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"Tuomi Logistiikka Oy pyyt\u00e4\u00e4 Pirkanmaan sairaanhoitopiirin (PSHP) toimeksiannosta tarjouksia s\u00e4dehoidon suuren annosnopeuden HDR (high-dose-rate) -j\u00e4lkilatauslaitteistokokonaisuudesta Ir-192-l\u00e4hteell\u00e4.",
"",
"Laitteiston sijoituspaikka on PSHP:n sy\u00f6v\u00e4nhoidon vastuualueella Radius-rakennuksessa tyk\u00f6hoitohuone ja siihen liittyv\u00e4 ohjaustila, ja suunniteltu kliininen k\u00e4ytt\u00f6\u00f6nottoajankohta toukokuussa 2021. Asennus edellytt\u00e4\u00e4 vanhan laitteen poisviennin. Nykyisess\u00e4 laitteessa olemassa olevan l\u00e4hteen poisviennist\u00e4 huolehtii sen nykyinen toimittaja.",
"",
"Toimintaymp\u00e4rist\u00f6n kuvaus",
"",
"Ir-192-HDR-j\u00e4lkilatauslaitteena on t\u00e4ll\u00e4 hetkell\u00e4 k\u00e4yt\u00f6ss\u00e4 MicroSelectron V3 (Elekta). L\u00e4hteenvaihto tehd\u00e4\u00e4n 3\u20134 kertaa vuodessa. S\u00e4dehoidon potilastietoj\u00e4rjestelm\u00e4n\u00e4 on ARIA (Varian Medical Systems; t\u00e4ll\u00e4 hetkell\u00e4 versio 15.6). Sis\u00e4isen s\u00e4dehoidon annossuunnitteluohjelmistona on k\u00e4ytett\u00e4viss\u00e4 Eclipse Brachytherapy Planning 15.6 (Varian Medical Systems) sek\u00e4 Vitesse 4.0 (Varian Medical Systems). Laitteella toteutetaan t\u00e4ll\u00e4 hetkell\u00e4 gynekologisten tuumoreiden, eturauhasen, keuhkoputken, keloidiarpien sis\u00e4ist\u00e4 s\u00e4dehoitoa sek\u00e4 joitakin interstitielleja neulahoitoja. Gynekologiset hoidot tehd\u00e4\u00e4n CT\/MRI-pohjaisesti ja eturauhasen hoidot ultra\u00e4\u00e4nipohjaisesti. Keloidiarpien ja keuhkoputken hoidot toteutetaan joko ilman kuvausta tai CT-pohjaisesti.",
"",
"HDR-laitteen lis\u00e4ksi klinikalla on seitsem\u00e4n Varianin lineaarikiihdytint\u00e4: 2 kpl Varian Clinac 2300 iX (hankintavuosi 2007), 2 kpl Varian TrueBeam STx (2012, 2016), 2 kpl Varian TrueBeam (2017, 2018) sek\u00e4 yksi varalla oleva Varian Clinac 600C\/D -kiihdytin (2004). Ulkoisen s\u00e4dehoidon s\u00e4dehoitotiedot tallentuvat ARIA-j\u00e4rjestelm\u00e4\u00e4n. CT-simulaattoreita on kaksi: Siemens Somatom Confidence (2019) ja Philips Brilliance Big Bore CT (2005). Lis\u00e4ksi yksik\u00f6\u00f6n asennetaan parhaillaan MRI-simulaattoria (Philips Ingenia Ambition 1.5T (2021). Ultra\u00e4\u00e4nilaitteistona on k\u00e4yt\u00f6ss\u00e4 BK Medicalin laitteisto (bk3000). Laitehuollosta vastaa Istekki Oy.",
"",
"Nyt hankittava Ir-192-HDR-j\u00e4lkilatauslaite tullaan sijoittamaan nykyisen nyt uusittavan j\u00e4lkilatauslaitteen tiloihin, joten s\u00e4teilysuojaus on riitt\u00e4v\u00e4 uudelle laitteelle. Tila sis\u00e4lt\u00e4\u00e4 olemassa olevan j\u00e4rjestelm\u00e4n varoitusvalot, h\u00e4t\u00e4pys\u00e4ytykset sek\u00e4 ovikytkimet. Tarjouksen tulee sis\u00e4lt\u00e4\u00e4 j\u00e4lkilaitteen asennus t\u00e4h\u00e4n tilaan ja vanhan laitteen poisvienti. Normaalin k\u00e4yt\u00e4nn\u00f6n mukaisesti nykyisen laitteen laitevalmistaja huolehtii vanhan j\u00e4lkilatauslaitteen Ir-192-l\u00e4hteen poisviennist\u00e4. Istekki Oy vastaa my\u00f6s hankittavan laitteen huollosta tai huollon j\u00e4rjest\u00e4misest\u00e4.",
"",
"Tarjottavan kokonaisuuden tulee muodostaa toimiva kokonaisuus yll\u00e4 kuvatuissa hoidoissa, joko olemassa olevien j\u00e4rjestelmien kanssa tai siihen tulee sis\u00e4lty\u00e4 tarvittavat ohjelmistot, mik\u00e4li olemassa olevia j\u00e4rjestelmi\u00e4 ei voi k\u00e4ytt\u00e4\u00e4. Eduksi katsotaan yhteensopivuus olemassa olevien j\u00e4rjestelmien kanssa sek\u00e4 hoitotiedon automaattinen tallentuminen (tai mahdollisuus tallentaa) olemassa olevaan s\u00e4dehoidon potilastietoj\u00e4rjestelm\u00e4\u00e4n. Eduksi katsotaan, ett\u00e4 j\u00e4rjestelm\u00e4 muodostaa ajank\u00e4yt\u00f6lt\u00e4 tehokkaan ja toimivan kokonaisuuden."
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