ELEKTA
Brachytherapy Applicator and Accessories User Guide 2017
User Guide
127 Pages
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Page 1
User Guide
At Elekta we believe that our solutions, services and extensive knowledge of precisely targeted radiation therapy play a vital role in the successful treatment of cancer. Our key technological advances have resulted in an integrated package of brachytherapy treatment planning and delivery systems. This applicator guide provides a comprehensive overview of the Elekta applicator portfolio for brachytherapy.
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Elekta Brachytherapy Elekta Brachytherapy solutions are part of Elekta’s leading radiation therapy portfolio and encompass more than 40 years of Nucletron® innovations. The latest advancements include Flexitron® treatment delivery, new Oncentra® Brachy treatment planning modules and a variety of new and innovative applicators.
Industry-leading brachytherapy applicator portfolio Applicators are a pivotal part of Elekta’s fully integrated solutions. With a broad portfolio of dedicated applicators, we offer a complete applicator range for more than 15 types of cancer in a variety of anatomies, developed in close collaboration with clinical experts. With applicators that are leading in 3D-imaging compatibility as well as a legacy of 2D products, you can select from the largest applicator portfolio to match your choice of treatment and clinical setup.
Flexitron treatment delivery Elekta’s afterloading platforms have established an unparalleled reputation for reliability, safety and performance in treatment delivery. Their all-in-one versatility and unmatched flexibility prove their value on a daily basis in the majority of brachytherapy institutes around the world. The new ‘Safety through simplicity’ Flexitron family is designed for safety and better team efficiency. With more logic and fewer variables, the Flexitron afterloading platform optimizes the treatment delivery process and offers you a safe investment for today and in the future.
Oncentra Brachy treatment planning With the Oncentra Brachy treatment planning system, the creation of highly conformal plans in an efficient workflow is within reach. The latest version of Oncentra Brachy offers a series of useful tools that facilitate many repetitive tasks for you such as contouring and reconstruction. Oncentra Brachy buys you time to focus on what matters: designing the optimal dose distribution. When Oncentra Brachy treatment planning is used in combination with the new Flexitron afterloading platform, you will optimally benefit from a number of smart features that allow an easy, standardized way of treatment planning-while feeling confident about accurate and safe treatment delivery.
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How to use this applicator guide
Safety in the magnetic resonance environment
In this applicator guide, brachytherapy applicators
The symbols shown below are used to indicate safety of
are presented by body site. When a particular
medical devices in the magnetic resonance environment.
applicator can also be used for other body sites, a cross reference is given on the index page at
MR safe: An item that poses no known hazards
the start of the relevant applicator section.
in all MR environments (1.5T, 3T, 6T and others).
The applicators and accessories in this guide are
MR conditional: An item that has been
designed for use with the Flexitron and microSelectron afterloaders only. Applicators and accessories specific
demonstrated to pose no known hazards
to Flexitron or microSelectron are so indicated.
in a specified MR environment with specified
Corresponding transfer tubes, x-ray catheters and
conditions of use (specified in the User
CT and MRI markers per applicator and afterloader
Manual, typically compatible for 1.5T and 3T
type can be found in the appendixes.
MR environment).
Consumables information:
MR unsafe: An item that is known to pose hazards in all MRI environments.
single use, delivered sterile single use, delivered non-sterile
Note:
multiple use, delivered non-sterile
ot all products in this guide are available in all markets. N Please contact your local Elekta representative for more information.
Sterilization advice
pplicators as mentioned in this guide can be used A with both Iridium-192 and Cobalt-60 afterloaders, except for the Valencia and Leipzig applicators.
Sterilization advice provided in this document is indicative and applies to newly purchased applicators. For more information regarding sterilization of a
If no information is provided under ‘part number,’ this item cannot be ordered separately.
particular applicator, please consult the User Manual or Sterilization Advice Chart.
The latest version of the applicator guide is leading and can be downloaded from www.elekta.com/brachytherapy/ applicators Find your information under the relevant bodysite.
The contents of this document are subject to change without
References to literature are not included in this guide.
notice. All rights reserved. Comments or questions may be directed to [email protected].
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Applicators Gynecology
6
Prostate, rectum and bladder
50
Breast
62
Bronchus and esophagus
72
Head and neck
80
Skin and surface
86
Needles and flexible implant tubes 94
Quality assurance tools 104
Accessories 110
Index 116
Appendixes Table for Flexitron x-ray, CT and MRI markers
118
Table for Flexitron transfer tubes
120
Table for microSelectron x-ray, CT and MRI markers
122
Table for microSelectron transfer tubes
124
Visit elekta.com/brachytherapy
for the most up-to-date applicator overview 5
Gynecology Applicator Dimensions Ring Applicators Ring dimension IU angle
Ring tube 90°
Ring angle
Intrauterine tube
xx mm
Ovoid Applicators IU angle
Ovoid tube
Ovoid dimension*
90°
Ovoid angle
Intrauterine tube
xx mm
* Not applicable for Cervix Rotterdam applicator. The ovoid and ring sizes as provided in the descriptions in the guide are
the measurements of the inner diameter (source path). The outer diameters vary for both rings and ovoids. For the correct outer diameter size, refer to the appropriate applicator user manual.
6
Cervix
The intrauterine tubes are available as sets in 4 mm and 6 mm.
Intrauterine tube (4 mm) Easier to insert and less uncomfortable for the patient, these tubes have a straight distal end and dilation is not necessary. For this set,
Advanced Gynecological Applicator Venezia
8
Utrecht interstitial CT/MR applicator set
10
Fletcher CT/MR shielded applicator set
12
Fletcher CT/MR applicator set
14
Standard CT/MR applicator set
16
Fletcher Williamson applicator set
18
Cervix Rotterdam applicator set
20
Henschke titanium applicator set
22
Interstitial ring CT/MR applicator set
24
Vienna ring CT/MR applicator set
26
Ring CT/MR applicator set
28
Ring applicator set
30
Adjustable cervix applicator set
32
Vagina
the special rector retractors are also available.
Intrauterine tube (6 mm) Dilatation of the cervix is often needed and this tube has a curved distal.
Note: · The intrauterine tubes can be sterilized using steam sterilization and ethylene oxide · User manual 777.00088
Vaginal CT/MR multi channel applicator set
34
Vaginal CT/MR applicator set
36
Vaginal cylinder applicator set titanium
38
Shielded cylindrical applicator set
40
Miami vaginal applicator set
42
Vaginal applicator set
44
Vaginal mold applicator set
46
Endometrium Rotte endometrial applicator set
48
Alternatives for Vaginal Brachytherapy Prostate stepper template set Prostate, rectum and bladder
MUPIT applicator set Prostate, rectum and bladder
Intracavitary mold applicator set Prostate, rectum and bladder
56 58 60
Perineum MUPIT applicator set Prostate, rectum and bladder
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58
Gynecology
Advanced Gynecological Applicator Venezia™ Reach cervix, parametrium and vagina-expanding clinical capabilities
Simplify (interstitial) gynecological brachytherapy Interstitial brachytherapy for advanced stage cervical cancer can be performed by free-hand needle placement. Although Venezia still allows free-hand needle placement, it is not necessary because the parallel and oblique needle holes in the ovoids and perineal template guide the needles to the desired location. In addition, the needle insertion tool enables the physician to advance the ovoid needles to the prescribed depth. This guided needle placement ensures reproducible dosimetric results, making needle placement easier and more accurate.
Venezia allows you to reach beyond: access tumors in the parametrium and the vagina with ease. The Advanced Gynecological Applicator allows treatment of patients with IIIB cervical cancer, but also IB, IIA/B, IIIA and stage IVA tumors. One applicator can treat multiple tumor stages, so you can use the same applicator type for various patient groups. The two lunar-shaped ovoids form a ring when clicked together, allowing you to benefit from the advantages of a tandem and ovoid applicator in combination with the dose distribution of a ring-high dose
Venezia is much easier to insert and assemble than conventional gynecological applicators. Simply insert the first half of the applicator and attach the second half by sliding and clicking the two parts together. The applicator contains no screws and requires no tools, making applicator assembly and insertion an easy do-it-yourself task.
to the target volume while sparing organs at risk.
Reproducible dosimetric results The numbered hole positions on the Venezia ovoids and template facilitate consistent needle placement for every fraction-every time. Additionally, the insertion tool helps to insert the needles at the exact prescribed depth.
Easily integrate into the workflow Venezia comes in various sizes to accommodate every patient’s pelvic anatomy, for increased patient comfort. And, depending on the patient’s indication, the physician can select vaginal and/or perineal needle insertion. The multipurpose applicator eliminates the need for a separate device for every indication.
Venezia is included in the Oncentra® Brachy Applicator Modeling module, making reconstruction easy and fast. Simply select Venezia, then import and modify to meet clinical needs. Manual reconstruction becomes obsolete, saving time and streamlining workflow.
Venezia suits all imaging modalities including ultrasound, CT, x-ray and MRI. For virtually any imaging workflow, Venezia will always be clearly visible in the image dataset.
Intended use: · Cervix · Endometrium
Note: User manual 777.00493
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Order information
Why the Advanced Gynecological Applicator Venezia?
Advanced Gynecological Applicator Venezia Part number
Description
126.001
Interstitial lunar ovoid tube 22 mm 60° right
126.002
Interstitial lunar ovoid tube 22 mm 60° left
126.003
Interstitial lunar ovoid tube 26 mm 60° right
126.004
Interstitial lunar ovoid tube 26 mm 60° left
126.005
Interstitial lunar ovoid tube 30 mm 60° right
126.006
Interstitial lunar ovoid tube 30 mm 60° left
126.007
Vaginal cap 22 mm right
126.008
Vaginal cap 22 mm left
126.009
Vaginal cap 26 mm right
126.010
Vaginal cap 26 mm left
126.011
Vaginal cap 30 mm right
126.012
Vaginal cap 30 mm left
126.013
Intrauterine tube 0 mm
126.014
Intrauterine tube 30 mm 30°
126.015
Intrauterine tube 40 mm 30°
126.016
Intrauterine tube 50 mm 30°
126.017
Intrauterine tube 60 mm 30°
126.018
Intrauterine tube 70 mm 30°
126.019
Intrauterine tube 30 mm 15°
126.020
Intrauterine tube 40 mm 15°
126.021
Intrauterine tube 50 mm 15°
126.022
Intrauterine tube 60 mm 15°
126.023
Intrauterine tube 70 mm 15°
126.024
Fixation element
126.025
Fixation clip
126.026
Perineal template dorsal 0°
126.027
Perineal template dorsal 12°
126.028
Perineal template ventral 0°
126.029
Bracelet for guiding tubes (5 x 1)
126.030
Number tag for guiding tubes (5 x 1)
126.031
Guiding tubes for interstitial lunar ovoid (5 x 1)
126.032
Guiding tubes for vaginal cap (5 x 1)
126.033
Perineal bar
101.012
Sterilizing caps CT/MR
110.268
ProGuide obturator bulk set, 6F x 294 mm (1 x 5)
189.714
Insertion tool
189.040
Cleaning brush Ø 2.5 mm x 250 mm (set of 3)
189.043
Cleaning brush Ø 6.5 mm x 100 mm (set of 3)
137.287
Lock inserts set for 6F plastic needles
137.290
Needle lock tool
101.015
CT/MR sterilization box
· Reach cervix, parametrium and vagina, expanding clinical capabilities · Ensure reproducible dosimetric results · Simplify (interstitial) gynecological brachytherapy · Easily integrate into workflow
“With Venezia, I expect to treat advanced cervical cancer patients with more ease. Venezia will allow me to reach tumors extended to the parametrium because I can position needles at multiple angles, in the vagina and through the perineum.” Petch Alisanant, MD Division of Radiation Oncology Chulalongkorn University Bangkok, Thailand
ProGuide 6F needles and obturators (plastic) Part No.
Name
110230
ProGuide Round Needle Set, 6F x 294 mm
189607
ProGuide Round Needle Set, 6F x 240 mm1
189608
ProGuide Round Needle Set, 6F x 200 mm1
189623
ProGuide Round Needle Bulk Set, 6F x 200 mm1
189622
ProGuide Round Needle Bulk Set, 6F x 240 mm1
110231
ProGuide Sharp Needle Set, 6F x 294 mm
189601
ProGuide Sharp Needle Set, 6F x 240 mm1
189602
ProGuide Sharp Needle Set, 6F x 200 mm1
189617
ProGuide Sharp Needle Bulk Set, 6F x 200 mm1
189616
ProGuide Sharp Needle Bulk Set, 6F x 240 mm1
189.628
ProGuide obturator bulk set, 6F x 240 mm (12 pcs)
189.629
ProGuide obturator bulk set, 6F x 200 mm (12 pcs)
110268
Obturators, set of 5, for needles 6F and l = 294 mm (flexible)
¹ These sets include obturators
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Gynecology
Image shows the applicator with the 4 mm intrauterine tube
Utrecht Interstitial CT/MR Applicator Set A compelling workflow for image-guided adaptive brachytherapy (IGABT)
Intended for:
The Utrecht Interstitial applicator is a state-of-the-
· Endometrium
· Cervix
art treatment solution for combined intracavitary and interstitial gynecological brachytherapy.
Note:
Targeted dose optimization
· Can also be used as a standard intracavitary applicator
In addition to the regular intracavitary treatment
· Asymmetrical ovoid placement is possible
channels of the applicator, the ovoids act as a template
· Use of needles with rounded tip can reduce the risk of perforation of critical structures, and is required for use with interstitial cervix applicators
for placing additional needles in the cervical area. The interstitial needles provide additional control of dose coverage to the tumor, while sparing the surrounding
· The applicator can be sterilized using steam sterilization
tissue. The insertion depth of the needles can be easily controlled using the insertion tool. The needles
· User manual 777.00077
are individually locked in place for treatment.
Order information
Optimized for 3D imaging and planning
Utrecht Interstitial CT/MR applicator set (4 mm) part # 110.270A02
The applicator uses strong composite fiber tubing and plastic to eliminate distortion on CT and MR
The same set as the below 6 mm set, but with 4 mm
imaging. With the use of transversal slices, and the
intrauterine tubes
Applicator Modeling and Library Plans modules
Utrecht Interstitial CT/MR applicator set (6 mm) part # 110.270A01
in Oncentra Brachy, the applicator is quickly reconstructed during treatment planning.
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Part number
Description
189.735
Ovoid tube 1
189.740
Ovoid tube 2
189.739
Intrauterine tube 15º
189.745
Intrauterine tube 30º
110.240
Interstitial ovoid pair 15 mm, 15º
110.241
Interstitial ovoid pair 20 mm, 15º
110.242
Interstitial ovoid pair 25 mm, 15º
110.243
Interstitial ovoid pair 30 mm, 15º
189.714
Insertion tool
110.268
Obturator set (set of 5)
189.751
Rectal retractor 40 mm
189.742
Rectal retractor 30 mm
189.741
Fixation nut for rectal retractor
189.722
Fixation mechanism
189.750
Fixation clip
189.930
Spare fixation nuts set (5 pcs)
101.012
Sterilization caps (50 pcs)
110.267
Cervical stopper
110.283
Screwdriver for ovoids and stopper
008.033
Plastic screw M5 PPSU (10 x 008.033)
189.040
Cleaning brush set (2.5 mm)
189.043
Cleaning brush set (6.5 mm)
Why the Utrecht Interstitial CT/MR applicator? · Targeted dose optimization · Complex interstitial brachytherapy made easy · Artifact-free 3D images
Part number
Description
110.230*
ProGuide round needle set, 6F x 294 mm
110.231
ProGuide sharp needle set, 6F x 294 mm
110.232*
Guiding tube for ovoids
189.769
Intrauterine tube, d = 6 mm, 45º
110.296/298/300
Intrauterine tube, d = 4 mm, 15°/30°/45°
110.272
Interstitial ovoid set 25º (15 mm, 20 mm, 25 mm, 30 mm)
101.031
Fixation mechanism for ovoid tubes
189.566**
Smit Sleeves CT/MR (10 pcs, l = 40 mm, d = 9 mm)
110.700
Pins for adjustable mechanism (5 pcs)
189.894
Spare part set plastic screw M5 PPSU (10 pcs)
189.724
Internal fixation mechanism
189.727
Clip bolt
189.731
Pin
110.315
Rectal retractor 30 mm with slot (for intrauterine tubes 4 mm)
“Combined intracavitary/ interstitial brachytherapy for cervical cancer not only provides the possibility to increase the target volume dose but also to reduce the dose to organs at risk.”
110.335
Rectal retractor 40 mm with slot (for intrauterine tubes 4 mm)
Ina Jürgenliemk-Schulz
110.395
Cervical stopper for 4 mm
110.396
Cervical stopper tool for 4 mm
101.015
CT/MR sterilization box
189.729
Fixation axle
Accessories
University Medical Center Utrecht, The Netherlands
*Required for interstitial treatment **For more options, refer to Accessories section Consumables information Single use, delivered sterile Single use, delivered non-sterile Multiple use, delivered non-sterile
11
Gynecology
Image shows the applicator with the 4 mm intrauterine tube
Fletcher CT/MR Shielded Applicator Set Combining the benefits of 3D imaging with ovoid shielding
Intended for:
During recent years, 3D image-guided brachytherapy
· Endometrium
· Cervix
using CT and MR imaging has steadily replaced x-raybased dose planning. Visualization of the targeted area
Note:
and untargeted anatomies enables conformation of
· Includes unique moveable shielding mechanism
the dose distribution to the target volume and dose
· MR conditional (up to 3 Tesla)
reduction to organs at risk. Sparing of the organs at risk
· This applicator can be sterilized using plasma sterilization
was traditionally accomplished by the use of shielded
(STERRAD®)
ovoids. However, the metal components of such ovoids
· User manual 777.00157
interfere with modern 3D-imaging modalities and distort acquired images.
· The most accurate dose effect of the shields in your plans
The Fletcher CT/MR shielded applicator is the first of its kind
for both Iridium-192 and Cobalt-60 sources. Oncentra
to overcome these issues. Moveable shielding incorporated
also provides a shield approximation that can be used
in the ovoids allows you to lower the dose to organs at risk
for TG-43 calculations for Iridium-192.
can be calculated with ACE (TG-186) in Oncentra Brachy,
during gynecological brachytherapy treatments. High-
Order information
quality CT and MR images for 3D dose planning can now
Fletcher CT/MR shielded applicator set (4 mm) Part # 110.980
be combined with protection of the organs at risk.
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Part number
Description
110.930
Shielded ovoid tube 1
110.940
Shielded ovoid tube 2
110.970
Intrauterine tube (4 mm), 15º
110.971
Intrauterine tube (4 mm), 30º
189.722
Adjustable fixation mechanism
110.957
Fixation clip
110.967
Cervical stopper (4 mm)
101.012
Sterilization caps (IU tube) (50 pcs)
110.960
Ovoid cap 25 mm (2 pcs)
110.961
Ovoid cap 30 mm (2 pcs)
110.963
Transfer tube cap (2 pcs)
110.283
Screwdriver titanium
189.930
Fixation nuts (spare; 5 pcs)
189.894
Plastic screw M5 PPSU (10 pcs)
Why the Fletcher CT/MR shielded applicator? · High dose to target combined with significant protection of organs at risk
Fletcher CT/MR shielded applicator set (6 mm) Part # 110.950 Part number
Description
110.930
Shielded ovoid tube 1
110.940
Shielded ovoid tube 2
189.739
Intrauterine tube (6 mm), 15º
189.745
Intrauterine tube (6 mm), 30º
189.722
Adjustable fixation mechanism
110.957
Fixation clip
110.954
Cervical stopper (6 mm)
101.012
Sterilization caps (IU tube) (50 pcs)
110.960
Ovoid cap 25 mm (2 pcs)
110.961
Ovoid cap 30 mm (2 pcs)
110.963
Transfer tube cap (2 pcs)
110.283
Screwdriver titanium
189.930
Fixation nuts (spare 5 pcs)
189.894
Plastic screw M5 PPSU (10 pcs)
· Minimize image artifacts with moveable shields · Maximum workflow efficiency with Oncentra Brachy planning tools
Accessories Part number
Description
110.972
Intrauterine tube (4 mm), 45º
189.769
Intrauterine tube (6 mm), 45º
189.566*
Smit Sleeve CT/MR 40 mm (10 pcs)
189.676*
189.676 and following Smit Sleeves, l = 20 mm and longer, d = 6 mm (10 pcs)
101.031
Fixation mechanism for ovoid tubes
101.015
CT/MR sterilization box
189.931
CT/MR applicator clamp with axle
189.932
CT/MR applicator clamp with base plate
110.700
Pins for adjustable fixation mechanism (5 pcs)
189.724
Internal fixation mechanism
189.930
Fixations nuts (spare 5 pcs)
189.894
Plastic screws M5 PPSU (10 pcs)
189.729
Fixation axle
Consumables information Single use, delivered sterile Single use, delivered non-sterile Multiple use, delivered non-sterile
*For more options, refer to the Accessories section
13
Gynecology
Fletcher CT/MR Applicator Set The optimal solution for volume-based intracavitary cervical brachytherapy
Intended for: · Cervix
The Fletcher CT/MR applicator uses two ovoids to shape
· Endometrium
a ‘Fletcher-type’ dose for intracavitary gynecological brachytherapy. This proven pear-shaped dose matches
Note:
the anatomy of the cervix and surrounding areas.
· The separate Utrecht Interstitial applicator complementary set (110.271) contains all components to add interstitial functionality to a Fletcher CT/MR applicator, thereby upgrading it to the state-of-the-art Utrecht Interstitial CT/MR applicator
The applicator uses strong composite fiber tubing and plastic to eliminate distortion on CT and MR imaging. With the use of the Applicator Modeling module in Oncentra Brachy, the applicator is reconstructed with
· Asymmetrical ovoid placement is possible
just a few mouse clicks.
· The applicator can be sterilized using steam sterilization
The flexible geometry of the applicator provides the options
· User manual 777.00287
to optimize the position of the ovoids to the cervix, and to adjust the intrauterine tube to ensure an optimal fit with the patient’s anatomy.
Unique solution for narrow anatomy of vagina An extra-small version of this applicator is available. The Fletcher CT/MR applicator set XS has small ovoids that optimally fit women with a narrow vagina, e.g. patients from regions in Asia. The thin intrauterine
4 mm IU tube with new stopper
tubes in this set facilitate easy insertion.
14
Order information
Why the Fletcher CT/MR applicator set?
Fletcher CT/MR applicator set, part # 189.730 Part number
Description
189.735
Ovoid tube 1
189.740
Ovoid tube 2
189.739
Intrauterine tube 15°
189.745
Intrauterine tube 30°
189.783
Ovoid pair 15 mm (half ovoids)
189.754
Ovoid pair 20 mm
189.755
Ovoid pair 25 mm
189.756
Ovoid pair 30 mm
189.757
Ovoid pair 35 mm
189.758
Ovoid pair 40 mm
189.742
Rectal retractor 30 mm
189.751
Rectal retractor 40 mm
189.741
Fixation nut for rectal retractor
110.267
Cervical stopper
189.722
Adjustable fixing mechanism
189.750
Fixation clip
008.033
Plastic screw M5 PPSU (10 x 008.033)
110.283 101.012
· Ideal for volume-based intracavitary cervical brachytherapy · Adjustable to the patient’s anatomy · Compatible with CT · MR safe Accessories Part number
Description
110.296/.298/.300
Intrauterine tube (4 mm) 15°/30°/45°
189.566**
Smit Sleeves CT/MR Ø 9 mm (box of 10)
Screwdriver for ovoids and stopper
189.676**
189.676 and following Smit Sleeves, l = 20 mm and longer, d = 6 mm (10 pcs)
Sterilization caps (pack of 50)
189.769
Intrauterine tube 45° (6 mm)
101.031
Ovoid tube fixing mechanism
101.015
CT/MR sterilization box
189.900
Ovoid set with radius 12.5 mm (25, 30, 35, 40 mm)
189.901
Ovoid set with radius 15 mm (30, 35, 40 mm)
110.700
Pins for adjustable mechanism (5 pcs)
189.930
Spare fixation nuts (5 pcs)
110.271
Utrecht Interstitial applicator complimentary set, to expand the use of the Fletcher CT/MR applicator to interstitial treatments
189.894
Spare part set plastic screw M5 PPSU (10 pcs)
110.315
Rectal retractor 30 mm with slot (for intrauterine tubes 4 mm)
110.335
Rectal retractor 40 mm with slot (for intrauterine tubes 4 mm)
189.741
Fixation nut for rectal retractor
110.395
Cervical stopper for 4 mm
110.396
Cervical stopper tool for 4 mm
189.729
Fixation axle
Fletcher CT/MR applicator set XS, part # 110.216 Part number
Description
189.735
Ovoid tube 1
189.740
Ovoid tube 2
110.296*
Intrauterine tube (4 mm), 15º
110.298*
Intrauterine tube (4 mm), 30º
110.300*
Intrauterine tube (4 mm), 45º
110.540
Ovoid pair 15 mm, R7.5 (micro ovoids)
189.783
Ovoid pair 15 mm, R10 (half ovoids)
189.754
Ovoid pair 20 mm, R10
189.755
Ovoid pair 25 mm, R10
189.722
Adjustable fixation mechanism
189.750
Fixation clip
101.012
Sterilization caps (50 pcs.)
110.283
Screwdriver titanium for ovoids and stopper
008.033
Plastic screw M5 PPSU (10 x 008.033)
*The 4 mm IU tubes include a cervical stopper **For more options, refer to the Accessories section
Consumables information Single use, delivered sterile Single use, delivered non-sterile Multiple use, delivered non-sterile
15
Gynecology
Standard CT/MR Applicator Set The standard CT/MR applicator set is designed using
Intended for:
composite fiber tubing to eliminate distortion on CT or
· Cervix
MR images. This enables conformal treatment planning
· Endometrium
with the use of transverse slices. To ensure applicator and
Note:
treatment integrity, the standard CT/MR applicator has a fixed geometry.
· The applicator can be sterilized using steam sterilization or ethylene oxide · User manual 090.613
16
Order information
Why the standard CT/MR applicator?
Standard CT/MR applicator set, part # 101.020 Part number
Description
101.021
Ovoid tube 1
101.022
Ovoid tube 2
101.023
Intrauterine tube 40 mm
101.024
Intrauterine tube 50 mm
101.025
Intrauterine tube 60 mm
101.026
Ovoid pair 20 mm
101.027
Ovoid pair 25 mm
101.028
Ovoid pair 30 mm
101.029
Rectal retractor 30 mm
101.030
Rectal retractor 40 mm
101.031
Ovoid tube fixing mechanism
008.034
Screwdriver for ovoid and stopper
101.012
Sterilizing caps, CT/MR
008.033
Plastic screw M5 PPSU (10 x 008.033)
· Compatible with CT, and MR safe · Applicator with fixed geometry ensures reproducible geometry
Accessories Part number
Description
101.015
CT/MR sterilization box
110.302
Intrauterine tube (4 mm), l =50 mm, 40º
189.566*
Smit Sleeves CT/MR, l = 40 mm, d = 9 mm (box of 10)
189.768
Cervical stopper for 110.302
Consumables information Single use, delivered sterile Single use, delivered non-sterile Multiple use, delivered non-sterile
*For more options, refer to the Accessories section
17
Gynecology
Fletcher Williamson Applicator Set This applicator is based on the dosimetry of the
Order information
conventional shielded Fletcher-style applicator.
Fletcher Williamson applicator set, part # 085.230
A lightweight tungsten alloy shielding is incorporated
Part number
Description
085.233
Ovoid tube 1
085.234
Ovoid tube 2
085.231
Shielded ovoid tube 1
085.232
Shielded ovoid tube 2
084.203
Ovoid pair, mini, 16 mm unshielded
085.235
Ovoid cap pair, 20 mm, small
085.236
Ovoid cap pair, 25 mm, medium
085.237
Ovoid cap pair, 30 mm, large
Intended for:
084.028
Fixing mechanism, ovoid tube
· Cervix
084.024
Intrauterine tube 15°
084.025
Intrauterine tube 30°
084.026
Intrauterine tube 45°
Note:
084.030
Cervical stopper, small
· The applicator can be sterilized using steam sterilization
084.027
Adjustable fixing mechanism
084.158
Sterilizing caps, 3.2 mm (50 pcs)
006.182
Screwdriver
in the ovoid tubes to reduce the dose to the bladder and rectum. Ovoids are positioned at a 60° angle to the vaginal axis. The set includes mini ovoids for narrow vaginas and thin 3.2 mm intrauterine tubes. A specific Fletcher Williamson ‘Asia Pacific’ applicator set is available, which is unshielded and has small geometry ovoids.
· Endometrium
· User manual 090.604
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Fletcher Williamson Asia Pacific set, part # 085.260 Part number
Description
085.233
Ovoid tube 1
085.234
Ovoid tube 2
084.203
Ovoid pair, mini, 16 mm unshielded
084.041
Ovoid pair, half, unshielded
084.042
Ovoid pair, 20 mm, small, unshielded
084.028
Fixing mechanism, ovoid tube
084.024
Intrauterine tube 15°
084.025
Intrauterine tube 30°
084.026
Intrauterine tube 45°
084.030
Cervical stopper, small
084.027
Adjustable fixing mechanism
084.158
Sterilizing caps, 3.2 mm
006.182
Screwdriver
Why the Fletcher Williamson applicator? · Embedded shielding reduces dose to critical organs
“The Fletcher Williamson applicator is a well-crafted, precision instrument with bladder and rectal shielding. This instrument allows us to continue a quality technical approach to gynecological brachytherapy with High Dose Rate brachytherapy.”
Accessories Part number
Description
084.043
Ovoid pair, 25 mm, medium, unshielded
084.044
Ovoid pair, 30 mm, large, unshielded
084.421
Rectal retractor, 4 x 30 mm (thickness x width)
084.422
Rectal retractor, 4 x 40 mm (thickness x width)
086.010
Rectal retractor, 10 x 40 mm (thickness x width)
086.009
Rectal retractor, 10 x 30 mm (thickness x width)
086.011
Fixing mechanism, retractor
006.025
Spare fixing screw
006.030
Torque screwdriver, 2.5 mm
101.015
CT/MR sterilization box
189.676 and following*
Smit Sleeves CT/MR for Ti intrauterine tube, l = 20 mm and longer, d = 6 mm (box of 10 pcs)
Consumables information Single use, delivered sterile Single use, delivered non-sterile
J. Stitt, MD
Multiple use, delivered non-sterile
University of Wisconsin, Madison United States
*For more options, refer to the Accessories section
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Gynecology
Cervix Rotterdam Applicator Set The lightweight applicator for cervical brachytherapy
Note: · The applicator can be sterilized using steam sterilization
The Cervix Rotterdam applicator supports fast and
· User manual 777.00281
reproducible cervical brachytherapy. The use of titanium makes the applicator thin and lightweight, with a design
Order information
that aids correct implantation. The applicator is compatible
Cervix Rotterdam applicator set IU-15°, part # 137.218
with CT and MR images.
Fixed geometry The lightweight applicator can easily be assembled during insertion. The applicator’s geometry is fixed once inserted, which provides reproducible delivery setup during all treatment fractions.
Easy treatment extension
Part number
Description
137.235
Right ovoid tube I, IU-15° (ti)
137.236
Left ovoid tube III, IU-15° (ti)
137.191
Ovoid pair, 20 mm, small
137.192
Ovoid pair, 25 mm, medium
137.193
Ovoid pair, 30 mm, large
137.230
Intrauterine tube IIIII, IU-15°, l = 30 mm, (ti)
137.232
Intrauterine tube IIIII, IU-15°, l = 50 mm, (ti)
137.234
Intrauterine tube IIIII, IU-15°, l = 70 mm, (ti)
With the optional vaginal cylinder, the treatment can be
137.246
Ovoid tube coupling for 15°, for ovoids only (ti)
easily extended to include the vaginal wall in the same
137.570
Closing caps (25/pack)
treatment fraction.
137.574
Screwdriver for ovoid screws
Enhancing your workflow
Accessories for 15° set
With the use of the Applicator Modeling module of Oncentra Brachy, the Cervix Rotterdam applicator is quickly reconstructed during treatment planning.
Intended for:
Part number
Description
137.245
Vaginal cylinder locking pin (ti)
137.237
Vaginal cylinder and cap 15°, Ø 30 mm, l = 60 mm
137.207
Vaginal cylinder and cap 15°, Ø 37 mm, l = 60 mm
137.238
Vaginal cylinder and cap 15°, Ø 40 mm, l = 60 mm
· Cervix
137.229
Intrauterine tube IIIII, IU-15°, l = 20 mm, (Ti)
· Endometrium
137.231
Intrauterine tube IIIII, IU-15°, l = 40 mm, (Ti)
137.233
Intrauterine tube IIIII, IU-15°, l = 60 mm, (Ti)
· Vagina
Indication of ovoid dimensions of Cervix Rotterdam applicator
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