
Isocentric, 2 side lasers LAP CT-4-3
(coronal and axial), 1
sagittal laser for off-center
marking
Real-time interactive Real time
DCRs in <1 sec, 512 x 512 Real time
Philips System 810 (dual Dell Precision
AMD Opteron CPUs, Solaris
10 OS)
8 GB standard, 16 GB 146 GB
maximum
DVD-R, optional LTO tape CD ROM, EOD
backup
Ricoh color laser Customer option
(PostScript)
Interactive DRRs/DCRs, Interactive DRRs/DCRs,
virtual fluoroscopy, optional virtual fluoroscopy, image
automated fusion, model- preview, tumor LOC
based segmentation, full 2- (localization on console),
D/3-D dose calculation respiratory correlated
localization including MIP,
minimum IP and average IP
This is the second of three
pages covering the above
model(s). These
specifications continue onto
the next page.
25
Radiotherapy Simulation Systems

Chart B: CT Simulation Systems

MODEL ECRI INSTITUTE'S GE HEALTHCARE PHILIPS PHILIPS

RECOMMENDED
SPECIFICATIONS1
CT Simulation Systems LightSpeed RT 16 CT AcQSim³ Brilliance CT Big Bore Oncology
Simulator Configuration
RTP SYSTEM Any DICOM RT DICOM 3.0 images, Client to Pinnacle³, DICOM RT connectivity to
INTERFACE DICOM-RT (RTSS, integrated with Pinnacle³ compatible systems
RTPLAN, RTIMAGE) dose, or DICOM RT
import/export connectivity to compatible
systems
NETWORKING TCP/IP Ethernet TCP/IP, DICOM Ethernet, DICOM 3.0, Ethernet, DICOM 3.0, DICOM
import, export, query DICOM print, DICOM RT print, DICOM RT
SITE
REQUIREMENTS
Floor space, ft² (m²) 28 (2.6), optional 45 (4.2) Depends on CT scanner 85 (7.9)
Ceiling height, ft 8 (2.4) Depends on CT scanner Not specified
(m)
POWER 480 VAC, 50/60 Hz, 3- Depends on CT scanner 200/208/240/380/400/416/480/500
REQUIREMENTS phase delta/wye and software options VAC
PURCHASE
INFORMATION
List price Not specified Depends on scanner Depends on scanner
selected
Warranty 1 year, parts and labor 1 year, parts and labor 1 year
Delivery time, ARO 45 days 30 days 30 days
Year first sold 2006 1993 2005
Number installed Not specified 410 NA
worldwide
Fiscal year January to December January to December January to December
GREEN FEATURES None specified None specified None specified
OTHER Multislice helical (16); 8 None specified. None specified.
SPECIFICATIONS MHU x-ray tube anode heat
storage; 53.2 kW x-ray
generator; 120 sec
maximum scan time; 6
sec/image reconstruction
time.
UMDNS CODE(S) 13280, 20548 13280, 20548 13280, 20548 13280, 20548
LAST UPDATED November 2010 September 2008 September 2008
Supplier Footnotes 1These recommendations
are the opinions of ECRI
Institute's technology
experts. ECRI Institute
assumes no liability for
decisions made based on
this data.
Model Footnotes
Data Footnotes

26 ©2010 ECRI Institute. All Rights Reserved.

 Radiotherapy Simulation Systems

Chart B: CT Simulation Systems

MODEL SIEMENS ONCOLOGY SIEMENS ONCOLOGY SIEMENS ONCOLOGY SIEMENS ONCOLOGY

Somatom Definition AS 20 Somatom Definition AS 40 Somatom Emotion 6 Somatom Sensation 16
WHERE MARKETED Worldwide Worldwide Worldwide Worldwide
FDA CLEARANCE Yes Yes Yes Yes
CE MARK (MDD) Yes Yes Yes Yes
SYSTEM COMPONENTS
Standard Table, gantry, controls, Table, gantry, controls, Table, gantry, controls Table, gantry, controls
therapy protocols therapy protocols
Optional Fusion, simulation table and Fusion, simulation table and Fusion, simulation table and Fusion, simulation table and
workstation, lasers, chiller, workstation, lasers, chiller, workstation, lasers, workstation, lasers, chiller,
accessories accessories accessories accessories
CT SCANNER Yes Yes Yes Yes
Bore diameter, cm 78 78 70 70
Max FOV, cm 50, extended 78 50, extended 78 50, optional 70 50, optional 70
Slices 20 40 6 16
Slice widths, mm 1.2, optional 0.6 1.2, optional 0.6 0.1-10 0.1-10
Resolution
Axial spatial (50% MTF), 15.4 @ cut-off 15.4 @ cut-off 15.5 lp @ 0% MTF/0.29 mm 16
lp/mm
Low-contrast, mm @ % 5 @ 3 HU 5 @ 3 HU 5 @ 3 HU 5 @ 3 HU
@ ≤2.5 rads
Noise, % @ ≤2.5 rads 0.28 0.28 Not specified 0.28
COMPATIBLE CT All Siemens Somatom All Siemens Somatom All Siemens Somatom All Siemens Somatom
SCANNERS systems systems systems systems
PATIENT TABLE
L x W, cm (in) 244.5 x 75 (96.3 x 29.5) 244.5 x 75 (96.3 x 29.5) 244 x 53 (96.3 x 20.8) 244 x 53 (96.3 x 20.8)
dimensions of carbon fiber dimensions of carbon fiber dimensions of carbon fiber dimensions of carbon fiber
insert insert insert insert
Max load capacity, kg 220 (485) 220 (485) 200 (440) 200 (440)
(lb)
X-RAY
Generator, kW 80, 100, 120, 140 80, 100, 120, 140 40, optional 50 50
Tube
Heat capacity, MHU 0; straton tube technology 0; straton tube technology 5 5
with superfast cooling with superfast cooling
equivalent to 30 MHU heat equivalent to 30 MHU heat
capacity capacity
Heat dissipation rate, 7.3 7.3 Not specified Not specified
HU/min
Rotation rate, sec 1, 0.5, 0.33 1, 0.5, 0.33 0.8 0.6, 1
IMAGE
RECONSTRUCTION
Images/sec ≤20 ≤40 ≤8 ≤16

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specifications continue onto
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©2010 ECRI Institute. All Rights Reserved. 27

Radiotherapy Simulation Systems
MODEL SIEMENS ONCOLOGY
Somatom Definition AS 20
LASER SYSTEM
Configuration Wall-mounted lateral and
sagittal lasers
Laser type Diacor, Gammex, LAP
Wavelength(s), nm Not specified
Power output, mW Not specified
Positioning accuracy, Not specified
mm
Projected beam pattern Not specified
size, mm
RECONSTRUCTION TIME
Beam's-eye view Depends on study size
DRRs <1 sec, depends on study
size
WORKSTATION
Hardware platform syngo MultiModality
Workplace, dual processors
Memory, MB ≤12 GB RAM
Storage media Onboard DVD writer,
optional archiving solutions
up to 16 TB in initial
configuration
Hard-copy devices Not specified
Software features Syngo platform, features
contouring, reference-point
placement, beam
placement, automatic
multimodality fusion,
respiratory gating support
28
Chart B: CT Simulation Systems
SIEMENS ONCOLOGY
Somatom Definition AS 40
Wall-mounted lateral and
sagittal lasers
Diacor, Gammex, LAP
Not specified
Not specified
Not specified
Not specified
Depends on study size
<1 sec, depends on study
size
syngo MultiModality
Workplace, dual processors
≤12 GB RAM
Onboard DVD writer,
optional archiving solutions
up to 16 TB in initial
configuration
Not specified
Syngo platform, features
contouring, reference-point
placement, beam
placement, automatic
multimodality fusion,
respiratory gating support
©2010 ECRI Institute. All Rights Reserved.
SIEMENS ONCOLOGY
Somatom Emotion 6
Wall-mounted lateral and
sagittal lasers
Diacor, Gammex, LAP
Not specified
Not specified
Not specified
Not specified
Depends on study size
<1 sec, depends on study
size
syngo MultiModality
Workplace, dual processors
≤12 GB RAM
Onboard DVD writer,
optional archiving solutions
up to 16 TB in initial
configuration
Not specified
Syngo platform, features
contouring, reference-point
placement, beam
placement, automatic
multimodality fusion,
respiratory gating support
SIEMENS ONCOLOGY
Somatom Sensation 16
Wall-mounted lateral and
sagittal lasers
Diacor, Gammex, LAP
Not specified
Not specified
Not specified
Not specified
Depends on study size
<1 sec, depends on study
size
syngo MultiModality
Workplace, dual processors
≤12 GB RAM
Onboard DVD writer,
optional archiving solutions
up to 16 TB in initial
configuration
Not specified
Syngo platform, features
contouring, reference-point
placement, beam
placement, automatic
multimodality fusion,
respiratory gating support
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model(s). These
specifications continue onto
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 Radiotherapy Simulation Systems

Chart B: CT Simulation Systems

MODEL SIEMENS ONCOLOGY SIEMENS ONCOLOGY SIEMENS ONCOLOGY SIEMENS ONCOLOGY

Somatom Definition AS 20 Somatom Definition AS 40 Somatom Emotion 6 Somatom Sensation 16
RTP SYSTEM INTERFACE DICOM DICOM DICOM DICOM
NETWORKING Yes Yes Yes Yes
SITE REQUIREMENTS
Floor space, ft² (m²) 194 (18) for complete 194 (18) for complete 194 (18) for complete 194 (18) for complete
system system system system
Ceiling height, ft (m) ≥7.54 (2.3) ≥7.54 (2.3) ≥7.54 (2.3) ≥7.54 (2.3)
POWER REQUIREMENTS 110 VAC for simulator 110 VAC for simulator 110 VAC for simulator 110 VAC for simulator
station station station station
PURCHASE
INFORMATION
List price Not specified Not specified Not specified Not specified
Warranty 1 year 1 year 1 year 1 year
Delivery time, ARO 6 weeks 6 weeks 4 weeks 4 weeks
Year first sold 2009 2009 2003 2000
Number installed Not specified Not specified >6,000 Emotion CTs Not specified
worldwide worldwide
Fiscal year October to September October to September October to September October to September
GREEN FEATURES None specified None specified None specified None specified
OTHER SPECIFICATIONS None specified. None specified. None specified. None specified.
UMDNS CODE(S) 13280, 20548 13280, 20548 13280, 20548 13280, 20548
LAST UPDATED November 2010 November 2010 November 2010 November 2010
Supplier Footnotes
Model Footnotes
Data Footnotes

©2010 ECRI Institute. All Rights Reserved. 29

Radiotherapy Simulation Systems

Chart B: CT Simulation Systems

MODEL SIEMENS ONCOLOGY TOSHIBA

Somatom Sensation Open Aquilion Large-Bore CT
WHERE MARKETED Worldwide Worldwide
FDA CLEARANCE Yes Yes
CE MARK (MDD) Yes Yes
SYSTEM COMPONENTS
Standard Table, gantry, controls, 90 cm gantry, couch,
therapy protocols console, phantoms
Optional Fusion, simulation table and RPM, CT fluoro, DICOM
workstation, lasers, chiller, MWM, DICOM MPPS, ECG
accessories gated scan
CT SCANNER Yes Yes
Bore diameter, cm 82 90
Max FOV, cm 50, extended 82 standard 70
Slices 24 or 40 16
Slice widths, mm 1.2, optional 0.6 0.5, 1.0, 2.0
Resolution
Axial spatial (50% MTF), 15.4 @ cut-off 14.5 @ 2%
lp/mm
Low-contrast, mm @ % 5 @ 3 HU1 2 @ 0.3%
@ ≤2.5 rads
Noise, % @ ≤2.5 rads 0.28 2.63
COMPATIBLE CT All Siemens Somatom All DICOM-compatible
SCANNERS systems systems
PATIENT TABLE
L x W, cm (in) 244 x 53 (96.3 x 20.8) 218 x 47 (86.1 x 18.5), 189
dimensions of carbon fiber x 47 (74.3 x 18.5)
insert
Max load capacity, kg 200 (440) 205 (450)
(lb)
X-RAY
Generator, kW 50 60
Tube
Heat capacity, MHU 0; Straton tube technology 7.5
with superfast cooling
equivalent to 30 MHU heat
capacity
Heat dissipation rate, 5 1,386,000
HU/min
Rotation rate, sec 1, optional 0.5 0.5 full rotation
IMAGE
RECONSTRUCTION
Images/sec ≤20 ≤10

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model(s). These
specifications continue onto
the next two pages.

30 ©2010 ECRI Institute. All Rights Reserved.


Chart B: CT Simulation Systems
MODEL SIEMENS ONCOLOGY
Somatom Sensation Open
LASER SYSTEM
Configuration Wall-mounted lateral and
sagittal lasers
Laser type Available from Diacor,
Gammex, LAP
Wavelength(s), nm Not specified
Power output, mW Not specified
Positioning accuracy, Not specified
mm
Projected beam pattern Not specified
size, mm
RECONSTRUCTION TIME
Beam's-eye view Depends on study size
DRRs <1 sec, depends on study
size
WORKSTATION
Hardware platform syngo MultiModality
Workplace, dual processors
Memory, MB ≤12 GB RAM
Storage media Onboard DVD writer;
optional archiving solutions
up to 16 TB in initial
configuration
Hard-copy devices Not specified
Software features syngo platform, features
contouring, reference-point
placement, beam
placement, automatic
multimodality fusion,
respiratory gating support
Radiotherapy Simulation Systems
TOSHIBA
Aquilion Large-Bore CT
Wall-mounted lateral and
sagittal lasers, LAP lasers
Diode red or green
635, 532
<1
±0.25
<0.5 @ 13 ft
Real time
<1 sec
CMS FocalSim, custom
configuration by CMS to
meet customer needs
Custom configuration
Custom configuration
DICOM-print-compatible
laser film image
Dedicated for CT simulation,
dynamic 3-D visualization of
anatomy and beam
parameters, 1 integrated
application performs
contouring, beam
placement, block/port
definitions, real-time DRRs,
virtual fluoroscopy, volume-
of-interest reduction
techniques for DRR quality
and speed, dual DRR
rendering techniques:
additive (normal DRR),
maximum-intensity
projection, integrated
multimodality support (all
CT simulation functions
available in any registered
modality)
This is the second of three
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model(s). These
specifications continue onto
the next page.
©2010 ECRI Institute. All Rights Reserved. 31
Radiotherapy Simulation Systems

Chart B: CT Simulation Systems

MODEL SIEMENS ONCOLOGY TOSHIBA

Somatom Sensation Open Aquilion Large-Bore CT
RTP SYSTEM INTERFACE DICOM DICOM
NETWORKING Yes Yes
SITE REQUIREMENTS
Floor space, ft² (m²) 323 (30) includes machine, ≥27 (2.5) long couch; ≥25
allowances for service and (2.3) short couch
operating area
Ceiling height, ft (m) ≥7.54 (2.3) 8.2 (2.5)
POWER REQUIREMENTS 110 VAC for simulator 200 VAC
station
PURCHASE
INFORMATION
List price Not specified $995,009 (includes 4-D and
CMS FocalSim with Fusion)
Warranty 1 year 1 year
Delivery time, ARO 6 weeks 8 weeks
Year first sold 2004 2005
Number installed 1,600 >180
worldwide
Fiscal year October to September April to March
GREEN FEATURES None specified None specified
OTHER SPECIFICATIONS None specified. None specified.
UMDNS CODE(S) 13280, 20548 13280, 20548
LAST UPDATED November 2010 November 2010
Supplier Footnotes
Model Footnotes
Data Footnotes 1Spiral;phantom
CATPHAN, 20 cm; object
size, 5 mm; contrast
difference, 3 HU; dose at
surface, 21 mGy @ 140
mAs; technique, 10 mm,
120 kV.

32 ©2010 ECRI Institute. All Rights Reserved.