Sentinel Brochure - C-RAD

The dedicaTed soluTion for moTion
managemenT

Product description
c-rad sentinel is an easy-to-use, laser based optical
surface scanning system that monitors the patient for
motion during treatment and optionally assists in quick
re-positioning whenever a large movement has been
detected.
The system checks the patient’s position more than once
every second with sub-millimeter accuracy. Being completely
non-invasive, no markers will need to be placed on
the patient or the couch. a detected deviation outside of set
tolerances will clearly be indicated by an audible and visual
alarm.
The sentinel monitor in the control area will give a clear
indication on what part of the patient has moved, which will
assist the therapist in deciding whether the patient needs
to be repositioned or the treatment can continue.
Workflows
Intra-fraction motion detection
• The patient is set up according to tattoos and room
lasers.
• a cone-beam cT scan is performed and the resulting
computed couch shift is applied.
• The sentinel starts scanning the patient continuously,
and will during the first breathing cycles record the
initial position and normal respiratory range.
• monitoring of the patient continues to detect any motion
outside of the initial respiratory range.
• Treatment delivery begins.
• in case of motion outside of set tolerances, an audible
and visual alarm will be triggered and the therapist can
decide whether to stop the beam.
With today’s advanced treatment techniques, detecting and reacting on
intra-fraction patient motion has become more important than ever. Even
so, this task is largely done the same way as decades ago, where the
therapist is watching the patient on TV monitors connected to the in-room
camera system. While large movements can be detected, gradual shifts in
patient position are almost impossible to recognize.
Patient positioning and intra-fraction motion detection
• The patient is setup within 5 cm of the treatment position.
• The sentinel scans the patient and computes the
required couch shift, based on a reference position recorded
during an earlier session. The couch shift is then
applied manually or automatically.
• The sentinel starts scanning the patient continuously,
and will during the first breathing cycles record the
initial position and normal respiratory range.
• monitoring of the patient continues to detect any motion
outside of the initial respiratory range.
• Treatment delivery begins.
• in case of motion outside of set tolerances, an audible
and visual alarm will be triggered and the therapist can
decide whether to stop the beam.
• a sentinel positioning can be triggered to quickly find
the required couch shift to bring the patient back in
position and continue treatment.

Configurations
Basic package
The basic sentinel package consists of a single ceiling
mounted scanner unit placed above the foot end of the
couch, and a workstation Pc which runs the user-friendly
application software. The system can be operated both
from within the treatment room using the sentinel
remote control, or by using the mouse and keyboard in the
control area.
Options:
DICOM and patient synchronization
With the dicom and patient synchronization option enables
import of patient data from the treatment planning system,
thus minimizing manual data entry. in the treatment room,
the sentinel will also interface to the r&V or linac software
to detect the currently selected patient. This means
that the correct settings will be called up automatically,
without the need for manual selection.
Patient positioning
adding the option for patient positioning will enable the
system to compare the current patient position against
a previously stored reference position and produce the
required couch shift to bring the patient to the treatment
position. depending on the capabilities of the r&V, linac,
and couch control systems, the computed couch correction
may be applied automatically through auto-setup.
Networking
adding the networking option will keep all the patient data
in a central database, ensuring that the correct settings
are always available even if the patient needs to be treated
in a different room. it is possible to add more sentinel
client workstations to the network so that data can be
accessible from e.g. the treatment planning room or
physicists’s office.
4DCT
(Works in progress. not for sale in the us)
With this option, a sentinel system installed in the cT
room will be usable as a respiratory gating device for
prospectively gated as well as retrospectively gated imaging
(aka 4dcT) on modern oncology cTs. The respiratory
motion is measured optically on the patient’s skin, without
requiring any markers or other equipment to be placed on
the patient. Two detection points can be selected which
enables both thoracic and abdominal breathing motion to
be detected in parallel.

WORLD WIDE SERVICE AND SUPPORT
complies with the iec-60825-1
standard, safety of laser products.
complies with fda performance
standards for laser products except for
deviations pursuant to laser notice
no. 50, dated June 24, 2007.
WORLD WIDE SERVICE AND SUPPORT
www.c-rad.se/support
support@c-rad.se
phone +46 18 66 69 30
Service during office hours
C-RAD Positioning AB
Bredgränd 18, se-753 20 uppsala, sweden
www.c-rad.se
sP -001-050921-001-03