TomoTherapy is a Madison, Wisconsin based innovative company that developed a unique product to deliver radiation therapy treatments.

The TomoTherapy HI.ART system at Appleton Medical Center was installed in June 2005 and was clinically operational in July 2005.

This system was a significant leap forward in technology. This was the third system installed in the State of Wisconsin and provides us with a tool that delivers IMRT (intensity modulated radiation therapy) treatments with three-dimensional image guidance.

IMRT - Intensity Modulated Radiation Therapy
IGRT - Image-guided Radiation Therapy

IMRT is available on a number of conventional linear accelerators. The radiation is delivered with many small fields that are controlled in time and shape. By adding radiation from different angles and intensity patterns a customized treatment is obtained.

In the conventional case, the linear accelerator uses a limited number of treatment angles and typically uses two-dimensional imaging or existing skin alignment marks to target the daily treatment. The field size and alignment for conventional IMRT may have some limitations. In many instances, conventional IMRT is an excellent option.

TomoTherapy's IMRT delivery capability is a better option when the target is very close to a critical structure, is large and irregular in shape, and/or needs very precise alignment each day.

TomoTherapy’s improved delivery results from radiation being possible from all angles while the patient is dynamically moved.

In addition, three-dimensional images, similar to a CT scanner, are possible with this radiation source. These images are taken just before a treatment to precisely guide the radiation plan on a daily basis. This type of radiation delivery is referred to as IGRT.

New features are continually updated on this system and these will be upgraded as they become available.

Intensity modulated radiation therapy(IMRT) has the capability to reduce radiation doses to surrounding healthy tissues and provide a dose distribution of almost any shape and intensity. Multiple targets may be dosed at different levels at the same time.

Planning for these computer-controlled treatments benefits from staff and physicians who are very experienced in this delivery. At Appleton Medical Center we have three physicians, two physicists, and three dosimetrists who have been involved with IMRT planning since it became commercially available.

Our center offered the first IMRT treatments in the State of Wisconsin in 1999 with a special system that could perform IMRT planning and delivery prior to the capability being available on conventional linear accelerators. We are very aware that certain new technologies should be an advantage for many patients and our goal is to provide access to these technologies as they become safe for clinical use.