This year, ASTRO was in San Antonio, Texas, and it was one of the best shows I have attended all year.

Manufacturers are making great strides in the area of cancer detection and cancer treatment. Both large companies and smaller ones were well represented at this year's meeting. Attendance was phenomenal. I do not know the exact numbers but I know that it was one of those shows where you had to dodge and weave because there was so many people.

We will be covering many of these topics in the upcoming days but here is a little hint of what to expect.

MR simulation. Think about it. We have gone from using X-ray image intensifier to locate the tumor and simulate and plan the treatment to CT scanners and now to MR scanners. As we know, MR is particularly useful for soft tissue so for planning around the male prostate, it is going to be a real improvement.

CT scanners are using some amazing technology to create a 70 centimeter wide image for planning purposes. This brings the planning and simulation closer in line with the 80 centimeter circle that most accelerators are designed around.

There are some really interesting developments using cameras to monitor patients' breathing and link it to gating.

I was impressed with the efforts Philips is making to reduce the time between planning and treatment, which puts a lot less mental stress on the patient and their family.

Then there was the Discovery RT from GE. It is a CT simulator that utilizes an 80 centimeter bore and field of view to help providers with more complex treatment plans, more complex setups, and dealing with artifacts in motion.

That system can draw on data from beyond the normal detector range to create iterative reconstruction — a technology GE calls Max Field of View.

The Biograph RT Pro from Siemens is also bringing new benefits to the planning stage by communicating directly with the therapy planning system to optimize workflow. Software integration is a key component, which is something Siemens has emphasized with many of its newer imaging systems.

Proton beam was very well represented at the show with multiple different technologies. Varian had the biggest booth at the show and had, probably, a third of the booth dedicated to its ProBeam product. The people from Mevion were floating on air coming in after their recent successes, including their first European install contract. They have commented and it is no longer a discussion of how they can do it — it is now a discussion of how well they can do it.

P-Cure has a completely different technology where they move the patient, rather than the beam and incorporate a suspended CT scanner in their process. They expect that approach to drastically drive proton therapy costs down.

Between all of the developments in simulating, planning and treatment in both linear accelerator and proton, it seems to me that there are some tremendous developments in the oncology space.

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