Stereotactic Radiosurgery: evolution, challenges and a new solution

Stereotactic radiosurgery is not new to medicine despite its recent growth and the attention it has received. Since the initial inception of the idea, the technology has evolved from a solely intracranial application with the Gamma Knife® to the newer extracranial versions with machines such as the CyberKnife® and the Novalis Tx™. This type of high dose, extremely targeted radiation initially became the standard of care for the neurosurgery community as they saw tremendous success with intracranial treatments. This initial success led the medical community to work toward similar treatments for extracranial indications. Fortunately, with advances in imaging and image guidance, physicians are now able to use this technology throughout the body as they track tumors that move and target them with such precision and accuracy that they are able to safely treat tumors near critical structures. With the evolution of the technology the population of patients that can be treated with stereotactic radiosurgery has grown exponentially.

Challenges
With any new advancement comes a new challenge. With a growing patient population, stereotactic radiosurgery has become a viable option for healthcare providers of all sizes. However, many of the early adopters have found that these facilities require more focus and resources than the typical provider is able to dedicate. This highly specialized treatment modality coupled with the extraordinary cost of equipment and education created the need for an experienced partner.

A new solution
To meet this need, an experienced healthcare management team based in Nashville, TN, started a company to develop and manage these programs in conjunction with hospitals and physicians across the country. The company, US Radiosurgery, has grown tremendously since the acquisition of the first center in Boulder, Colorado in 2005. After syndicating to additional physicians and implementing a new marketing and operations plan, the case volume in the center doubled over the course of the first year. This facility is now one of the busiest and most experienced CyberKnife sites in the world and it serves as the prototype for success in other US Radiosurgery locations.

Continued success: a case study
In January 2007, the team at US Radiosurgery met Dr. Luther Brady, a world-renown radiation oncologist located in Philadelphia, PA. Dr. Brady and a colleague knew that the Philadelphia area was in need of this type of technology and had made the decision to purchase a CyberKnife machine during the previous year. They opened the facility and were treating patients when US Radiosurgery met them but the physicians were not satisfied with their ability to manage both the clinical and business aspects of the center. They quickly decided partnership with US Radiosurgery was the right solution for their center.

Over the following months, US Radiosurgery restructured the partnership between the two physicians to include the local hospital system, additional radiation oncologists and surgeons. They also educated the local community and area physicians about the benefits of the technology, and brought in members of the company’s team (both clinical and administrative) to work with the existing physicians and staff to create systems that helped the facility run more efficiently and effectively. Today, Philadelphia CyberKnife treats approximately 3 times as many patients per month than they were treating at this time last year. 

Furthermore, the center is now participating in a shared network of US Radiosurgery facilities that provides them with detailed information on each of the approximately 1500 tumors treated so far within the network. The HIPAA compliant database provides information on diagnosis, anatomy, treatment method, doses, images, and outcomes as well as the treating physician’s information so clinicians can contact one another in order to work in a collaborative fashion. In addition to providing clinical support for the centers, this database also enables the centers to streamline patient flow and manage their operational processes more efficiently.

The increased case volume at Philadelphia CyberKnife means that the facility is effectively reaching more of the appropriate patient population. The local medical community is responding as well in an effort to continuously provide their patients with the most advanced care possible. Currently, there are almost twenty local physicians who are both credentialed and certified to treat at the facility and several more are in the process of fulfilling the requirements. 

Philadelphia CyberKnife illustrates the value of the US Radiosurgery solution for an existing facility but the company specializes in start up facilities as well. US Radiosurgery provides everything from the initial market research to determine the feasibility of such a project to the actual design and construction. Because full body stereotactic radiosurgery is the sole focus of the company, their partners have the complete support of a highly experienced and concentrated team of people who are committed to the excellence of their center.

New advancements in technology may present new challenges but US Radiosurgery offers an innovative solution that benefits hospitals, physicians and communities in need of this type of ground-breaking cancer care.