1. Awareness - Information - Understanding

2. What is PEARL? Simply – A Virtual Linac on your desk  communicate Linac machine size and sounds to patients and others  Show treatment plan concepts and delivery  To increase understanding and awareness and build confidence  Complementary to the existing patient information framework.  Plans from your clinic, for a specific patient (DICOM) © Vertual 2013

3. W  Increase confidence for patients undergoing treatment  Increase understanding and provide information regarding treatment  A tool to help you answer the in depth questions some patients have  Show target volumes, organs at risk and treatment delivery  Show dose to the target and avoidance of organs at risk  PEARL was released in 2012 Why do we need PEARL? © Vertual 2013

5. Software – Software – Equipment and structures © Vertual 2013

6. Software – Software – Patient View © Vertual 2013

7. Software – Software – User Interface  Simple  Easy to navigate  Patient Focussed  Windows look and feel  Common Plan Browser  Demonstration Patients © Vertual 2013

8. ‘Virtual reality technology is an excellent way forward to provide, amongst other, information to patients receiving radiotherapy on how their treatment is planned and given. The possibility for them and their relatives to receive this extra knowledge in 3D reduces their anxieties, and relatives feel more involved in the treatment of their loved ones. ’ Dr Josep Sulé-Suso MB ChB, PhD Associate Specialist and Senior Lecturer in Oncology, Keele University and Stoke University Hospital Customer Experience © Vertual 2013

9. ‘I now understand how radiotherapy is planned and given and it has helped me and my partner to reduce our fear factor. ’ Patient receiving radiotherapy for prostate cancer at Stoke University Hospital, The new cancer centre building was opened in 2009. Patient Experience © Vertual 2013

10. PEARL Options PEARL Software only  Permanent license to use PEARL on 1 PC in 2D  Includes 5 standard demonstration patients  1 Linac included  DICOM import license optional  Additional Linac optional  Minimum hardware specification applies © Vertual 2013

11. PEARL Options PEARL Hardware and Software packages  Laptop option 15” high performance laptop  Desktop option high performance workstation PC with 24” flat panel  Touch screen PC High performance desktop workstation PC with 21” touchscreen  3D PEARL system Full projection system with laptop, 3D glasses and 3D projector © Vertual 2013

12.  3 manufacturers Linacs supported Simple, intuitive user interface  5 example patients  DICOM Import optional  Light beam, lasers, room lights  Visualisation of Dose wash  Delivery of IMRT and Arc Treatment Plans  Patient structures  Transverse CT slices Software - Software - Product Features © Vertual 2013

13. Software – Software – Patient setup © Vertual 2013

14. Software – Software – Animate delivery © Vertual 2013

15. Software – Software – Dose colourwash © Vertual 2013

16. How does PEARL differ from VERT? PEARL Patient Information VERT Staff Training and Education DICOM ImportOptionIncluded Patient Anatomy and Images Structures Side crosses / skin marks CT Structures Side crosses / skin marks Multi-plane CT Contours Interest Points and Markers MRI/PET planned in future. Beam Display Beam Display including MLC Animation of Delivery Arc Treatments Beam Display including MLC Animation of Delivery Arc Treatments Multiple Beam Display Lights and Lasers Room Light Field Light Lasers Room Light Field Light Lasers SSD Range Finder Controls and DisplaysSimple controls for Gantry and Couch movement Actual Hand Pendant(s) Simulated Couch Controls In Room Monitor Electronic Gantry Display Functionality Comparison with VERT

17. How does PEARL differ from VERT? Functionality Comparison with VERT Virtual Presenter Create your own slide shows / presentations. Include pictures and text. Share your presentations with colleagues. Video planned in future. Dose Visualization Dose Colour Wash (Red high dose, Blue low dose) Dose Colour Wash Dose Surface (Dose Cloud) Absolute & Relative Dose Range of Dose Colour Maps Interactive Controls Beam Eye View (BEV) Inset view showing MLC and patient anatomy Inset view showing MLC and patient anatomy. Large Beam Eye View (Split Screen) Real-time DRR Interactive movement of Jaws Display on In Room Monitor. Touch-screen controls. IGRT and OBI Features Demonstrate kV and MV imager panel deployment. Demonstrate IGRT alignment. Simulate positional errors. Touch-screen controls.

18. Patient Representative …the Virtual Linac presentation assists patients in getting to know themselves as three- dimensional bodies who can be, and are, treated without mystery. The rest is wonderment. Charing Cross Hospital Since 1995 8 years, patient representative Fortnightly, 1 hour CT, Linac, VERT MLCs, beams etc Future Plans Daytime sessions