X-RAD SmART

What is the X-RAD SmART?

The X-RAD SmART, the successor of the X-RAD 225Cx, is a micro-IGRT (image-guided radiation therapy) unit, developed in-house by researchers at UHN and manufactured by Precision X-Ray. It is an advanced research platform designed to study the radiobiological effects of conformal radiation dose distributions in preclinical specimens; duplicating clinical IGRT as accurately as possible. Additionally, the platform enables quantifying radiobiological effects, leading to improved clinical delivery methods.

How is treatment delivered?

Employing cone beam CT (CBCT) imaging in conjunction with a dual focal spot x-ray tube, the X-RAD SmART delivers treatment with better than 0.1 mm targeting accuracy. First, the specimen is placed in the unit, and imaged using CBCT. The operator can then move the treatment isocenter to the desired location based on the anatomy visible in the CBCT scan. For tumors that are not visible in CBCT images, the X-RAD SmART is capable of co-registering images from external imaging systems such as MRI and PET.

Once imaging is complete, treatment planning is achieved through SmART Plan (Small Animal RadioTherapy). Developed purely for preclinical studies by researchers at Maastro Clinic, SmART Plan employs state-of-the-art Monte Carlo calculation algorithms to deliver precision dose to the target while minimizing dose to surrounding healthy tissues. Its simple interface, combined with X-RAD SmART’s intuitive workflow make even the most complex studies easy to accomplish.

How is the X-RAD SmART different?

Advances in our understanding of the molecular biology of cancer—combined with rapid technological advances in radiation therapy targeting and delivery—are emphasizing the need for greater capacity to study radiation effects in complex systems. Additionally, during preclinical cancer drug trials, it is imperative to accurately deliver precise radiation dose to tumour areas to better simulate clinical practice and better predict the effects of adjuvant therapies. The X-RAD SmART addresses these needs with its advanced image-guided, conformal dose delivery.

The X-RAD SmART system’s ability to deliver precise, image-guided radiation therapy is only part of the story. In the last few years, integrated bioluminescent imaging (BLI) modules have been mounted in systems all over the world, including UCLA, Stanford and ETH Zurich. BLI allows the system to not only to visualize tumors invisible to CBCT, but also longitudinally track tumor viability to measure treatment efficacy and develop adaptive therapies. The BLI module, developed at UHN, is fully integrated within the X-RAD SmART or 225Cx cabinet, allowing seamless image acquisition alongside CBCT.

Licensed through UHN’s Technology Development and Commercialization office, the X-RAD SmART / 225Cx platform has enjoyed commercial success with systems being sold by Precision X-Ray in locations across North America, Europe, Asia and Australia. The latest system to be sold was purchased by Mayo Clinic in Rochester, Minnesota.