For more than 80 years, radiation therapy has been used in cancer care. Through the decades, the primary challenges have remained the same:

• How can doctors be sure the beam is reaching the tumor as planned?
• How can harm to healthy tissue around the tumor be minimized?

With a fresh approach and a new design, the TomoTherapy “Hi-Art” treatment system addresses these needs.

Revolutionary, not evolutionary

Today’s conventional radiation treatment devices are at the end of an evolutionary path. With design roots in 2D x-ray imaging equipment from more than a century ago, they have been adapted over time to stay current with advances in the field. The Hi-Art treatment system, in contrast, was designed in the 1990s. The goal was to develop a machine free of historical constraints – one that could make full use of recent, key advances in computing, diagnostic imaging and treatment delivery technologies.

Discrete-angle delivery with TomoDirect

TomoDirect is a non-rotational treatment option for the Hi-Art system. With up to 12 discrete angles for target tumors with, it enables the tumors to be treated more efficiently.

The imaging advantage

The Hi-Art treatment system looks like a CT scanner because it is a CT scanner. It lets clinicians efficiently acquire 3D CTrue images of every patient, every day. With these images, clinicians can check the size, shape and location of tumors before each treatment. Then they can compare that day’s image with the one used for planning, to make sure that radiation will be directed to where it should be. Importantly, daily CTrue images can also be used to analyze – and, if necessary, modify – a patient’s treatment at any point during the treatment course.

A simplified treatment process

The Hi-Art treatment system is an all-in-one solution, incorporating software for treatment planning, quality assurance, patient set-up and treatment delivery. It facilitates the first fully-integrated process for radiation therapy, reducing the number of technical decisions that need to be made and giving clinicians more time to focus on patients.

Unparalleled precision

Conventional radiation therapy machines deliver a wide beam of radiation from only a few angles. The Hi-Art treatment system uses its unique CT scanner design to deliver radiation continuously from all angles around the patient. And, it features patented beam-modulating technology that divides a single beam into many smaller, narrow “beamlets”. More angles and more precise modulation result in dose distributions that conform to tumors like never before. This, in turn, minimizes damage to surrounding healthy tissue.

Behind the scenes

Before beginning a TomoTherapy treatment, the doctor puts together a plan using 3D images from a combination of scanning technologies (such as CT and MRI) and special software to establish the precise contours for each tumor and surrounding sensitive organs or tissues.

The doctor then prescribes how much radiation the tumor should receive, as well as acceptable levels for healthy tissue nearby. The Hi-Art treatment system calculates the appropriate pattern, position and intensity of the radiation beams to be delivered, based on the doctor’s prescribed dose.

The day of treatment

After checking in for a daily treatment, the patient will be taken to the TomoTherapy treatment room where a radiation therapist will help them onto the Hi-Art system’s couch. The patient will most likely lie on their back, and the therapist may fit them with a special device to help them hold still during treatment.

First, the couch will move the patient through the machine once for daily CTrue imaging. Based on these images, the therapist may fine tune the patient’s position via small couch adjustments. Then the couch will move the patient through the machine once again, this time more slowly, as the Hi-Art system delivers the daily treatment.

What you can expect

A typical course of radiation therapy involves a daily process, Monday through Friday. The number of treatments varies by case. On the average, the full daily TomoTherapy procedure takes 20 minutes from when the patient enters the treatment room until they leave. This includes about five minutes for the daily CT to be performed and another five minutes for treatment to be delivered (“beam-on time”). The remaining time is used for patient set-up and image registration for proper positioning.

TomoTherapyI treatments are completely painless. The experience is similar to having a CT scan or an x-ray taken. You may hear a clicking noise and the hum of machine, both of which are normal sounds that the machine makes.

A new standard of care

In July of 2003, the first patient was treated on a clinical TomoTherapy Hi-Art treatment system. Today, hundreds of people will begin their own Tomo* treatments at hospitals, clinics and cancer centres worldwide. The rapid, widespread embrace of the TomoTherapy process is one way to gauge its impact on cancer care.

This state-of-the-art cancer treatment system is now available at Sime Darby Medical Centre Subang Jaya, Malaysia.

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