Elekta Showcases Accuracy, Efficiency of Esprit, and Unity’s Motion Management at ASTRO

By Kerri Reeves


At ASTRO 22, held Oct. 23-26 in San Antonio, the booth at Elekta was abuzz with excitement over the recent FDA 510(k) clearance of Elekta Esprit, its new Leksell Gamma Knife radiosurgery platform. The company also reported results from the MOMENTUM Study—the largest prospective international registry of high-field MR-guided therapy—which showed enhanced precision radiation therapy using MR-guided online adaptation with Elekta Unity to improve outcomes in both the pancreas and prostate. The MR-Linac also just received CE mark for its Comprehensive Motion Management with True Tracking and automatic gating functionalities.

Gamma Knife

As she spoke about Elekta’s 7th generation Gamma Knife technology, Elekta Esprit, Misty Brownd, (pictured right) vice president of neurosciences for the Americas, summarized the initial mission behind its development: “protect the mind, protect the person.”

“It's really about ensuring that we preserve as much healthy tissue as possible and we protect all of the memories past, present, and future,” Brownd said during an exclusive booth interview. “Gamma Knife is truly zero margins.”

This vital precision required to safeguard motor, sensory and neurocognitive function is now one step closer to widespread use as Elekta received CE mark for its radiosurgery platform, enabling treatment for those with brain disease in Europe (and elsewhere). Elekta Esprit enables submillimeter precision targeting and treatment planning that can be completed in less than 60 seconds with minimal effect on healthy tissue.

“The new optimized Lightning and remote planning is going to decrease planning time by about 80%, so an average plan is created in less than a minute,” Brownd reported, noting it’s optimized for “just a couple of clicks.”

The technology, which is also an option on the Gamma Knife Icon system, is now embedded within Elekta Esprit. “The software aspect of Gamma Knife has improved leaps and bounds in the last few years. It’s really the software that fuels the hardware,” she said, touting reduced beam-on times by 50% for average treatment times of less than one hour.

The company also completely redesigned the patient positioning system and couch for maximum patient comfort, and provides various options for frames.


John Christodouleas, MD, senior vice president of medical affairs, reported on the company’s recent CE marking for comprehensive motion management, as “taking Elekta Unity’s capabilities to the next level.”

“This is the first radiation therapy delivery solution that measures and reports the 3-D position of the target tissue noninvasively anywhere in the body,” Dr. Christodouleas said, explaining the history behind experts trying to solve the engineering challenge of a magnetic field accompanying accelerating electrons. Elekta’s solution solves it in a way that “maximizes the value of the MR at the time of treatment,” he said, also highlighting the various strategies to expedite treatment planning.

With automatic gating, the radiation beam is turned off when the tumor moves outside of the beam, ensuring treatment is always focused on the target. The technology does so in real time, noninvasively and without surrogates, delivering personalization, precision, and efficiency of treatment with diagnostic image quality. In a demonstration, Dr. Christodouleas showed how users can see X, Y, and Z positions of the tissue they’re interested in to make patient-specific decisions about safety margins that are appropriate.

“We know what the right spot is because we’re constantly tracking it all the time. We’re literally checking the position every 200 milliseconds,” he explained.

Dr. Christodouleas also reported on two abstracts from the MR-Linac Consortium that showed enhanced precision radiation therapy using MR-guided online adaptation that may improve outcomes in pancreas and prostate cancers. While large, randomized trials are needed, he said the news was promising and results will likely further drive hypofractionation in treatment.

He also revealed that Unity was being investigated for applications in the following areas: glioblastoma, oropharyngeal cancer, esophagus, lung, pancreas, liver, rectum, prostate, cervix, and bladder.

While the technology is expensive, Dr. Christodouleas predicted that the latest evolution with Comprehensive Motion Management will lower labor barriers to the highest quality care so even centers in resource-constrained environments will be able to offer the treatment to patients.