White River Medical Center

Services Provided: Commissioning Services, Radiation Oncology Phyics and Dosimetry Services

The Challenge

White River Medical Center is a busy cancer center in Batesville, AR, and was treating a variety of IMRT and 3D conformal plans. However, without a MLC, plans were all created using custom compensators. Additionally, there Varian machine did not have kV imaging capabilities. The decision was made to purchase a TrueBeam, and with the drastic evolution in technologies compared to the existing platform, a substantial amount of training and work would be required to get the center clinical in the desired timeframe.


We have partnered with the Alyzen Medical Physics for over 14 years now. The physics and dosimetry staff have been a major resource that we rely on. We have built a great relationship with Alyzen and we know they are just as dedicated to providing the best radiation oncology services to our area as we are.

- Robert Wright, Associate Administrator Ancillary Support Services

The Solution

Our staff was able to integrate within White River Medical Center, stepping in as needed based on patient volumes. We also helped to implement effective clinical practices to help the clinic grow.



Alyzen's clinical staff performed the following in a period of two weeks:

  • Commisioning
  • Acceptance Testing
  • Radiation Shielding Survey
  • Data Collection
  • Treatment Planning System Modeling (AAA, eMC, PDIP, PRO, DVO, PGO)
  • End-to-End Validation using the AQUIRE Software Platform
  • IMRT and RapidArc Validation
  • Absolute Calibration via TG-51
  • Databooks

• New Machine Purchase
Physicists and dosimetrists from Alyzen assisted in the decision making process and review of the quotes for the TrueBeam.

• Configuration of EMR (ARIA)
In addition to the setup done during commissioning, the Alyzen team:

- Create Care Paths to manage clinical workflow
- Configured User Rights and Agendas for all staff
- Assisted in training and created custom reports to aid in reviewing charges
- Recurring QA patients created to facilitate morning checks on the machine


• Treatment Planning System Configuration     (Eclipse) 
- Created DICOM Import/Export filters
- Imported the CT Density Curve from Alyzen’s scanned CT Density Phantom
- Enabled and trained custom coding for electron treatment planning

• RadCalc Setup
- Configured RadCalc via importation of measured beam data and properties of the machine
- Validated open fields for correct output, and sample IMRT plans for accuracy
-Created network shares for import/export from Eclipse

• Networking and IT
- Worked with IT to ensure connectivity of the calculation servers
- Established remote desktop connectivity
- Mapped drives for connectivity to TrueBeam

• Ongoing Quality Assurance
- Established test plans from morning QA
- Developed IGRT QA processes for the therapists to perform daily
- Electron cutout plans were created for each cone/energy combination in order for diode outputs to be checked
- Established baselines post calibration for DailyQA3 device

The Results

  • Alyzen worked with the center in all aspects of purchasing a new TrueBeam and taking it clinical
  • Due to construction delays, the clinic was down much longer than anticipated. Alyzen continued to support the center without billing for the time period without patient treatments
  • The TrueBeam Acceptance, commissioning, TPS modeling and survey were performed in a week, allowing the center to overcome construction delays much sooner
  • Patient treatments resumed and the revenue loss due to construction delays were minimized