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Keeping Standards High – How Instituto Zunino stays on top of technology to offer the best patient care

Updated January 29, 2024 5 minute read
Brainlab Digital Operating Room

We were delighted to sit down with Silvia Zunino, MD, PhD and Daniel Venencia, PhD of Instituto Zunino to discuss the topic of advances in cancer treatment and the ways in which the institution improves lives. Based in Córdoba, Argentina, a small city of around 2 million people, the institution welcomes patients from the surrounding areas of Bolivia, Paraguay and Uruguay.

Here we find out about the impact of their daily work and how the Novalis certification program has benefited patients and supported the institution in achieving their goals.

What is the main mission of Instituto Zunino?

Dr. Zunino: “Our main mission is the treatment of cancer and provision of health services to the community. We are looking to extend this into other fields, for example in the areas of epilepsy, trigeminal nerves, Parkinsons and neuralgia. In the future, the possibilities and uses of Radiation therapy will continue to expand. We are currently using Brainlab Systems to develop out treatments.” 


How is radiotherapy a promising treatment for solid tumor cancers?

Dr. Zunino: In the last 20 years, interest has increased due to advances in technology, opening a field of new opportunities for doctors and patients. Particularly in terms of offering the patient the best treatment and improving their quality of life.”

Mr. Venencia: “When patients know that they have cancer and radiotherapy is one of the treatments that they have available, we can reassure them that we have the best technology available in the world for this type of treatment. We always want to implement the newest treatment techniques and the newest software available. It’s very important to develop not just treatment techniques, but also to develop things like automatization, or artificial intelligence in radiotherapy. Research puts us very close to what is done in other developed countries.”

Why did you decide to enter the Novalis certification program, and how have you benefited? 

Mr. Venencia: To be an institution with high standards, you need somebody else that audits your work. Via the Novalis program, useful protocol and instructions have to be created. You need to have everything correct to be observed by the auditor. This was good opportunity to improve our work, to have somebody that sees what we are doing, and how we are doing it and get feedback on how we can improve. We can then be sure that patients really are getting the best available treatment.”

Dr. Zunino: “The other important aspect is if we are under certification, we can be sure we are working in the same way as the best centers of United States or Europe. Novalis certification was very important in giving us confidence in our methods. We applied all the corrections and the suggestions.”

What is your experience treating tumors with ExacTrac Dynamic and using deep inspiration breath hold?

Dr. Zunino: We have had ExacTrac Dynamic for 18 months and began using ExacTrac in 2008.”

Mr. Venencia: “We are really happy with the system. Compared with a Cone Beam CT, it’s a faster way to position the patient and allows us to do intra-treatment verification that is not possible with Cone Beam CT. We upgraded to ExacTrac Dynamic in the TrueBeam began using the treatment for cranial diseases immediately after installation.

We use deep inspiration breath hold with ExacTrac Dynamic on at least eight patients per day. The system works perfectly, and it’s faster compared to the RPM. One of the main advantages of this new deep inspiration breath hold system is that you can consistently reach the same inspiration amplitude. The images of the thoracic wall are very good, and it has a lot of features like restricted DRR that can improve better visualization of the ribs close to the target.”

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