The Tomo-Therapy Hi Art System for sophisticated IMRT and IGRT with helical delivery: recent developments and clinical applications

The advent of 3D conformal radiotherapy and intensity modulated radiation therapy (IMRT) make possible the dose optimization to complex target volumes close to sane organs at risk. IMRT's introduction of numerous small radiation fields inherently increases delivery inaccuracies. As a consequence, the use of IMRT without precise localization of the tumor and sensitive structures, at both the planning and delivery stages, and the absence of continuous verification represent the most significant challenges to the implementation of IMRT in routine clinical use. Intensity modulated (or not) conformal radiotherapy delivery requires better precision in the definition of treatment volume, frequently if necessary. Helical tomo-therapy has been designed to use CT imaging technology to plan, deliver, and verify that the delivery has been carried out as planned. The image-guided and intensity modulations processes of helical tomo-therapy that enable this goal are described. (author)