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Image-guided technology - enabling better outcomes in cancer surgery
 
 
The Princess Margaret has very successfully pioneered the use of image-guided technology both in radiation therapy and more recently in surgical oncology. Because tumours shift and change in size over time, real-time CT (computed tomography) images allow radiation therapists to apply radiation much more precisely, sparing more healthy tissue. All of the hospital’s 17 radiation treatment rooms are now equipped with CT imaging technology.

Similarly, surgeons tasked with the responsibility of removing tumours have a tremendous advantage when they can see a tumour in relation to surrounding organs, critical nerves, and blood vessels.

While previous technology pictured a 2-dimensional cross-section of an affected area, the new technology generates 1,024 images at once and provides a real-time 3-dimensional picture of the patient’s interior. These images are used to plan and prepare for surgery, and they can also be updated throughout the surgery, confirming whether the entire tumour has been removed or whether more malignant tissue remains.

Dr. Jonathan Irish, Head of Surgical Oncology for The Princess Margaret, says that the “new technology is providing today’s surgeon with vastly superior vision of a patient and their condition, which leads directly to more successful outcomes.”

“While the new technology is beneficial for all surgeons,” continues Dr. Irish, “it is particularly advantageous for new surgeons who haven’t had 20 years to develop their ‘sixth sense’ about the positioning of each artery and nerve.” This kind of technology will reduce surgical complications and give young surgeons more confidence.”


Re-constructive Surgery

A cancerous tumour in the head and neck region often spreads to the bone, and this ‘infected’ bone must be removed and the bone must be ‘re-built’ using bone tissue harvested from another part of the patient’s body. This is obviously a complex process and one that surgeons prepare for as much as possible prior to the actual surgery. CT imaging is extremely useful in preparing for this re-constructive phase of the surgery.

With the CT images, the surgeon can study the patient’s skull to see precisely how much bone will need to be removed—the dimensions and the shape of the bone. With this knowledge, the surgical team can plan ahead and determine where they can best harvest replacement bone tissue (typically from the leg or hip).


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The invention of the Cobalt machine, the root technology for many radiation therapy machines still in-use today, was developed by PMH's Dr. Harold Johns.
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