In June 2005 Mannheim Cancer Center distinguished itself as one of the first two hospitals in Germany to operate clinically with Elekta Synergy in response to increasing demand for IGRT.

“By introducing IGRT – particularly the online 3D imaging [i.e., VolumeView ] that Elekta Synergy offers – we completely changed the way radiation oncology is delivered,” says Frederik Wenz, M.D., professor and chairman, Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg. “We migrated from a strictly linear workflow, in which we acquired a planning CT and several days later we treated, to one in which there is a time-crucial adaptive feedback loop, where we acquire the planning CT at the linear accelerator, then need to reconstruct the images within seconds, process the images and treat within seconds. It’s a completely different approach.”

“We also have several IMRT planning systems that for several years we had to archive differently,” adds Frank Lohr, M.D., vice chairman, Department of Radiation Oncology at Mannheim. “This was a major problem, because everything needed to be backed up redundantly two or three times or there is a danger of data loss. From the beginning it was very clear that we needed an archive with online redundancy to avoid backing up every system separately. That takes a lot of time and there still is no guarantee that the data are secure.”

In 2006, the collaboration between IMPAC, Elekta and Mannheim resulted in MOSAIQ Oncology PACS, the first oncology PACS and the first PACS to fully integrate with the oncology EMR. MOSAIQ Oncology PACS enables Mannheim Cancer Center, to easily transport plans and images to a central storage device, eliminating the need for individual database and imaging workstation backups to archive, retrieve and manage information necessary to support advanced IGRT techniques within the context of the individual patient charts.

“IMPAC was the only option that was integrated,” Dr. Wenz says. “The EMR, Oncology PACS and data storage are combined in a single platform; and the speed of data access was critical.

“The way we see our patients has basically been transformed,” he continues. “When we conduct our first admissions for patients, we have the image information readily available in the EMR. We have instant access to electronic patient information and all relevant images. Over the summer, I predict we will be entirely paperless.

“Our department, like our previous data storage paradigm, is decentralized,” he remarks. “The 20-bed inpatient treatment ward is about 200 meters [656 ft.] away from the core department. MOSAIQ gave us the ability to transfer all information and images from the treatment department so that data is available at both locations. We no longer have a resident running around carrying films and paper files.


“My gut feeling,” Dr. Wenz concludes, “is that MOSAIQ Oncology PACS is saving 30-60 minutes of time per day for every doctor in the department.”

Mannheim Cancer Center