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Tomo Therapy

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The TomoTherapy system is a pioneering radiation therapy platform that enables precise cancer treatment by tightly conforming the radiation dose delivered to the shape of the tumor. Combined with the option of innovative, TomoHelical TM and TomoDirect TM radiation delivery, the all-in- one system results in more control and greater accuracy in treating a wide variety of cancers.

TomoTherapy is a form of computed tomography (CT) guided intensity modulated radiation therapy (IMRT). Daily low-dose CT imaging helps physicians know that radiation will reach the tumor as planned, and that exposure to healthy tissue will be minimized along the way. And, these daily images can be used to monitor and maintain the prescribed treatment during each and every treatment session.

Advantage of TomoTherapy

For Physicians

TomoTherapy enables for fine adjustments to be made prior to radiation delivery due to its efficient, daily CT scans powered by Image-guided radiation therapy (IGRT).

● Wide variety of cancers can be treated with greater accuracy and precision, while minimizing radiation exposure to surrounding tissues because the more beam angles provide a highly conformal dose distribution.

● Precision of treatment results in reduced toxicity, which is especially important for concurrent chemo-radiation therapies

● Acquiring images daily will help in tracking the progression of treatment and make changes in treatment process, if necessary

● System facilitates creation of aggressive, higher-dose treatment regimens which can deliver the prescribed dose in a shorter, more convenient treatment cycle for patients.

● Multiple areas of tumor involvement can be done in one go. Primary and multiple metastatic can be treated with ease.

● Large fields Radiation is of a great advanced with TOMOTHERAPY. Eg. Whole body Radiotherapy for BMT.

For Patients

● The unique design of TomoTherapy helps in treating a wide range of cancers, including recurrent disease in patients who’ve already received maximum radiation doses to critical organs.

● Treatment plans can be customized according to the patient’s needs, monitored and modified over the course of the treatment.

● Minimal dose to the surrounding healthy tissues will help in reduced treatment related side effects and improves patient’s quality of life.

● It allows for simultaneous treatment of multiple tumors, which results in greater comfort for patients and reduced treatment time.

● TomoTherapy treatment is noninvasive and as painless as having a CT scan or an x-ray

Novalis Tx Radiosurgery

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Novalis TX ™ Radio surgery and Radiation therapy

No Knife. No Pain. No Compromises.

Choosing Novalis TX ™ Radiosurgery means making no compromises on your treatment—a painless, non-invasive outpatient procedure for cancerous and non-cancerous conditions of the entire body. Novalis TX Radiosurgery uses a treatment beam contoured to the exact shape of your tumor, pre­cisely delivering treatment while protecting surrounding healthy tissue. And a treatment session lasts just minutes, not hours. Novalis TX Radiosurgery—giving new hope to patients with tumors once considered untreatable.

Tumor Treatment Tailored to Your Needs

Being diagnosed with a tumor or lesion brings about many challenges, concerns and questions. Below is information on Novalis TxTM Radiosurgery personalized radiosurgery to help you understand this revolutionary technology and how it can help you. Novalis TX Radiosurgery ensures that you receive the best possible treatment for your individual diagnosis.

Discuss Novalis TX Radiosurgery with your doctor to find out if it’s right for you. For additional information on Novalis TX Radiosurgery, visit www.poweringhope.com.

Novalis TX Radiosurgery Benefits

Novalis TX Radiosurgery represents a new standard in radiosurgery, offering advanced technologies that deliver highly precise, fast treatment.

Precise

  • Shapes the radiation beam to match the exact contour of the tumor or lesion, ensuring the maximum prescribed dose of high-energy radiation is delivered to the entire tumor
  • Protects surrounding healthy tissue
  • Adapts the treatment beam to breathing and other body movements to continuously maintain safe, complete and accurate dose delivery

Fast

  • Non-invasive, outpatient procedure lasts just 15 to 20 minutes, rather than hours, for a more comfortable and less restricted treatment experience than other radiosurgery devices
  • Reduces the likelihood of patient or tumor movements, ensuring the highest possible level of treatment accuracy
  • Treatment can take place in a single day, although your doctor will decide if your treatment should be administered in a single dose or in a series of doses

Versatile

  • Employs a wide range of treatment modalities, ensuring you receive the best treatment for your individual case. Other radiosurgery devices are limited to only one treatment modality
  • Delivers the industry’s highest dose rate, penetrating deeper to treat tumors previously considered untreatable
  • Offers hope to patients with clinical conditions once considered untreatable and those for whom surgery is not an option
  • Frameless radiosurgery offers a more patient-friendly alternative to other radiosurgery devices that require immobilization with a head ring that attaches to the skull.

Frequently Asked Questions

What types of conditions can be treated with Novalis TX Radiosurgery?

Novalis TX Radiosurgery can treat non-cancerous and cancerous conditions of the entire body such as:

  • Arteriovenous malformations (AVM)
  • Cavernous angiomas
  • Trigeminal neuralgia
  • Intractable seizures
  • Parkinson’s disease
  • Brain metastases/Gliomas
  • Acoustic neuromas
  • Pediatric brain tumors
  • Recurrent brain tumors
  • Pituitary adenomas
  • Meningiomas of the skull base
  • Craniopharyngiomas
  • Spine Tumors/Metastases
  • Prostate Cancer/Metastases
  • Liver Tumors/Metastases
  • Lung Tumors/Metastases

How does Novalis Tx Radiosurgery work ?

Novalis TX Radiosurgery incorporates a powerful linear accelerator, which rotates around the patient to deliver treatment beams anywhere in the body from virtually any angle. A set of sophisticated image-guidance and motion management tools provide clinicians with detailed information about the shape, size and position of the targeted lesion, guide patient setup and positioning, and monitor motion during treatment.

Why is fast treatment important ?

Prolonged treatment times can affect patient comfort and treatment accuracy. Fast treatment reduces the likelihood of patient or tumor movements, which can impact overall accuracy. In addition to offering one of the industry’s fastest treatment times, Novalis TX Radiosurgery continuously tracks patient and tumor motion and automatically adjusts the beam of radiation to maintain the highest possible level of treatment accuracy.

What is the treatment advantage of Novalis Tx Radiosurgery over other radiosurgery devices ?

Other radiosurgery devices utilize circular beams to treat. As most lesions are irregular in shape, a circular dose does not completely cover the exact shape of the tumor. Novalis TX Radiosurgery shapes the radiation beam to contour to the exact shape of your tumor or lesion, ensuring the optimal treatment dose is delivered and protecting healthy tissue. The targeted beam adapts to your breathing and other body movements to continuously maintain safe, complete and accurate dosage.

Will there be any side effects ?

Your doctor will discuss potential side effects with you depending on your overall treatment plan. Novalis TX Radiosurgery treatment is not painful in most cases and does not require anesthesia. There is no scarring or disfigurement and little risk of infection, compared to conventional surgery.

You may experience a headache, dizziness and fatigue immediately following treatment, so driving is not recommended. Make sure to arrange for transportation home.

What effect can radiation have on my tumor or lesion ?

Radiosurgery and radiotherapy use high-energy radiation beams to deliver the prescribed radiation dose directly to tumor cells, causing them to die. Treatment results, visible on follow-up scans, may include shrinkage of the tumor or no further tumor growth. Because cell destruction and absorption of the cells within your system can be a lengthy process, it can take up to six months before the effect of treatment can be determined by your doctor.

What is the difference between stereotactic radiosurgery and fractionated stereotactic radiotherapy ?

Stereotactic radiosurgery and fractionated stereotactic radiotherapy refer to two radiation treatment delivery methods. Stereotactic radiosurgery delivers a high dose of radiation treatment to the tumor in a single session. Fractionated stereotactic radiotherapy delivers a series of radiation treatments to the tumor over a period of time.

While both methods typically involve a similar total dose of radiation, fractionated stereotactic radiotherapy delivers radiation in smaller amounts. Novalis Tx Radiosurgery offers both stereotactic radiosurgery and fractionated stereotactic radiotherapy treatments. Your doctor will recommend the best treatment method for you based on your individual case.

Terms to Know

Radiotherapy – The use of high-energy radiation from x-rays, gamma rays, neutrons and other sources to treat tumors and destroy cancer cells.

Radiosurgery – A radiation therapy procedure that delivers a large dose of radiation to a tumor over one to five treatment sessions.

Stereotactic Radiosurgery – Radiation treatment of a tumor that is applied in a single session with a high dose of radiation.

Fractionated Stereotactic Radiotherapy – A series of radiation treatments over a period of time.

Image-Guided Radiosurgery (IGRS) – Radiation treatment that uses real-time x-ray and CT imaging to deliver precisely focused high-energy radiation to a tumor.

High Dose Rate (HDR) Brachytherapy

As opposed to External Beam Radiation, in Brachytherapy, the source of radiation is placedhigh_dose within or adjacent to tumor tissue itself.

This process is useful for cervical, breast, esophageal, bronchial, bile duct cancers etc. The HDR Brachytherapy Unit has its own dedicated and computerized 3-D Treatment Planning System and the treatment is delivered in a few minutes.

Intensity Modulated Radiotherapy & Radiosurgery (IMRT)

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It refers to the use of multiple spatially inhomogeneous energy beams which converge upon a treatment volume in order to create a conformal and spatially homogeneous dose. This is accomplished using so-called inverse planning where the physician defines a set of ideal dose constraints from the standpoint of minimal and maximal allowed doses to the target structure as well as organs at risk. Using this technique, high tumoricidal doses can be delivered to the tumours, with normal tissue sparing, thus increasing the cure rates and improving local control of the disease, which was not possible.

before with conventional 2D/3D conformal modalities. Thus it is considered a revolution in the field of Radiation treatment. It is ideally suited for irregular/concave shaped tumors and for tumors surrounding radiosensitive structures. The technique is delivered by the Linear Accelerator machines with Multi Leaf Collimators (MLC), which shape the radiation beam according to the tumour contour. The smaller the leaf width of the MLC, the better the tumour conformality and normal tissue sparing. The Novalis TX has the smallest leaf width of 2.5mm, to ensure the best possible conformality.

Image - Guided Radiotherapy (IGRT)

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It is the integration of various radiological and functional imaging techniques in order to perform high-precision radiotherapy. The main aim is to reduce setup margins which could occur during daily positioning, and internal margins occurring due to the patient body's respiratory or bowel movements, and to account for target volume changes during radiation therapy, such as a tumor volume decrease or weight loss (Adaptive radiotherapy). This is not only an IMRT technique; it enables various radiotherapy techniques, including IMRT, to be delivered more accurately.Therefore, it will allow further dose escalation and/or conformal avoidance than IMRT alone, which will lead to improved treatment outcome.

In Novalis Tx, IGRT is Provided by

  • The ExacTrac (R) system that automatically aligns the target volume with the treatment beam based on infrared tracking of external body markers. It also uses automated registration of bony structures and implanted radiopaque markers using stereoscopic X-ray imaging.
  • The Exactrac 6D Couch enables fast and precise couch correction in all directions to account for any misalignment or rotation.
  • For the treatment of tumors that move with respiration, a respiratory gating system, which makes use of implanted markers, is being used.
  • Daily Cone Beam CT, to match the initial treatment planning CT is done to ensure the best precision.
  • On Board kV X-ray imaging.Stereotactic Radiotherapy (SRT)
    Stereotaxy refers to using a precise three-dimensional mapping technique to guide a procedure. Steriotactic Radiotherapy is delivered by several beams that are precisely focused on a three-dimensionally localized target. A special frame or a thermoplastic mask is used for CNS tumors, while a body frame may or may not be used for extracranial sites.
    • If given in one-five fractions in ablative doses ? stereotactic radiosurgery (SRS)
    • If given in more than five fraction ? SRT.
      Stereotactic Body Radiation Therapy (SBRT)

      Stereotactic Body Radiation Therapy (SBRT)

    SBRT is a novel cancer treatment strategy .Whereas conventional external beam radiotherapy is typically administered in daily doses, or fractions, in the range of 1.8 to 2.0 Gy to total doses of 60 to 70 Gy or so, with SBRT ultra-high doses per fraction are applied, generally in the range of 10 to 20 Gy per fraction, in an abbreviated, hypofractionated regimen of 5 or fewer fractions. Such high doses per treatment were unthinkable in the past because of limitations in treatment delivery technology that raised concerns about potential toxicity if large volumes of normal tissues were exposed to so much radiation in each treatment.

    These are now possible with the best anatomical imaging modalities like MRI, and also biological imaging modalities like PET-CT, MR spectroscopy. The technique is suitable for tumors in the Lung, Liver, Pancreas, Spine and Prostate.

    High Definition RapidArc

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    HDRC is a volumetric intensity-modulated arc therapy, which can deliver the required dose distribution with one or a few arcs. For most treatments, this can be performed within few minutes. During the rotation, the dose rate, micro-MLC setting, and speed of the gantry change simultaneously. It can also be used for SRS/SRT. RapidArc combines high conformity with significantly shorter treatment times, which reduce the risk of patient or tumor movement, is more comfortable for the patient and allows a higher throughput of patients,

    enabling lesser waiting times for treatment. It consists of a single arc where MLC (max 5 mm/degree and 2.5 cm/s), dose rate (max 600 MU/min), and gantry speed (max 72 s/turn, i.e. ~5 degrees/s) are optimized simultaneously to achieve the desired degree of modulation. Our Novalis-Tx has got the latest RapidArc Technology with the HD (High Definition) micro-MLCs having leaf width of 2.5 mm enabling the best accuracy with the fastest treatment times.

PET-CT Scanner

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PET-CT Guided (Tumor guided) Radiation Therapy Planning

The PET-CT Scanner combines PET and diagnostic CT to produce a biograph image and measurements, which records in exquisite detail the life process at molecular level of tissues and internal organs from one non-invasive diagnostic procedure.

It has superior diagnostic accuracy and patient management and is used clinically to detect & stage cancer, plan treatment and monitor therapy. PET-CT Scanner images are transferred to 3-D Planning System.

PET-CT Guided Radiotherapy is planned based on Cellular & Molecular Diagnostic information given by PET-CT Scanner. Treatment is based at cellular & molecular level!