AVATAR’s global impact

The AVATAR project, launched by Stanford Medicine Catalyst in May 2024, is enhancing pediatric radiotherapy by improving comfort and reducing the need for anesthesia. The innovation has been deployed to 20 global sites in just one year.

In the ever-evolving landscape of medical innovation, the Audio Video Assisted Therapeutic Ambiance for Radiotherapy (AVATAR) project has provided comfort and relief for pediatric patients undergoing radiotherapy. Launched as part of the Stanford Medicine Catalyst program in May 2024, AVATAR has quickly made a significant global impact by easing treatment sessions and minimizing the need for general anesthesia.

Children who face the difficult journey of cancer treatment often must undergo radiotherapy as a critical part of their care. To deliver this treatment safely and effectively, patients must lie completely still—sometimes for extended periods—so radiation can be precisely targeted. Patients are sedated to keep them still, often every day for several weeks, placing a heavy emotional, logistical, and financial burden on families and caregivers. This also carries medical risks, including cardiopulmonary complications, infection, and potential long-term neurodevelopmental effects. And in low- and middle-income countries where anesthesia services are limited or unavailable, many children may be unable to access radiotherapy at all—making safe, anesthesia-free alternatives even more vital.

Photo caption: Lawrie Skinner, PhD (center), co-inventor and Stanford medical physicist, deployed AVATAR at Kenyatta National Hospital in Nairobi, Kenya. Skinner helped train the staff there on how to use the AVATAR device on patients.

AVATAR is a radiolucent device designed specifically for young patients, particularly those aged 3 to 10 years, to help them remain still during radiotherapy sessions. This innovative approach not only enhances the effectiveness of the treatment but also significantly improves the overall patient experience. In just one year, AVATAR has been deployed to 20 sites worldwide, including eight in the United States and 12 in low- to upper-middle-income countries such as Kenya, Uganda, South Africa and Romania.

Photo caption: A 7-month-old child in Romania — AVATAR’s youngest patient to date — receives abdominal radiotherapy treatment while using AVATAR.

One of the most notable aspects of AVATAR's deployment is its adaptability to various use cases. While the previous youngest patient treated with AVATAR was just 2 years old, a recent case in Romania showcased the device's versatility when it was successfully used with a 7-month-old baby receiving abdominal radiotherapy. This achievement underscores the potential of AVATAR to cater to even the most vulnerable patients, ensuring they receive the care they need without the risks associated with general anesthesia.

Susan Hiniker, MD, one of the key innovators behind AVATAR, expressed her enthusiasm for the project's progress.

“The AVATAR project represents a significant advancement in pediatric radiotherapy,” Hiniker said. “Our goal has always been to enhance the treatment experience for children, and seeing the positive outcomes from our deployments has been incredibly rewarding.”

The impact of AVATAR on patient care has been swift, especially when compared to other medical innovations that often face lengthy approval processes, according to Catalyst program leaders. The Catalyst program has played a crucial role in this rapid deployment, providing strategic and hands-on support that includes funding, procurement of supplies, physical space, help with device assembly, technical support for deployment sites, business development assistance and establishing strategic partnerships.

As of early June, the AVATAR project has reached a significant milestone with its successful licensing to a leading upright proton therapy company. This partnership is poised to enhance the capabilities of AVATAR, as the upright radiation therapy treatment machine requires a smaller physical footprint, making it an ideal complement to the AVATAR device. Stanford Medicine Children’s Health is set to begin treating patients with this innovative machine later this year, further solidifying AVATAR's role in improving pediatric radiotherapy.

“AVATAR’s impact on the quality and safety of cancer treatment for children is profound”, said Krithika Kumar, Director of Discovery at Catalyst. “At Catalyst, we strive to work side by side with our innovators, and this project is exemplary of a collaboration with multiple stakeholders who have come together to bring this innovation to the world. It has been a deeply gratifying experience to be part of this journey, and we are excited to see the next stage of growth with the new strategic partnership.”

As AVATAR continues to make strides in pediatric radiotherapy, the Catalyst team remains committed to supporting its mission. With ongoing innovations and partnerships, AVATAR is set to transform the landscape of treatment for children worldwide, ensuring that they receive the best possible care in a safe and supportive environment. Is your project the next Catalyst innovation? 

The AVATAR project is just one example of the innovative work being supported by the Catalyst program. The program is helping to accelerate the development of several new health care technologies that have the potential to improve the lives of patients around the world.

Catalyst is seeking health care innovations from all members of the Stanford community (faculty, university and health care staff, and students) that can significantly impact global health care. Catalyst will award select projects with validated science that hold the promise of becoming world-changing solutions and are ready to be implemented through piloting, advanced prototype development, or early-stage utilization.

Take the next steps by:

• Reviewing the Catalyst site for additional details and FAQs.

• Evaluating whether your project might be a good fit.

• Interested teams can apply through July 31 on the Catalyst website.