Advanced Technologies - Tomo and Vero

Question 1

What is tomotherapy?

Answer 1

• The first popular IMRT
• Loud as used compressed air
• Additions to Linac to make delivery finer and more precise

Question 2

Disadvangtages of Tomotherapy?

Answer 2

• Only delivers 6 MV, no 10MV, no electrons
• Training different, i.e inverse planning
• breakdown, need contingiency
• Problems with motion, e.g breathing during breast treatment, tomodirect aimed to solve this

Question 3

Advantages of Tomotherapy?

Answer 3

• Reduces computing needed
• No flattening filter needed (modulating, making unflat)
• Shielding is built in so rooms can be more compact (consider commissioning)
• Has potential to rotate much more quickly
• Single unit, planning and treatment
• Intrafractional imaging is possible (but needs to be reconstructed unlike MR Linac)
• sculpt dose more finely
  -Useful in things like palliative treatment and tangential pair where modulation is unnecessary and gantry can be locked in place
• Lends self to adaptive radiotherapy due to integral planning within the system, daily online IGRT, dosimetric verification via imaging with treatent beam and possible adaptation of plan

Question 4

What is Vero?

Answer 4

• Japan and Holland development
• CT gantry based but limited in rotational capacity but with more degrees of freedom, particularly useful for smaller targets
• rotate the actual beam
• ## Used in SBRT Lung, oligomets and dynamic wave arc