The FDA has approved Accuray’s Dose Control System (DCS), a new feature of the company’s TomoTherapy System.

The equipment is the first dose servo-controlled helical delivery system of its kind, providing accuracy in dose stability through complex rotational treatments.

Dr Euan S. Thomson, President and CEO of Accuray, said that the device’s clearance by the FDA “is a positive step toward improving TomoTherapy System performance and customer satisfaction.”

The system introduces helical delivery to radiation therapy, providing accurate dose applications whilst sparing healthy tissue. Static delivery through the TomoDirect option provides a consistent dose rate at any angle. 

The DCS technology ensures a stable output over longer duration treatments, offering improved patient experience and overall system performance.

Based in Sunnyvale, California, is a radiation oncology company that develops, manufactures and markets personalised treatment solutions.

Nanotechnology holds the key to a new generation of medical devices and diagnostics. Mike Fisher of the Nanotechnology KTN looks at how miniaturisation is changing the face of healthcare.

Over the past decade there has been significant interest in the promise that micro and nanotechnology holds for life sciences.

An estimated 40% of US nanotechnology venture capital is being allocated to life science start-ups – and over 2008 and 2009, according to a study carried out by Lux Research, healthcare and the life sciences saw an increase in investment of 42%, while other areas such as manufacturing and materials saw a decline.

Europe has a number of leading biotechnology companies, as well as world-renowned R&D facilities. Traditionally the emphasis of these companies has been exclusively on biotechnology – but more recently the lines between biotechnology and the electronics industries have become blurred, creating a new and exciting field of new applications and markets using techniques acquired in the semiconductor world.

The electronics industry has been transformed by the strategy that ‘smaller is better’, and using these same techniques and applying them in medical and pharmaceutical contexts has opened exciting new market opportunities. The next level of miniaturisation, into nanoscale dimensions, is a booming area of R&D with significant funding being invested worldwide.

Mobile diagnostics

Using miniaturisation, medical diagnosis equipment can now be used outside of the lab: in doctor’s surgeries, remotely, and even on mobile phones. The applications are endless.

Imagine a world where all you need is your smart phone to detect any disease through blood analysis, without the need for costly and lengthy analysis in the lab. That could be real in five or ten years’ time.

Ten years ago the ‘lab-on-chip’ was a concept without a viable market entry point, but now point-of-care diagnostic systems are starting to show clear benefits in disease detection and cancer therapy.

By using these applications to analyse samples of blood, interstitial fluid, urine and saliva, medics are able to use minimally invasive techniques to obtain quick results that are easily collected, with minimal stress and discomfort to patients.

Using miniaturisation in diagnosis means that the size and cost of equipment can be reduced dramatically. Sensors can be made available at the point of care, in many cases providing a diagnosis while the patient is with the doctor. Providing early diagnosis means that the right treatment can be given early, avoiding complications caused by delays.

Micro and nano diagnostic devices can also provide closed-loop systems that continuously monitor patients and respond immediately to physiological changes. This is particularly important in the intensive care unit, where simple parameters such as oxygen levels can be critical.

In the future, as medical systems become fully integrated with semiconductor technology, we can expect lab-on-chip devices that measure information on disease markers, cell count or DNA-RNA from a very small quantity of blood or other biological fluid sampled by pain-free needles, and ways to receive and transmit real-time information from sensors located inside the human body.

With applications such as point-of-care diagnostics already emerging with huge benefits to patients, there is no doubt that the next generation of healthcare technology will be enabled by the use of miniaturisation.

Taking a simple and effective concept from the semiconductor world has already delivered a dramatic effect on medical diagnostics and is now moving into drug discovery, creating new and exciting applications across a wide variety of markets.

Chain reaction

Getting these applications to market has been hindered by a lack of potential investors and early adopters willing to take a leap of faith. However, there are now a significant number of international companies developing these new application technologies, as they have begun to see the clinical effectiveness offered by nanotechnology and miniaturisation.

The current interest in the use of miniaturisation in the life sciences has been driven by the many advances this new concept promises. Individuals, companies and funding bodies are looking for ways to invest in this newly commercialised technology. To ensure success, nano-companies need to secure support from venture capitalists and other funding bodies, which can be difficult in the current economic climate.

However, despite the advanced developments in miniaturisation in the life sciences, the industry is still relatively new and there are a number of gaps in the supply chain that prohibit products from getting to market in an effective manner. It is crucial with any new technology to ensure that all parts of the supply chain interact and keep each other informed of developments and capabilities.

One of the Nanotechnology KTN’s main remits is to analyse this supply chain, determine where the gaps are and encourage companies to recognise the commercial gains that can be reaped from bridging them.

Connecting members of the supply chain with one another means that academics, research specialists, industrial practitioners and funding sources can meet to discuss ideas and business opportunities, thus ensuring the developments in this application of nanotechnology continue.

Clearly, many of the applications in these new markets are novel and as a result have yet to be fully developed and become economically viable. In the quest to make these technologies and applications available to a wider market, clinical efficacy and value to the healthcare payer are ultimately the deciding factors.

Increasingly, products need to be cost-effective – and the materials used to produce each device represent a significant part of the cost. It can be expected that as the use of miniaturisation in life sciences becomes more widespread, the associated costs will reduce and the applications will expand much more widely.

Given the economic benefits it promises, it is inevitable that the use of miniaturisation in the life sciences will continue to be adopted and supported.

Mike Fisher, PhD, is Theme Manager – Life Sciences & Healthcare at the Nanotechnology Knowledge Transfer Network (KTN).

Home healthcare provider Amcare, part of the ConvaTec UK group, has acquired UK company Farnhurst Medical, a specialist in home delivery of stoma and continence care products.

Farnhurst Medical holds three licences in the south of England, and its home delivery business will be integrated with the Amcare network.

Current orders and delivery schedules will not be interrupted during the transition.

ConvaTec is a leading supplier of medical technologies for stoma care, wound therapeutics, continence care, critical care and infusion, spanning hospital and community health settings.

Amcare is a Dispensing Appliance Contractor that specialises in stoma and continence care, providing home delivery and care services. The company also supplies NHS organisations with a wide range of prescription medical devices and appliances to support community care.

Farnhurst Medical specialises in home delivery of stoma and continence care products, offering a comprehensive range of technologies from a number of manufacturers.

The application of a bio-decontamination programme, including the use of hydrogen peroxide vapour (HPV), by Gloucestershire Hospitals has reduced the incidence of Clostridium difficile infection.

In three years, the Trust’s infection control programme – which includes the use of cohort wards and antibiotic control as well as UK company Bioquell’s HPV technology – has achieved a 65% reduction in C. difficile infection rates (from 771 cases to 267).

C. difficile (pictured) is the leading cause of hospital-acquired diarrhoeal disease in the UK, and its control is a major target for healthcare professionals.

Over the three-year period, 2,763 areas were decontaminated using HPV within the hospital. HPV can eradicate all biological contamination, providing a clean environment for patient re-admission.

C. difficile endospores are usually resistant to decontamination and can survive for months on hard surfaces, creating a reservoir of infection. The HPV process ensures complete surface sterilisation, breaking down endospores,

Deputy Nursing Director Paul Garrett commented: “HPV technology has played an important part in helping to reduce C. diff infection as part of an overall bundle of interventions. The Bioquell system has now been successfully integrated into the daily operations of our hospitals.”

Based in Hampshire, Bioquell is a leading supplier of bio-decontamination equipment and services, including its unique HPV technology.

A new imaging technology could help to identify lung cancer more accurately, enabling earlier intervention and minimising surgery.

Diffusion-weighted MRI, which measures water movement in lung tissue, can differentiate benign from malignant lung lesions.

A Belgian study has found that the new scan can help to diagnose lung cancer more accurately than the current standard method, a PET-CT scan.

The new scan is non-invasive and requires no radiation exposure.

The research analysed 50 people who were due to be operated on for lung cancer or suspected lung cancer:

• With PET-CT scans, 33 patients were diagnosed correctly, 7 incorrectly and 10 were undetermined.
• With diffusion-weighted MRI scans, 45 patients were diagnosed correctly and 5 incorrectly.
• The 10 cases undetermined with PET-CT were correctly diagnosed using diffusion-weighted MRI.

Dr Johan Coolen, from University Hospitals Leuven in Belgium, said: "Our study has shown that diffusion-weighted MRI scans could become an appropriate diagnostic instrument for preoperative lung cancer patients in the near future. PET/CT scans can wrongly diagnose cancer as they can misinterpret inflammation in the lungs as a malignant lesion. Diffusion-weighted MRI is more accurate, which could help avoid unnecessary surgical procedures for those people without malignant disease.”

According to Professor Marc Decramer, President of the European Respiratory Society, the new European Respiratory Roadmap places strong emphasis on the need for more effective screening and the potential value of personalised, targeted medicine.

“With the development and evaluation of new technologies such as the diffusion-weighted MRI scan, we can work towards achieving these goals,” he commented.