Dynamic Jaws and Dynamic Couch in Helical Tomotherapy

Sterzing, Florian; Uhl, Matthias; Hauswald, Henrik; Schubert, Kai; Sroka-Pérez, G.; Yu, Chen; Lu, Weiguo; Mackie, Rock; Debus, Jürgen; Herfarth, Klaus; Oliveira, Gustavo de

doi:10.1016/j.ijrobp.2009.07.1686

Cited by 60 publications

(67 citation statements)

References 27 publications

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“…Additionally, shorter treatments potentially increase treatment accuracy and safety, as less intrafractional movement can occur. With the use of a 5 cm beam, a reduction of beam on time in the range of 50% would be expected (6) . Yet, we could only reach a

~ 35 %

shorter beam on time as the gantry had to rotate slower to reach the same plan quality as with a smaller field width.…”

Section: Discussionmentioning

confidence: 91%

“…For nasopharyngeal cancer, it could be demonstrated that DJDC with a 5 cm beam (DJDC 5) reduced the dose penumbra and consecutively the integral dose to normal tissue compared to regular delivery with a 2.5 cm and 5 cm field width (Reg 2.5 and Reg 5), respectively. Beam‐on time could be lowered by about 66% (6) . Likewise, the treatment of very large target volumes, such as hemithoracic irradiation for mesothelioma, whole abdominal irradiation, and total marrow irradiation, with in DJDC 5 mode took less than half the time than the Reg 2.5 mode.…”

Section: Introductionmentioning

confidence: 99%

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Accelerated tomotherapy delivery with TomoEdge technique

Katayama

Haefner

Mohr

et al. 2015

J Applied Clin Med Phys

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TomoEDGE is an advanced delivery form of tomotherapy which uses a dynamic secondary collimator. This plan comparison study describes the new features, their clinical applicability, and their effect on plan quality and treatment speed. For the first 45 patients worldwide that were scheduled for a treatment with TomoEdge, at least two plans were created: one with the previous “standard”mode with static jaws and 2.5 cm field width (Reg 2.5) and one with TomoEdge technique and 5 cm field width (Edge 5). If, after analysis in terms of beam on time, integral dose, dose conformity, and organ at risk sparing the treating physician decided that the Edge 5 plan was not suitable for clinical treatment, a plan with TomoEdge and 2.5 cm field width was created (Edge 2.5) and used for the treatment. Among the 45 cases, 30 were suitable for Edge 5 treatment, including treatments of the head and neck, rectal cancer, anal cancer, malignancies of the chest, breast cancer, and palliative treatments. In these cases, the use of a 5 cm field width reduced beam on time by more than 30% without compromising plan quality. The 5 cm beam could not be clinically applied to treatments of the pelvic lymph nodes for prostate cancer and to head and neck irradiations with extensive involvement of the skull, as dose to critical organs at risk such as bladder (average dose 28 Gy vs. 29 Gy, Reg 2.5 vs. Edge 5), small bowel (29% vs. 31%, Reg 2.5 vs. Edge 5) and brain (average dose partial brain 19 Gy vs. 21 Gy, Reg 2.5 vs. Edge 5) increased to a clinically relevant, yet not statistically significant, amount. TomoEdge is an advantageous extension of the tomotherapy technique that can speed up treatments and thus increase patient comfort and safety in the majority of clinical settings.PACS numbers: 87.55.de, 87.55ne

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~ 35 %

shorter beam on time as the gantry had to rotate slower to reach the same plan quality as with a smaller field width.…”

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Accelerated tomotherapy delivery with TomoEdge technique

Katayama

Haefner

Mohr

et al. 2015

J Applied Clin Med Phys

Self Cite

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“…First, only the dynamic jaw mode was applied in this study with no use of the dynamic couch delivery, [11][12][13] because the latter mode is not yet available. If the dynamic jaw and dynamic couch delivery is applied, the doses of the OARs existing at the level of the PTV (eg, the lung and heart) are expected to be reduced, but the treatment time is estimated to be prolonged.…”

Section: Discussionmentioning

confidence: 99%

“…More suitable compromise between craniocaudal dose spread and treatment time may be the use of the recently developed dynamic jaw technology with dynamic adaptation of field width at cranial and caudal edges of a target. [11][12][13][14] This dynamic jaw mode of tomotherapy was recently introduced in our institution first in Japan. Figure 1 shows the difference between the dynamic jaw and conventional fixed jaw (constant field width) modes.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer

Sugie

Manabe

Hayashi

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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“…More recently, dynamic jaws have been implemented (HT‐D) to help reduce beam penumbra at the superior and inferior portions of the treated volume. This system can provide highly homogeneous and conformal dose distributions through a helical photon delivery system at a constant speed with a continuously moving couch combined with rapid binary MLC beam modulation 24, 27, 28, 29…”

Section: Introductionmentioning

confidence: 99%

Comparison of four techniques for spine stereotactic body radiotherapy: Dosimetric and efficiency analysis

Aljabab

Vellayappan

Vandervoort

et al. 2018

J Applied Clin Med Phys

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PurposeThe aim of this study is to compare the dosimetric differences between four techniques for spine stereotactic body radiotherapy (SBRT): CyberKnife (CK), volumetric modulated arc therapy (VMAT), and helical tomotherapy (HT) with dynamic jaws (HT‐D) and fixed jaws (HT‐F).Materials/methodsData from 10 patients were utilized. All patients were planned for 24 Gy in two fractions, with the primary objectives being: (a) restricting the maximum dose to the cord to ≤ 17 Gy and/or cauda equina to ≤ 20 Gy, and (b) to maximize the clinical target volume (CTV) to receive the prescribed dose. Treatment plans were generated by separate dosimetrists and then compared using velocity AI. Parameters of comparison include target volume coverage, conformity index (CI), gradient index (GI), homogeneity index (HI), treatment time (TT) per fraction, and monitor units (MU) per fraction.Results PTV D2 and D5 were significantly higher for CK compared to VMAT, HT‐F, and HT‐D (P < 0.001). The average volume of CTV receiving the prescription dose (CTV D95) was significantly less for VMAT compared to CK, HT‐F and HT‐D (P = 0.036). CI improved for CK (0.69), HT‐F (0.66), and HT‐D (0.67) compared to VMAT (0.52) (P = 0.013). CK (41.86) had the largest HI compared to VMAT (26.99), HT‐F (20.69), and HT‐D (21.17) (P < 0.001). GI was significantly less for CK (3.96) compared to VMAT (6.76) (P = 0.001). Likewise, CK (62.4 min, 14059 MU) had the longest treatment time and MU per fraction compared to VMAT (8.5 min, 9764 MU), HT‐F (13 min, 10822 MU), and HT‐D (13.5 min, 11418 MU) (P < 0.001).ConclusionBoth CK and HT plans achieved conformal target coverage while respecting cord tolerance. Dose heterogeneity was significantly larger in CK. VMAT required the least treatment time and MU output, but had the least steep GI, CI, and target coverage.

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Dynamic Jaws and Dynamic Couch in Helical Tomotherapy

Cited by 60 publications

References 27 publications

Accelerated tomotherapy delivery with TomoEdge technique

Accelerated tomotherapy delivery with TomoEdge technique

Efficacy of the Dynamic Jaw Mode in Helical Tomotherapy With Static Ports for Breast Cancer

Comparison of four techniques for spine stereotactic body radiotherapy: Dosimetric and efficiency analysis

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