Sarah Wilby is a Principal Clinical Scientist and Deputy Head of Brachytherapy Physics at Portsmouth Hospital NHS Trust.
She began a career in Medical Physics in 2000 following a degree in Physics with Medical Applications at the University of Nottingham. She joined the Medical Physics training scheme completing an MSc at the University of Surrey and basic Medical physics training at University hospital Southampton.
She covered specialties in Nuclear Medicine, Physiological Measurement and Radiotherapy before specialising as a Chartered Scientist in Radiotherapy physics. Sarah spent several years in industry as a Clinical Support Specialist for a medical oncology company, primarily providing training in the brachytherapy physics field. Sarah is now a collaborator on the CoBra EU research project and is completing a PhD in phantom design as part of this.
The CoBra project: An introduction and clinical perspective
The CoBra (Cooperative Brachytherapy) project aims to improve the quality of both diagnosis and treatment of localized cancers, initially in the prostate, with potential applications for other sites. The main deliverable is a robotic arm that can insert needles into the prostate under real-time MRI guidance.
CoBra has focused on advancing two techniques: prostate biopsies and prostate brachytherapy, a type of radiotherapy. Both techniques require precise needle insertion into the prostate, which can deform and swell during the procedure. For biopsies, it is necessary to extract tissue from lesions with a minimum cross-section diameter of 5 mm. For low dose rate brachytherapy, it is necessary to place radioactive seeds into the prostate through the needle, with an uncertainty of < 1mm. Routinely, 50 to 100 seeds are implanted, with the accuracy of their placement directly correlating to the quality of the treatment.
CoBra addresses limitations in current clinical practice, such as uncertainties in identifying the target volume accurately due to imaging techniques, anatomical obstructions that hinder delivery of the ideal treatment, need for high skills and training from the practitioner and potential radioactive risks. Solutions to these limitations are presented in the talks that follow. These include real-time MRI guided robot, with brachytherapy and biopsy module, steerable needles, live needle and dose planning and a bioinspired phantom.
Key learning outcome: An understanding of the current clinical techniques used in prostate biopsy and brachytherapy, their limitations and how the cobra project is addressing these.
Talk: The CoBra project: An introduction and clinical perspective