‘Game-Changing’ Adaptive Radiation Therapy Program Will Enhance Treatments for Cancer Patients at ChristianaCare

Revolutionary treatment boosts precision and effectiveness

Oct 21, 2024

3 min

Patients undergoing radiation therapy for certain types of cancer at ChristianaCare’s Helen F. Graham Cancer Center & Research Institute will be the first in Delaware to benefit from a cutting-edge treatment system that increases accuracy and precision, enhances patient comfort and minimizes side effects.


ChristianaCare expects to begin scheduling patients in early 2026 to receive treatment with the Varian Ethos™ system equipped with HyperSight. The innovative radiotherapy system leverages artificial intelligence and the fastest on-table imaging in the field to enhance precision and increase the likelihood of effectively treating tumors.



“As leaders in cancer treatment and care, we continually strive to stay at the forefront of medicine for our patients, and this new technology is a game-changer,” said Thomas Schwaab, M.D., Ph.D., Bank of America endowed medical director of ChristianaCare’s Helen F. Graham Cancer Center and Research Institute. “Adaptive radiation therapy enables members of the patient’s treatment team to create a new treatment plan every day in real-time based on the patient’s needs and anatomy in that moment as well as any changes observed during their therapy.”


In traditional radiotherapy, a plan is established at the beginning of treatment and followed through the treatment course. Adaptive radiotherapy allows for real-time modifications to the plan based on periodic assessments while the patient is on the radiation table.


Human anatomy changes quickly through normal bodily function even during treatment. In the context of radiation therapy, even slight shifts or alterations in the body while being treated can significantly impact effectiveness.


The advanced technology in the system enables real-time imaging on the radiation table to be completed in seconds, rather than minutes – a dramatic improvement that transforms targeting accuracy and patient comfort.


“This advancement will allow us to deliver personalized treatments, enabling radiation oncologists to make necessary treatment decisions even more quickly and accurately,” said Lindsay Romak, M.D., radiation oncologist at the Graham Cancer Center. “This will provide clinically meaningful benefits for patients who require radiotherapy for a wide range of cancers, including those of the prostate, bladder, abdomen and head and neck.”


Artificial intelligence powers patient treatments


Leveraging the power of artificial intelligence to capture and analyze rapid images in real time, the technology quickly detects changes in the patient’s anatomy and tumor size, shape or position. Using real-time imaging data, the system automatically suggests adjustments to the treatment plan to account for these changes, which is key to achieving better patient outcomes.


The system also uses artificial intelligence when determining the distribution of the radiation dose, ensuring the tumor receives the optimal amount of radiation. This streamlines the workflow making the entire process of adaptive radiotherapy more efficient.




"The integration of artificial intelligence into our treatment processes underscores our dedication to incorporating the most innovative treatments for our patients. With this technology, our patients can anticipate shorter treatment times and potentially fewer sessions, significantly enhancing their overall experience,” Laura Doyle, Ph.D., chief clinical physicist at the Graham Cancer Center said.

Adaptive radiation therapy is covered by Medicare and most insurance carriers.


The system will be located in the radiation oncology suite at the Graham Cancer Center.


Equipment installation is expected in the fall of 2025 with patient use starting in early 2026.


ChristianaCare’s Radiation Oncology Department is recognized by the American Society of Radiation Oncology Accreditation Program for Excellence. Its radiation oncologists are leaders in adapting the very latest imaging and treatment advances into clinical practice. The team also helps write the standards for best practices in care delivery and teaches other doctors and health care professionals in this specialty.


With this latest advancement, ChristianaCare’s Helen F. Graham Cancer Center and Research Institute continues to solidify its position at the forefront of cancer care in Delaware and beyond, underscoring its commitment to improving patient outcomes and quality of life.


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4 min

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While the fellowship directly trained four nurses, its reach extended well beyond thazt. Fellows shared what they were learning along the way, sparking wider interest in research across the health system. The research program was highlighted as a new knowledge and innovation exemplar in the latest evaluation by the American Nurses Credentialing Center, which in March awarded ChristianaCare its fourth Magnet designation — the gold standard for nursing excellence. Adriane Griffen, DrPH, MPH, MCHES, vice president of programs at the American Nurses Foundation, praised ChristianaCare’s responsiveness in shaping the program around nurses’ needs and building a model for future innovation. “What makes this fellowship stand out is its focus on giving bedside nurses a real seat at the table,” Griffen said. “When nurses are trusted to lead and have the right support, they develop solutions that are practical, sustainable and transformative. 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2 min

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Vishesh Agarwal, M.D., has been appointed chief of Addiction Medicine Services at ChristianaCare. In this role, Agarwal will lead and expand ChristianaCare’s comprehensive addiction treatment services, guiding care for people with substance use disorders across inpatient, outpatient, emergency and consultation settings. He will oversee addiction programs across all campuses, help create consistent care guidelines and support teams of experts working together to provide safe, effective and compassionate care for patients. A key priority for Agarwal will be to explore strategic growth opportunities to broaden ChristianaCare’s reach and strengthen its impact on individuals and families affected by substance use disorders. His leadership will be instrumental in ensuring that ChristianaCare continues to set the standard for innovation and excellence. Agarwal will continue in his role as vice chair of the Department of Psychiatry at ChristianaCare, maintaining his leadership of clinical and operational initiatives in the Behavioral Health Service Line. He will continue to lead efforts to improve provider well-being, develop care pathways and foster clinical growth. He also oversees the Behavioral Health Unit, Emergency Department crisis services and psychiatric consultations for hospitalized patients. Agarwal is board certified in general adult psychiatry, addiction psychiatry and obesity medicine. He has published research on substance use and behavioral addictions in peer-reviewed journals and has presented at national conferences. His 2021 study linking gambling disorder, major depression and suicide risk was published in Addictive Behaviors and gained national attention. Agarwal holds an Executive MBA from Quantic School of Business and Technology and completed an addiction psychiatry fellowship at the Zucker Hillside Hospital. He completed his psychiatry residency and served as administrative chief resident at Einstein Medical Center. He earned his medical degree from Gauhati Medical College. Agarwal teaches and mentors psychiatry residents and medical students as a clinical assistant professor at Sidney Kimmel Medical College at Thomas Jefferson University. He also co-chairs system committees and serves on the board of the Mental Health Association in Delaware. He reports to Mustafa Mufti, M.D., chair of the Department of Psychiatry.

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