Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
Screen Platform Assistant-Radiation oncology Kids (SPARK) is a visual distraction device used during radiation therapy treatment in the paediatric setting to reduce the requirement for general anaesthesia.
Dates: January 2024 - ongoing
Implementation sites: Princess Alexandra Hospital
Partnerships: PolyMed Technologies
HICOP
Aim
The aim of this project was to develop a device which would permit visual distraction without interfering with the radiation treatment delivery for our paediatric patients.
Outcomes
SPARK was used to reduce treatment anxiety and the need for general anaesthesia (GA) for paediatric patients.
The outcomes of this concept:
- A 3D-printed arm and radiotranslucent screen was developed which can be attached to the treatment couch.
- TV shows, movies and other audiovisual distractions are projected onto the 3D-printed arm and screen with sound transmitted from in-built projector speakers.
- Transmission and attenuation testing resulted in <0.1% attenuation to the screen and <1.5% when combined with other treatment compatible components.
- Paediatric patients who would otherwise req
Background
Audiovisual distraction has been demonstrated to be highly effective at reducing anxiety and the need for general anaesthetic for paediatric patients during radiation therapy treatment. 1,2,3.
Although painless, radiation therapy can be difficult for children as they are required to remain alone and motionless in the treatment room for the duration of treatment delivery. The time taken for treatment delivery can be protracted and these factors can cause fear and anxiety for the child and their carers. This can result in the child requiring daily general anaesthetic to tolerate treatment.
Limited commercial devices exist that enable visual distraction for patients receiving radiation therapy. For many techniques, the treatment machine would block the patient's view of a projection on the ceiling of the treatment room, and it is not possible to treat through any device which could be attached to the treatment couch like an iPad or similar.
Screen Platform Assistant for Radiation oncology Kids was developed for our department in collaboration with a medical technology company. This device projects TV shows, movies, and other visual distractions onto a 3D-printed, low-density screen. As the screen and support structure are printed using a low beam attenuation material, the device can be treated through without impacting the radiation treatment delivered to the patient. Initial development and testing have been completed with the first patient having successfully completed treatment with the pilot device.
Methods
The system was co-designed by a multidisciplinary team of medical physicists and radiation therapists in partnership with PolyMed Technologies. The primary design objective was to develop a radiotranslucent audiovisual display platform compatible with external beam radiotherapy delivery. The system incorporated a radiotranslucent screen mounted on a customised articulating arm capable of supporting a projector with integrated speakers, while attaching securely to treatment equipment without interfering with gantry rotation, immobilisation devices, or patient positioning.
An iterative design and prototyping process was undertaken to optimise mechanical stability, radiotranslucency, usability, and cost-effectiveness. Multiple materials and configurations were evaluated, including off the shelf components such as G-clamps and locking ball-and-socket gooseneck joints, carbon fibre rods and custom designed 3D-printed parts using polylactic acid (PLA), polystyrene, and polycyclohexylene dimethylene terephthalate glycol-modified (PCTG).
Engineering evaluation criteria included holding torque at full extension, range of motion, locking stability, structural robustness, fabrication cost, and radiotranslucency. Clinical usability requirements were defined for both patients and radiation therapists. For patients, key considerations included screen radius of curvature, comfortable focal distance, and audio-visual clarity. For radiation therapists, the system was required to be fully wireless, easy to mount and remove, compatible with existing immobilisation devices (including treatment couch extensions, vacuum cushions, and thermoplastic head masks), and safe during gantry rotation with adequate collision clearance.
Optimisation focused on achieving sufficient base stability of the articulating arm while minimising beam attenuation and dose perturbation. Critical in-beam components were fabricated from thin, low-density, radiotranslucent materials to reduce attenuation. The final prototype represented a balance between structural robustness and beam transparency and colour coding was used for visually identification.
Dosimetric evaluation was conducted to quantify beam attenuation and verify minimal perturbation to dose delivery using Advanced Markus ion chamber and Varian Truebeam linac. Transmission measurements were acquired for individual components and for the fully assembled system. Testing was performed across all clinical photon beam energies used at our institution, under both static field and rotational arc delivery.
Discussion
The aim of our project was to develop a device which would enable Paediatric patients to receive radiotherapy treatment without the need for daily general anesthesia. The reduction of the use of general anesthesia has positive effects on patients and their families. It reduces complexity for the radiation oncology treatment team and of course has an additional cost reduction for overall treatment and staffing costs. We believe that similar devices could be implemented in other radiation therapy departments who treat paediatric cancer patients.
There are still some limitations of the device. There are still some components which are non-treatment compatible and some radiation beam arrangements are not able to be treated with the SPARK system.
General anaesthetic is still necessary for the very young or for children who are unable to be distracted with the device but for some children the use of the system has been encouraging.
As an additional benefit, we have identified that it can be particularly useful for others in our patient cohort. Several of our treatment techniques rely on verbal instructions from our treating Radiation Therapists during the treatment delivery including those involving taking a breath in, holding breath and then exhaling. This can be difficult for patients who are hearing impaired or for whom English is not their first language. In both cases, instructions (including in other languages) can be projected onto the screen for the patient to follow.
Future work will focus on expanding accessibility for culturally and linguistically diverse patient populations through collaboration with professional interpreters and established consumer networks. Planned developments include integration of professionally translated audiovisual content to support communication in multiple languages, prioritising the population demographics in our HHS. This will enable delivery of accurate medical information in both visual and audible formats, ensuring consistency, cultural appropriateness, and clinical reliability. These enhancements aim to improve patient comprehension, reduce anxiety, support informed consent, and promote equitable access to care across diverse populations.
References
1. Willis D, Barry P. Audiovisual Interventions to Reduce The Use of General Anaesthesia with Paediatric Patients during Radiation Therapy J.Med.Imaging Radiat. Oncolo.2012; 54(3) 249-255. Doi: https://doi.org/10.1111/j.1754-9485.2010.02165.x
2. Schulz JB, Zalavari L, Gutkin P,et al. AVATAR 2.0: next level communication systems for radiotherapy through face-to- face video, biofeedback, translation, and audiovisual immersion. Front. Oncol. 2024; 14. Doi: https://doi.org/10.3389/fonc.2024.1405433
3. Gutkin PM, Skinner L, Jiang J, et al. Feasibility of the Audio-Visual Assisted Therapeutic Ambiance in Radiotherapy (AVATAR) System for Anesthesia Avoidance in Pediatric Patients: A Multicentre Trial. Int J Radiat Oncol Biol Phys. 2023; 117 (1): 96-104. Doi: https://doi.org/10.1016/j.ijrobp.2023.03.063.
Key contact
Narelle Wallace
Senior Radiation Therapist
Princess Alexandra Hospital