TOMOTHERAPY

A type of therapy in which radiation is aimed at a tumour from many different

directions. The patient lays on a table and is moved through a donut-shaped machine.
The radiation source in the machine rotates around the patient in a spiral pattern.
Before radiation, a 3-dimensional (3-D) image of the tumour is taken. This helps
doctors find the highest dose of radiation that can be used to kill tumour cells while
causing less damage to nearby tissue. Tomotherapy is a type of intensity-modulated
radiation Therapy (IMRT).

SEQUENTIAL (or serial) TOMOTHERAPY (NOMOS Peacock)

The NOMOS Peacock method of delivery, often referred to as serial tomotherapy because of
its "slice-wise" treatment of a tumour, has been used since 1994 to treat some 8000+
patients worldwide. This slice-wise method of treatment is known to produce extremely
conformal dose distributions due to its ability to specifically match the dose distribution on
each slice to the shape of the target volume on that same slice. According to the NOMOS
Corporation, that an increase in the number of treatment slices into which the target is
segmented would lead directly to an improvement in three-dimensional (3D) dose
conformality, a joint effort was undertaken to develop a new MIMIC collimator treatment
mode. Inherent to the original design of the NOMOS MIMIC binary multileaf collimator were
2 treatment modes: a 2-cm mode with a slice thickness of approximately 1.7 cm and a 1-cm
mode with a slice thickness of approximately 0.85 cm. As a result of this collaborative effort,
a new MIMIC treatment mode has been developed.
MAJOR SPECIFICATION
1) First form of IMRT
2) 90 NOMOS Peacock systems have been sold.
3) To date, more patients treated using peacock than any other form
of IMRT.
4) Most conformal delivery for complex target volumes and
avoidance structures.
5) Viable alternative to the delivery of IMRT using conventional
accelerators.

HELICAL TOMOTHERAPY
Helical tomotherapy (HT) is an innovative radiotherapy technique, which
integrates linear accelerator and computerized tomography (CT)
technology to deliver IMRT in a helical pattern, thanks to a continuously
rotating gantry. The integrated image-guidance system provides daily 3D
imaging of the tumour, achieving precise irradiation, and therefore
decreased toxicity to healthy tissue, with possible treatment adaption
(Image guided radiotherapy)
MAJOR SPESIFICATION
1) 6 MV siemens linac
2) Up to 8 gylmin @axis
3) 85cm diameter gantry bore
4) 64 leaves with 6.25mm resolution @ axis
5) 4cm * 40cm maximum field at axis
6) Slice field width from 5mm to 40mm at axis
7) Minimum beamlet size 5mm *6.25 mm at axis
8) Xenon CT detectors with per pulse acquisition
9) 0.25 mm precision CT couch.
10) Leaves 10cm thick, 95% tungsten alloy.
11) Primary collimator 22cm thick 95% tungsten alloy.
12) Fan Beam Characteristics
a) The fan field width along the longitudinal direction is continuous
from 5 mm to 50 mm.
b) There is no field flattening filter in the beam and so the beam
has a higher intensity along the centre as compared to either end.