What is Image- Guided Radiotherapy (IGRT)?

How Image-Guided Radiotherapy (IGRT) Came to Be

Image-guided radiotherapy, or IGRT as it is commonly known, evolved from IMRT. IMRT provides far greater beam shaping capabilities than 3D radiation therapy, in this manner allowing more sophisticated and precise treatment. However, radiologists continued to require a safety margin for error for all treatments because of the intrinsic doubt of exact tumor location each and every day.  For example, the prostate moves in a multitude of directions each day depending on how full or empty the bladder and rectum are. In the past, even with IMRT, Drs would need to add a safety margin around the prostate to account for this day-to-day variability in prostate location.  This added margin resulted in a larger target (prostate) to be treated with radiation and more of the bladder and rectum included within the radiation field, thereby, increasing the risk of damage to these healthy organs. Image-guided radiotherapy (IGRT) has changed all of this. IGRT does exactly what its name states: it uses the image of the target to guide the delivery of radiation for each and every treatment. 

Image-Guided Radiotherapy (IGRT), the All-Digital Treatment System

Image-Guided Radiotherapy (IGRT), the all-digital treatment system, allows physicians to see a patient’s tumor in real- time at treatment, even if a tumor has moved - because of a patient's breathing, heartbeat, gastrointestinal changes or other activities. Tumors also change their position and their size during the course of radiotherapy treatment, which typically consists of multiple treatments over several weeks.

At the start of radiotherapy, technicians take a CT scan of a tumor and enter that data into a treatment-planning system. Image-Guided Radiotherapy IGRT software produces a three-dimensional, digitized image of the patient's tumor, sharply identifying the slightest contour. Once that image is captured, it can be recalled for every treatment session. If significant tumor movement has occurred, physicians can then adjust the patient's position or, if required, re-do the treatment plan, minimizing damage to surrounding healthy tissue.

 Why Use Image-Guided Radiotherapy (IGRT)?

With Image-Guided Radiotherapy (IGRT), physicians can match the radiation beam to the precise shape of your tumor far more precisely reducing the total amount of radiation you using built-in imaging technology at ultra-low doses.  The Image-Guided Radiotherapy (IGRT) reduces or eliminates the need for implanting markers, as physicians can visualize soft tissue detail using imaging tools. Tumors that were previously untreatable, because of their proximity to organs or the spinal cord can now receive treatment, which is a huge advance in treatment methods.

The MedWOW Image Guided Radiotherapy (IGRT) Solution

MedWOW features a comprehensive selection of new, used and refurbished radiology equipment, including complete image-guided radiotherapy (IGRT) systems by Nomos, especially the Nomos Bat Belfry.

As the largest global online marketplace for all kinds of medical equipment, MedWOW features a comprehensive searchable catalogue that allows you to filter for make, manufacturer, continent, condition, price range, seller’s business type, and other filters particular to radiology equipment.

If you don’t find the specific image-guided radiotherapy (IGRT) system you are looking for, you can post a free buying request which typically will bring you a number of competitive quotes from some of MedWOW’s worldwide sellers.

The Importance of Forced-Air Warming Devices

What Does a Forced-Air Warming Device Do?

A forced air warming system is a medical electrical device used to help keep patients warm during anesthesia and surgery. The forced air warming unit is made up of a reusable controller and disposable, single-use blankets.

A forced air warming system comprises a controller plus a compatible disposable blanket. The controller contains the following components:

• Electric motor and fan
• Electric heating element
• Thermostats
• Air filter
• Hose

In operation the fan draws in air through the filter and the heating element heats it to a selected temperature, controlled by the thermostats. Heated air travels through the hose to the blanket, which connects to the hose nozzle.

The blanket is double layered and inflates in operation. The patient contact surface is permeable to air and the warm air exits the blanket and moves over the patient's skin and transfers heat to the patient by convection.

The most significant operational factors relate to the single use blankets. It is essential that the blankets are compatible with the controller and the range of blankets available for the controller is an important factor in the purchasing decision.

The blankets are bulky and require storage space.

Unplanned hypothermia (a core temperature of less than 36 degrees C) can negatively impact patients in many ways. Even mild hypothermia may contribute to complications such as: surgical site infection, altered drug metabolism, impaired blood clotting, cardiovascular ischemia, prolonged recovery following surgery and shivering.

It is maintained by many professionals in the field that active patient warming is associated with normalizing patient temperature. The literature supports the use of forced air warming devices for normalizing patient temperature and reducing shivering. In addition, the literature suggests that forced-air warming is associated with reduced time in recovery. Also, it is agreed that both the perioperative maintenance of normothermia and the use of forced-air warming reduce shivering and improve patient comfort and satisfaction. It is recommended that normothermia should be a goal during emergence and recovery, and that when available, forced-air warming systems should be used for treating hypothermia.

The Risks of Hypothermia

Inadvertent perioperative hypothermia is a common and preventable complication of surgery. Inadvertent perioperative hypothermia is defined when the core body temperature is drops below 36⁰C and is associated with poor outcomes for patients.

The possible consequences of hypothermia are:

• Increased risk of wound infection
• Increased perioperative blood loss
• Longer post-anesthetic recovery
• Postoperative shivering and thermal discomfort
• Morbid cardiac events including arrhythmia
• Altered drug metabolism
• Increased risk of pressure sores
• Reduced patient satisfaction with the surgical experience
• Longer hospital stay

Preventing Hypothermia Using Forced-Air Warming

Prevention of hypothermia requires the use of simple measures, such as warm clothing, use of a duvet (comforter) or blankets preoperatively and active warming of the patient and intravenous fluids, especially in the operating room. A range of active patient warming devices have been designed for use in the perioperative and critical care environment, including: electric blankets, heated fluid filled mattresses, radiant warmers and forced air warming devices.

The cost of disposable blankets is the most significant cost of forced air warming and purchasers should make use of bulk purchasing arrangements in order to benefit from volume discounts.

Where to Find Forced Air-Warming Devices

MedWOW offers a comprehensive selection of new, used and refurbished Forced Air-Warming Systems from a multiplicity of manufacturers and distributors throughout the world. As the main global eCommerce platform for all kinds of medical equipment, MedWOW features a comprehensive searchable catalogue that allows you to filter for make, manufacturer, continent, condition, price range, seller’s business type, heating intensity, size and uses when looking for the forced Air-warming device best-suited to your particular medical facility.

Currently MedWOW features Forced Air-Warming Systems from the following manufacturers:

Augustine Medical, Cincinnati Sub-zero, Gaymar Industries, Gibek, Kan Med, Mallinckrodt Puritan, Stihler Electronic and The Surgical Company.

If you don’t find the specific Forced Air Warmer you are looking for, you can post a free buying request which typically will bring you a number of competitive quotes from MedWOW’s global distributors.

Why PACS Workstations are Essential Tools

What exactly is PACS?

Picture Archiving and Communications Systems, or as they are more commonly known, PACS, are being used in most hospitals and radiology clinics. This digital imaging technology has replaced the old way of capturing x-rays and scans on film and paper, enabling clinical images to be stored electronically and viewed on screen.

PACS work with x-ray and scanning technology such as Computerized Tomography (CT), Magnetic Resonance Imaging (MRI) and ultrasound to make x-rays and scanned images available to view on screens within radiology, and to share with other hospital departments like accident and emergency, neurology and orthopedics.

With PACS, clinical images are instantly and simultaneously available for study at multiple locations within a trust. PACS supports more effective team working between clinicians and therefore aids swifter and more accurate diagnoses and treatment for patients.

In radiology, PACS is combined with a radiology information system, or RIS. Radiologists report on the x-rays and scanned images they can view on PACS, and the subsequent reports they produce are then accessible from the images with which they are associated.

Why do we need PACS?

For the past 100 years, film was the main means for capturing, storing and displaying radiographic images. However, film is a fixed medium with usually only one set of images available.

PACS allows for a near filmless process, with all of the flexibility of digital systems. It also removes the costs associated with hard film processing and releases valuable space previously used for film storage. Most importantly, PACS is helping to transform patients’ experience of the care they receive across the NHS. It does this by enabling a speedier diagnosis and by removing the risk of images being lost or misplaced.

How does PACS improve patient care?

With PACS clinicians can access the right image in the right place at the right time. The technology enables:

• Faster accessibility to medical images for the clinicians who evaluate and report on them. This can lead to the speedier availability of results.
• No lost or misplaced images, which means fewer patients having their consultations or operations postponed or cancelled.
• Fewer unnecessary re-investigations, which in turn reduces the amount of radiation to which patients are exposed.
• Flexible viewing, with the ability to manipulate images on screen, ensuring that patients can be diagnosed more effectively.
• Instant access to historic images, so that new and old images can be compared and the progress of patients’ treatment and condition(s) monitored.
• Better teamwork and collaboration because, with PACS, images can be viewed from multiple terminals and locations within a trust by a range of clinicians. And the vast majority of trusts now have the ability to share images electronically with other trusts.

As a result of all of these improvements, PACS is enabling patients to move on quickly to the next stage in their treatment.

MedWOW features an impressive array of new, used and refurbished PACS, as well as replacement PACS parts from a variety of manufacturers. As the principal international eCommerce platform for all kinds of medical equipment, MedWOW, features a comprehensive searchable catalogue that allows you to filter for make, manufacturer, continent, condition, price range, seller’s business type and communications protocols when shopping for your PACS.

Currently MedWOW features PACS from the following manufacturers:

Agfa, Agilent, AMS, Dicomit Imaging Systems, Dyonics, GE Healthcare, Hewlett Packard, Kodak, Radrix Systems, S&S MedCart, Sectra and Sony.

If you don’t find the specific PACS you are looking for, you can post a free buying request which typically will bring you a number of competitive quotes from MedWOW’s global inventories.

Leasing & Financing Solutions for US and Non-US Medical Equipment Purchasers

As making sure that no matter where in the world they are located, all MedWOW users have good access to medical equipment leasing & financing, the MedWOW medical equipment marketplace decided to associate with a leading US financing company, in order to provide individualized, tailor-made financing solutions. This is an unmatched opportunity to purchase US-produced medical equipment under excellent loan conditions, to creditworthy buyers anywhere in the world. This service is the latest in MedWOW’s commitment to providing turnkey, comprehensive solutions for medical equipment professionals globally.

This new leasing and financing service is powered by an experienced major funding leader in the United States. Exclusive to MedWOW, this new Financing Service Partner conducts business in more than 80 countries, and possesses the capability of carrying out transactions in nearly every country in the world; opening new purchasing possibilities to medical professionals everywhere. With the launch of this new partnership, MedWOW’s Financing Service Partner can now offer MedWOW users the most aggressive, customized rates and terms in the business. All of these favorable medical equipment financing services are available exclusively through MedWOW.

American customers can choose from 2 types of preferable financing services with excellent terms: either Leasing or Letter of Credit. Medical equipment leasing can be a shrewd option to purchasing. This especially can be the case if the equipment is expensive and won't turn a profit for years. Alternatively, you may need to maintain up to date equipment and avoid tying up cash in equipment that can become obsolete in a few years. Leasing can also be a good method of financing when you can't afford the down payment on an expensive instrument that is necessary to your practice. Either way, leasing your medical equipment can be a better alternative than a cash purchase or loan financing.

Medical equipment leasing enables US medical facilities to procure equipment, without having to draw down their current bank credit lines. The Letter of Credit program allows buyers of medical equipment to receive extended payment terms of 60, 90, 180 days and up to 2 or 3 years, depending on the transaction size.

Medical administrators everywhere know that the business of medicine is continually changing. New technology brings better opportunities for medical care, as specialized machines continue to be developed. As a result, medical equipment financing and leasing has become more important than ever.

Customers outside of the US can choose from 2 types of unique medical equipment financing services with excellent terms: either the exclusive U.S. Export-Import Bank Loan Program or Letter of Credit. The U.S. Export-Import Bank Loan Program gives creditworthy international buyers, in both the public and the private sector, an unmatched opportunity to purchase US-produced medical equipment under excellent loan conditions. Loans are available for purchase of both new and used medical equipment manufactured in the US, and all loans are guaranteed by the US government. Letter of Credit allows buyers of medical equipment to receive extended payment terms of 60, 90, 180 days, and up to 2 or 3 years, depending on the transaction size and country of origin for buyer and seller.

Shockwave Lithotripsy for Blasting Kidney Stones

Exactly what causes kidney stones is not known. There can be many different reasons. The most common type in about 80% of cases is composed of calcium oxalate crystals. Other types of kidney stones are composed of magnesium, ammonium, phosphate, calcium phosphate and cystine. Uric acid stones are another different type of stone in about 5–10% of cases.

Even though calcium is one of the major minerals in kidney stones, research now shows that having a low calcium diet actually increases the incidence of kidney stones. When calcium levels are low your body produces more oxalate which does increase your risk of kidney stones.

Usually kidney stones can pass without assistance or are removed from the body without causing permanent damage. However, if a kidney stone blocks urine flow for a period of time, complications can arise. Prevention of kidney stones is important because repeated occurrences of kidney stones increase the risk of developing chronic kidney disease.

A complication of kidney stones is the need for invasive treatments. If the stone cannot pass on its own, the first treatment tried is often shockwave lithotripsy. The shockwave lithotripsy procedure uses high-energy sound waves directed at the stone to break it up into smaller pieces so that it may be more easily passed.

According to the American National Kidney and Urologic Diseases Information Clearinghouse, more than 5 percent of the US population will have kidney stones, which is probably generalizeable to other countries. Men are more likely than women to acquire kidney stones, particularly between the ages of 40 and 70. For women, the prevalence actually decreases after age 50. Extracorporeal shockwave lithotripsy, or "blasting" of the stones, is a popular treatment for kidney stones.

In extracorporeal shockwave lithotripsy, shockwaves that are created outside the body travel through the skin and body tissues until they hit the denser kidney stones. After the stones have been hit, they will break down into sand-like particles that are easily passed through the urinary tract in the urine.

Extracorporeal shockwave lithotripsy uses shockwaves to break up stones, so that they can easily pass through the urinary tract. Most people can resume normal activities within a few days. Complications of extracorporeal shockwave lithotripsy include blood in the urine, bruising, and minor discomfort in the back or abdomen.

MedWOW features a large selection of new and used lithotripter systems, as well as replacement lithotripter parts from a variety of manufacturers. As the principal international eCommerce platform for all kinds of medical equipment, MedWOW, features a sophisticated searchable catalogue that allows you to filter for make, manufacturer, continent, condition, price range, coupling technique, DICOM 3.0 COMPLIANT, type of motor, transducer type, triggering and shockwave type when shopping for a lithotripter.

Currently MedWOW features lithotripters from the following manufacturers:
Direx, Philips, Siemens, Waltz, Gyrus Acmi, ENGEMED, Dornier MedTech, Fuzhou Secure, MTS and many more. If you don’t find the exact extracorporeal lithotripter system you are looking for, you can post a free buying request which typically will bring you a number of competitive quotes from MedWOW’s global inventories.