Varian Medical Systems plans to address this global radiotherapy gap with the introduction of its latest treatment delivery system - the Halcyon. Unveiled this morning at ESTRO 36 in Vienna, Halcyon is a totally new device, designed with the aim of expanding access to high-quality cancer care while reducing the total cost of ownership for hospitals.

"Varian is launching Halcyon to help address the worldwide cancer challenge," explained Mu Young Lee, Varian's director of new product solutions. "We achieve this by simplifying and enhancing high-quality radiotherapy, defined as volumetric image-guided radiotherapy and intensity-modulated techniques such as IMRT and RapidArc."

Prior to its development of Halcyon, Varian surveyed over 100 cancer clinics to determine their thoughts on the main challenges of running a radiotherapy programme in five to 10 years' time. "Some of the feedback was related to technical capabilities that Varian was already developing," said Lee. "But we found three big challenges that weren't being addressed: the need to expand access to high-quality treatment, to simplify clinical operations for users and to increase patient comfort. Those were the three areas that we aimed to address with this new platform."

Varian tackled the first challenge - expanding access to high-quality care - by integrating several technology advances that simplify and enhance treatment delivery. Increasing the gantry rotation speed by a factor of four, and reducing the time for a cone-beam CT scan down to just 15 s, substantially speeds the system's operation. Halcyon also incorporates a new dual-layer multileaf collimator that delivers faster beam modulation and significantly reduces leakage between leaf gaps.

"We haven't treated any patients yet, but this product has been evaluated extensively in a non-clinical fashion," Lee told medicalphysicsweb. This testing included using Halcyon with Varian's Eclipse treatment planning software to generate plans for CT scans and contours supplied for nine previous International Plan Challenge Competitions. Halcyon scored in the top 10 percentile and beat the average scores of past contestants for all cases.

To reduce the total cost of ownership, Varian worked to streamline all processes, from installation to clinical operation. Halcyon has a similar form-factor to a CT system, and can be simply wheeled into a vault and bolted to the floor, enabling installation in two weeks or less. The compact size also means that the device fits in existing small vaults found in some hospitals.

Other features include built-in shielding that reduces the amount of external shielding required when building new vaults, as well as a roughly halved quality assurance workload. Halcyon also offers a simplified treatment workflow. "Previously, it sometimes needed over 30 steps to deliver image-guided IMRT," said Lee. "So we designed the system to do it in just nine."

Finally, Halcyon was constructed to enhance patient comfort, by including a low couch that's easy to get on and off, a large 100 cm bore diameter, quiet operation, and touchscreens on the side of the device that display the patient's name, face and ID. The system's similarity to a CT system is intended to provide familiarity, while faster treatments minimize the time that the patient spends alone in the treatment room. "All of these features are intended to provide a closer connection between the therapist and the patient," said Lee.

Lee notes that Halcyon - which received CE clearance last week - is not intended as a replacement to Varian's flagship TrueBeam radiotherapy system but will provide a complementary platform. "Where TrueBeam excels is in maximum flexibility - if there's anything you want to do in radiotherapy and radiosurgery, TrueBeam can do it," he said. "Where Halcyon excels is in operational efficiency - we have developed a system that will simplify and enhance treatment."