Tomotherapy

The treatment field's length (the width of the radiation slice) is adjustable using collimator jaws. In static-jaw delivery, the field length remains constant during a treatment; in dynamic-jaw delivery, the field length changes so that it begins and ends at its minimum setting. Tomotherapy treatment times vary compared to normal radiation therapy treatment times. Tomotherapy treatment times can be as low as 6.5 minutes for common prostate treatment, There are few head-to-head comparisons of tomotherapy and other IMRT techniques, however there is some evidence that a conventional linac using VMAT can provide faster treatment whereas tomotherapy is better able to spare surrounding healthy tissue while delivering a uniform dose. While helical tomotherapy can treat very long volumes without a need to abut fields in the longitudinal direction, it does display a distinct artifact due to "thread effect" when treating non-central tumors. Thread effect can be suppressed during planning through good pitch selection. Fixed-angle delivery Fixed-angle tomotherapy uses multiple tomotherapy beams, each delivered from a separate fixed gantry angle, in which only the couch moves during beam delivery. This is branded as TomoDirect, but has also been called topotherapy. The technology enables fixed beam treatments by moving the patient through the machine bore while maintaining specified beam angles. ==Clinical considerations==

Lung cancer, head and neck tumors, breast cancer, prostate cancer, stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) are some examples of treatments commonly performed using tomotherapy. ==History==

The tomotherapy technique was developed in the early 1990s at the University of Wisconsin–Madison by Professor Thomas Rockwell Mackie and Paul Reckwerdt. A small megavoltage x-ray source was mounted in a similar fashion to a CT x-ray source, and the geometry provided the opportunity to provide CT images of the body in the treatment setup position. Although original plans were to include kilovoltage CT imaging, current models use megavoltage energies. With this combination, the unit was one of the first devices capable of providing modern image-guided radiation therapy (IGRT). The first implementation of tomotherapy was the Corvus system developed by Nomos Corporation, with the first patient treated in April 1994. This was the first commercial system for planning and delivering intensity modulated radiation therapy (IMRT). The original system, designed solely for use in the brain, incorporated a rigid skull-based fixation system to prevent patient motion between the delivery of each slice of radiation. But some users eschewed the fixation system and applied the technique to tumors in many different parts of the body. Mobile tomotherapy Due to their internal shielding and small footprint, TomoTherapy Hi-Art and TomoTherapy TomoHD treatment machines were the only high energy radiotherapy treatment machines used in relocatable radiotherapy treatment suites. Two different types of suites were available: TomoMobile developed by TomoTherapy Inc. which was a moveable truck; and Pioneer, developed by UK-based Oncology Systems Limited. The latter was developed to meet the requirements of UK and European transport law requirements and was a contained unit placed on a concrete pad, delivering radiotherapy treatments in less than five weeks. ==See also==