Truebeam versus Versa HD

[hot sauce]

If your hospital was willing to buy your department the latest machine from either Elekta or Varian which one would you get and why? Assume this machine is going to be your workhorse for treating pretty much everything.

---

Members don't see this ad.

 

[medgator]

What's your preferred planning system? Eclipse doesn't play well with elekta.

 

[Gfunk6]

Coke vs Pepsi. Both are marquee products from their respective manufacturers. But agree with medgator you want your hardware and software to be maximally compatible.


Sent from my iPhone using SDN mobile app

 

[Damn_Daniel]

Varian/Eclipse is more user friendly and a great workhorse but costs much more (generally speaking, for an "equivalent" machine from Elekta).

There isn't great data whether certain linacs have more down time, and I wish someone would do that study. We have one Elekta and one Varian. Both are down about the same time. The Varian treats faster. I like its CBCT better.

 

[Mandelin Rain]

Varian is the industry leader and most physics/dosimetry/therapists have planned/treated on Varian. In an academic setting, with an abundance of staff to help with the learning curve switching platforms, this probably matters less. Particularly, if the linacs are coming at steep discounts, as they seem to be from Elekta.

I think you should also look at Elekta's prospects/health for the future. They own Mosaiq. With people switching to TrueBeam (which doesn't require, but works much better with Aria), will they gain or lose market share? They own Gamma Knife. With linac SRS and Cyberknife, will they gain or lose market share?


Just thing to think about.

 

[Photoner]

Coke vs Pepsi. Both are marquee products from their respective manufacturers. But agree with medgator you want your hardware and software to be maximally compatible.

This thread is old but still relevant, so I will give my opinion at the risk of being considered spam according to the forum rules. In the last years it seems that Elekta spent so much money and effort in developing their MR-linac, that forgot to finish and improve other products like Versa HD or MOSAIQ. Here it goes a comparison of several points from my view:

Truebeam+ARIA is much more user friendly than VersaHD+Mosaiq, although any ot them is probably better than a mixed-vendor combination for compatibility reasons. This has an important impact in the learning curve of new staff (mainly therapists and probably physicists, not so much for physicians).

In Varian, the linac control is more compact: with Elekta the therapists need to use several computers and a mix of very different pieces of software to control the linac and the different image systems. For example, the registration of the CBCT images with the planning CT is done in the XVI program, but if you use orthogonal kV images the registration with the DRRs is done in Mosaiq with a completely different interface. At the end, people tend to forget the less used one and use CBCT for everything, even for cases where kV-kV may be appropriate.

Also, the Elekta 6DoF couch (Hexapod) needs its own software and its own computer, with its own keyboard etc, and the same happens with the Elekta add-on microMLC. Hexapod also needs to attach a bridge to the couch with IR reflectors. The Varian 6DoF couch does not need this and is more integrated in the system.

Varian MV and kV panels are mounted in robotic arms and can be moved remotely from the control room, which is not possible in Versa HD. In Elekta it is even neccesary to change the collimator and filters of the kV tube manually. In Varian the source-EPID distance is variable and the panel can go up to the isocenter (which is useful for linac QA), while in Elekta the distance is fixed. I think Varian recently introduced tools to automate the linac daily QA, while Elekta doesn’t have anything similar.

The Elekta couch needs to attach a head extension for most treatments, and the area of the couch where the extension board is attached produces very high attenuation (>20% for some angles), limiting the usable entry angles in some treatments. Varian linacs don’t have this issue.

The mechanical accuracy (gantry sag, etc) is better in Truebeam. The difference is not very relevant for conventional treatments but it it probably importannt for SRS.

And ARIA is more intuitive than MOSAIQ, in my opinion. Sometimes even the Elekta support specialists do not understand Mosaiq. They have added many tools and options over the time, which makes it more complex, but still keep the same old structure and design.

[Edit: and I forgot about it... I have been told that in "myvarian" you can find useful things. In "Elekta community" appart from the pdf manuals of the different products there aren't anything useful]

So, I wouldn’t say it is like Coke vs Pepsi.

 

[nkmiami]

I also would take varian. Just better integrated end to end solution for most community hospitals. With elekta would need 3rd party planning system because what they have is trash. Also varian better about service/uptime as much bigger footprint in us.

 

[Palex80]

With elekta would need 3rd party planning system because what they have is trash.

Do you find Monaco that bad?
I know Eclipse has a big fanbase, but "trash" may be a harsh wording?

 

[RadOncDoc21]

Do you find Monaco that bad?
I know Eclipse has a big fanbase, but "trash" may be a harsh wording?

I would go even further and call it a burning piece of sh___t, but that’s just me. I lean more towards being overly dramatic.

 

[gmsquid]

I like Monaco from the Dosimetry perspective. I like the Monte Carlo and like the plans Dosimetry gets with it. I think there’s a big learning curve with it and dosimetrists have to learn to plan differently than they used to. I don’t contour in Monaco though. That’s painful

 

[Photoner]

I would go even further and call it a burning piece of sh___t, but that’s just me. I lean more towards being overly dramatic.

Could you explain a little the reasons for this appreciation?

I like Monaco from the Dosimetry perspective. I like the Monte Carlo and like the plans Dosimetry gets with it. I think there’s a big learning curve with it and dosimetrists have to learn to plan differently than they used to. I don’t contour in Monaco though. That’s painful

Why is it so painful?
I have heard that in Monaco the optimization follows a philosophy a little different than in most planning systems, it is probably the reason why dosimetrists need to plan in a different way as you sad.