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Many women diagnosed with breast cancer undergo radiation as part of their
treatment. The benefit of radiation therapy in helping to stop cancer cells from growing and dividing usually outweighs
the risk for most breast cancer patients. However, because the treatment involves the administration of
radiation, radiologists want to ensure that that the dosage is correct and targeted to maximize the effect
on cancerous tissue while minimizing the effect on healthy tissue. The dose verification system
(DVS), which is manufactured by Sicel Technologies, has been approved by the U.S. Food and Drug
Administration (FDA) for radiation treatment of breast and prostate cancer in 2006.
"Increasingly, we are utilizing radiation therapy protocols designed to deliver higher doses of radiation to
smaller targeted areas. These protocols enable us to effectively kill cancerous cells while minimizing
damage to surrounding healthy tissue that may result in unwanted side effects," says Catherine
Lee M.D., Rex Cancer Center Raleigh, NC, in a 2008 Sicel Technologies news release. "But they also
require a high degree of accuracy and precision to be successful. DVS confirms that the
radiation we prescribe for our patient is getting to the intended target, and alerts us to
variations during the course of treatment when there is an opportunity to evaluate and
correct, if necessary, the cause of the variations."
DVS helps radiologists determine the amount of radiation a patient receives is within the prescribed range each time
radiation treatments are administered. To do so, the radiologist can use the system measures the amount of
radiation that is delivered to the tumor tissue, tumor bed, or healthy tissue. DVS differs from normal
radiation therapy in that the physician must implant DVS radiation dosimeters near the tumor or tumor
bed and/or surrounding normal tissue during a minimally invasive procedure. Most patients receive one
or two dosimeters. Once implanted, wireless technology transmits the information to a hand-held monitor
and radiation absorption rates are read during daily treatments, enabling radiologists to verify that
the dose received by the patient is within the prescribed range. The dosimeter does not produce radiation itself.
The DVS implantable dosimeter is 0.8 inches (20mm) long and 0.08 inches (2.1mm) in diameter. During radiation
treatment, each dosimeter transmits the amount of radiation that is received at its location. The dosimeter
near the tumor should receive the highest dose, while the other receives a lower dose. After radiation
treatment sessions are completed, the dosimeters will remain inside the patient without an effect on a patient's daily routine.
In January 2008, the U.S. Centers for Medicare and Medicaid created a new HCPCS code (Healthcare Common Procedure Coding
System) for the DVS. The code will cover the cost for the Dose Verification System (DVS). The code, which reimburses
radiation therapy centers for the medical device when implanted in any body site, makes DVS more accessible
to patients undergoing radiation treatment for breast and prostate cancer because private insurers will cover
the cost for the device. The cost for the device is also adequately covered by the new code for Medicare
patients treated in freestanding centers. Separate codes are available to cover the cost associated with implanting the device.
The patient's physician will determine whether she is a candidate for DVS. Some patients have experienced discomfort
after the implantation of the DVS dosimeters; however, according to Sicel Technologies, no adverse long-term
effects have been reported.
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