how to design long lasting devices - artist-embedded€¦ · • oo analysis/design ... workflow...
TRANSCRIPT
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How to design long lasting devices
December 7, 2009
for a fast changing world
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How to design long lasting devices
for a fast changing world
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion
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Introduction
• Johan Henning• Senior System Engineer• > 20 years working for Nucletron
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion
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Nucletron in facts• Nucletron B.V. is founded in 1975
• HQ Located in the Netherlands
• Spin-off from Delft Instruments in August 2007
• Nucletron’s current position:
– Over 500 employees (170 in NL)
– 120 M Euro turnover
– Over 20 offices in 16 countries
– Strong market presence in more than 80 countries
• Merged capabilities of:
– Oncology Software Solutions from MDS Nordion in 2003
– Helax, SE (External Beam Treatment Planning)
– Oldelft, NL (Imaging)
– Nucletron, NL (Brachytherapy)
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Nucletron worldwide
35% NASA
47% EMEA
18% APAC
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Nucletron’s vision
Nucletron is a knowledge-based leader in Radiation Oncology, working with the clinical team to realize innovative solutions that improve patient care
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Nucletron’s vision
• Knowledge based
– Creating value through our people and through their interaction with our customers
• Radiation Oncology
– Broader than a brachytherapy company or a treatment planning company
• Clinical Team
– Aspiring to integrating ourselves to our customers’ mission
• Innovative Solutions
– We will bundle our knowledge into solutions; a combination of all that is required to support our customers
• Improving patient care
– Making it possible to have the best choice of treatment modality for patients
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Nucletron’s product portfolio
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ImagingSolutions
3D Imaging and Simulation
Simulix Evolution™
Integrated Brachytherapy Unit
IBU-D
Oncentra® ConeBeam
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TreatmentPlanning Solutions
Dedicated body-site Planning
Oncentra® Prostate
Brachytherapy Planning
Oncentra® Brachy
External Beam Planning
Oncentra® MasterPlan
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TreatmentDeliverySolutions
Record & Verify
Oncentra® Visir
Applicators and Accessories
Afterloading
microSelectron® Digital
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InformationManagement Solutions
Oncentra® InformationManagement
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CustomerCare
Solutions
Global network of clinical experts
Professional training and consulting
On-site and remotesupport
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R&D partnerships• R&D Partnerships are critical to our success
• Key insertion of focus innovation
• Key insertion of clinical background
• Knowledge Based Solutions – designed by Clinical Users
• Our partners:– MD-Anderson, TX-USA
– UCSF, CA-USA
– Hotel Dieu, Canada
– University of Uppsala, Sweden
– RaySearch, Sweden
– University of Amsterdam, Netherlands
– University of Utrecht, Netherlands
– TatraMed, Slovakia
– Medcom/Pi-medical, Germany
– Nexus, Germany
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion
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About Cancer
• What is cancer• How to treat cancer
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About Cancer
A disease in which body cells become abnormal and divide without control
Breast Cancer
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Cell Division (Mitosis)
• Cancer is essentially a disease of Mitosis
• normal 'checkpoints' regulating mitosis are ignored or overridden by the cancer cell
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Cancer Incidence by Body Site
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Cancer treatment modalities
Cancer Treatment
Hormone Therapy
Surgery Chemotherapy
Immunotherapy
Radiotherapy
Brachytherapy Teletherapy
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RadiotherapyRadiotherapy
A treatment modality whereby ionizing A treatment modality whereby ionizing radiation is used to treat a tumorradiation is used to treat a tumor
Sources of ionizing radiation are:Sources of ionizing radiation are:
XX--Ray devicesRay devices
(sealed) sources containing(sealed) sources containingradioactive materialradioactive material
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Radiotherapy is aimed atRadiotherapy is aimed at
• Delivering a lethal dose to the tumor, while;
• Sparing surrounding healthy tissue
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Types of RadiotherapyTypes of Radiotherapy
• External beam (Linacs)
• Brachy Therapy (radiation sources)
See http://en.wikipedia.org/wiki/Brachytherapy
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Brachy treatment procedureBrachy treatment procedure
Applicator placement
Localisation of applicator
Contouring/reconstruction
Dose calculation/treatment plan
Treatment
Applicator removal
Diagnosis and localisation
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion
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System Engineering (1)System Engineering (1)
• Mechanics
• Electronics
• Firmware
• Software (GUI for devices / planning systems for treatment planning)
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System Engineering (2)System Engineering (2)
• Physics
• Algorithms (e.g. IPSA (= inverse planning by simulated annealing))
• Work flow
• Ergonomics
• Politics
EnergyEnergy
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System Engineering (4)System Engineering (4)
Gerrit Muller
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System Engineering (3)System Engineering (3)
Gerrit Muller
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Development historyDevelopment history
• Standard (Intel) boards (CPU / I/O)
• Own made boards (schematic, PCB)
• Own made firmware (only embedded)
• RTOS (uc/OS, SMX / VxWorks / WinCE)
• COTS boards (ETX) + custom made baseboard
• COTS systems (Beckhoff)
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SelectronSelectron LDRLDR
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microSelectronmicroSelectron--HDR HDR ‘‘classicclassic’’
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microSelectronmicroSelectron--HDR V2/V3HDR V2/V3
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microSelectronmicroSelectron--PDRPDR
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seedSelectronseedSelectron
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IBUIBU
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion
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Challenges (1)Challenges (1)
• Medical systems have a long lifetime (10+ yrs)
• Medical systems have a even longer service lifetime (20+ yrs)
• Nucletron: Some of the first produced systems (1975) are still in use
• Expensive medical systems are build in small quantities
• Validation / verification after changes is extensive (and expensive)
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Challenges (2)Challenges (2)
• Short time to market• Flexibility (adaptability). US / Europe /
Asia• Adhere to regulations / regulatory
approvals (CE, FDA, local regulations• Rapid changing development
environments (VS2002 / 3 / 5 / 8 / 10)• - Rapid changing development systems
(Win2000 / XP / 7)
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Challenges (3)Challenges (3)
• Obsolescence of IC's• Real time constraints• Reliability• Hospitals adhere to standards / treatment
protocols• Validation of new treatment techniques
takes a long time (> 5 years)
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion
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Solutions (1)Solutions (1)
• Standard GUI (Careface)• Industry standards (Ethernet, PoE,
EtherCat, Windows CE)• Industry standard hardware for
embedded systems (1st wave: ETX boards, 2nd wave: Beckhoff hardware)
• Use of programmable logic (CPLD's, FPGA's) instead of dedicated chips
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Solutions (2)Solutions (2)
• Libraries / common components – Database
– Dicom import/export/worklist– HIS connectivity
– Reporting– Licensing
– Users / rights / preferences– Logging / tracing
– Remote support / service / update
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Solutions (3)Solutions (3)
• Build / maintain older software / firmware projects in Virtual machines (VMWare / Virtual PC)
• Porting / complete rework of a software package (optimize, leave out unused features)
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Solutions (4)Solutions (4)
• OO analysis/design (OOA / OOD / COA)• Code generation (partly)• Simulation• C# - .NET - VS200x • Rational tools (Req. Pro, ClearQuest,
ClearCase)• UML / Enterprise Architect
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Workflow studiesWorkflow studies
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Workflow studiesWorkflow studies
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Where is the therapist during the treatment?
1 T in the same room
2 T outside in the hall3 T in his own office
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IDEAL: Feedback
Feedback
• Green LED: Device is on but no radiation
• Red LED: On and radiating
• Clearly visible
• Either on the tube, but then they can’t be big
• Or big on the device Same led’s on the control unit!
Small display showing
• Patient’s name and picture
• Picture of lesion and anatomicposition
• Sort of applicator that should beused
• Feedback whether the rightapplicator is being used
Preparation
• Patient’s medical information
• Lesion information
• Treatment planning
• Sort of applicator that has to be used
• Check whether the right applicatoris used
During treatment:
• Programmed time
• Timer running
• Pause key: stop the treatment butable to continue
• Stop key will be on control unit
• kV : energy
• mA : doses
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CarefaceCareface
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ETX board + custom baseboardETX board + custom baseboard
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Stepper motor controllerStepper motor controller
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COTS hardware (Beckhoff)COTS hardware (Beckhoff)
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Web based adjustmentWeb based adjustment
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Remote desktop (VNC)Remote desktop (VNC)
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Agenda
• Introduction• About Nucletron• About cancer and radiotherapy• System Engineering• Challenges• Solutions• Questions / discussion