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Services & Therapies
NOVAILS® Shaped Beam Therapy

What is SRS?
Stereotactic Radiosurgery (SRS) is a high precision non-invasive procedure that uses highly focused x-rays to treat certain types of tumors. SRS was originally developed to treat brain lesions, but with technological advances we are now able to use SRS for select sites elsewhere in the body. It may also be used to treat tumor that are inoperable (difficult for the surgeon to access) and as a post-operative treatment to eliminate any leftover tumor tissue. SRS treatment uses high energy X-rays delivered through multiple fixed beams or rotating arcs. The radiation beam is produced by a linear accelerator and is collimated to create custom shaped beams directed towards the tumor.

SRS at Loyola- The Caveney Family Novalis Center
At Loyola, we have been treating brain lesions with SRS since January 1994. In summer of 2003, Novalis, the latest innovation in non-invasive Stereotactic radiosurgery was installed at Loyola. Novalis represents the state of the art highly precise SRS delivery system. The heart of the system is a beam shaping device (MLC) with very small leaves (3mm width) that conforms to the shape of the target, thereby protecting healthy normal tissues. This system, first of its kind in the world, incorporates both precise shaping to conform to the target and real time image guidance using x-rays and infrared localization. Novalis is capable of treating many types of lesions within the brain as well as other parts of the body (lung, spine, liver, prostate, head, neck, etc.) with unprecedented accuracy. Additionally we have used Novalis to treat benign conditions such as arteriovenous malformations (AVM) and functional disorders.

At Loyola, the Novalis system is equipped with an image guided system that allows precise patient positioning with sub-millimeter accuracy. The image guided radiation therapy (IGRT) system is based on infra-red (IR) markers and X-ray localization. The patient positioning is guided by a highly sophisticated ROBOTICS controlled system which improves treatment accuracy and precision. Depending upon target size, shape and location, optimal SRS treatments are designed using circular arcs, 3DCRT, or IMRT.

Our experienced team of physicians (radiation oncologists and neurosurgeons), nurses, therapists and physicists guides the treatment delivery process.

What type of tumors may be treated by NOVALIS?
Brain: The brain disorders for which this therapy is used include:

Body: Novalis has shown many advantages in treating inoperable lesions in the following sites:

What to expect if you are going to receive SRS treatment?
Brain SRS treatments:
You will have an MRI (Magnetic Resonance Imaging) scan several days before your SRS treatment. On the treatment day, you will be given an orientation by the radiosurgery nurse. She will be placing an IV for medicine/contrast administration prior to your CT scan. You will be fitted with a stereotactic frame by a neurosurgeon, usually around 7 AM. Following this, a contrast enhanced CT (computed tomography) scan of the brain will be taken. This scan provides geometrical information needed to create an accurate treatment plan (beam shapes and orientation). A nurse will next take you to the SRS waiting room.

Your image scans from CT, MRI (and Angiography, if applicable) will be fused. A team of radiation oncologists, neurosurgeons and physicists will outline the area to be treated and normal tissues to be spared on these scans. A custom treatment plan will then be created using a specialized treatment planning computer. The treatment planning system takes into account precise tumor location, radiation dose, number and orientation of treatment beams, etc. The plan will be optimized for maximal sparing of normal structures before it is approved. Your treatment plan will next be verified for positional accuracy and delivery on the treatment machine. Following a series of checks in calculations and positional accuracy, your treatment will commence. The radiation machine will move around the target with focused radiation beams. Depending on the complexity of treatment plan, this could take 30-60 minutes. After treatment is complete, your frame will be removed and you will be discharged following a short period of observation.

Brain Stereotactic radiotherapy (SRT):
If you are going to be treated with Fractionated Stereotactic radiotherapy (fractionated dose given over several weeks), the above procedure is modified as follows. Instead of a Stereotactic frame, a custom face-mask will be created a few days before your treatments are to begin. This is done in a planning session in the CT room and takes approximately one hour. The mask is custom designed to fit your facial contours. After the mask is prepared, it is allowed to cool overnight and you will be asked to return next day for a CT scanning session. In addition to this CT scan, you may be asked to undergo an MRI scan to assist in the treatment planning process. The data from these scans are used to map the area for your treatment. You will be contacted with a start date.

Stereotactic Body Radiotherapy (SBRT):
For patients receiving SRS treatment to a body lesion (lung, liver, spine etc), you will be custom fit with a body-mold prior to CT scanning. This is a vacuum based system, designed to reduce breathing related target motion. A CT scan immediately follows fabrication of the body-mold. Several CT scans will be taken in order to note the movements of organs with breathing. A team comprised of your doctor and physicists will develop a customized radiation treatment plan. Depending on target size, shape and location, your treatment plan may call for 3DCRT (shaped beams) or IMRT (intensity modulated beams). Your treatments will typically last 5 days. Since treatments are given over a shorter time frame, each fractional dose is higher. Therefore your daily treatments may take somewhat longer time (30 – 45 minutes).

Novalis Advantage
Novalis is highly precise and accurate in delivering required radiation doses to the target and sparing normal structures. The treatment machine can deliver radiation in high dose rate mode thereby shortening treatment time considerably. Treatment is non-invasive with no surgical incisions and associated complications. Novalis is equipped with state of the art image guided radiation therapy tools and a sophisticated robotic patient positioning system. These allow for sub-millimeter accuracy and precision in patient setup. In many cases, the treatment is completed in a single day or within a week. When it is necessary to give radiation treatment in small doses over several weeks, each treatment session lasts no more than 15 minutes.

Loyola University Medical Center is the first hospital in Illinois to have the state of the art treatment option for the patients.

Whom to contact if you have any questions regarding your treatments:

Angela McCrum, RTT
Clinic coordinator
Loyola Outpatient Center
amccrum@lumc.edu
708-216-2729