Case Study | November 09, 2006

Hi·Art System Facilitates Improved Patient Throughput, Pioneering Conformal Avoidance Plans at UW Hospitals and Clinics

cIso-dose lines for whole brain treatment plan using helical TomoTherapy. A buffer zone of ~ 1cm around the hippocampus (red lines) with a lower dose is needed in order to keep the dose to the hippocampus as low as possible.

The University of Wisconsin Hospitals and Clinics in Madison, WI, is at the forefront of medical research and technology, so it makes sense that the first prototype image-guided IMRT system produced by TomoTherapy Inc. was installed in the same university where the research began over 15 years ago.
Minesh Mehta, M.D., UW professor of Human Oncology, has been a TomoTherapy user since 2001. He has overseen the transition from the world’s first clinical TomoTherapy research system to the upgrade of a production Hi·Art System in 2004.
Recently, the department decided to add a second TomoTherapy Hi·Art System. “Recent upgrades have made the system more robust, so we decided to expand our technology offering,” said Dr. Mehta. “We also decided to purchase a second system because of the IG/IMRT capabilities.”
In addition to treating a wide range of cases, TomoTherapy’s helical, image-guided IMRT allows for treatment of the most complex cases efficiently and effectively at the UWHC. Low-intensity MVCT imaging before each treatment allows for precise, confident dose delivery. The Hi·Art System can efficiently treat multiple lesions during one treatment at a rate up to 850cGy per minute, while the treatment length is 40 cm by 1.6 meters, allowing for head-to-toe delivery in cases such as craniospinal and total body irradiation. In addition, the TomoTherapy Planned Adaptive software allows Dr. Mehta and his staff to analyze and modify patient plans at any point during the treatment course. This is especially useful when patients lose weight or as treatment areas change, so the contours and structures can be adjusted to fit the plan and optimize treatment dose to the tumor, while sparing healthy tissue.
In particular, Dr. Mehta and his team are looking at ways the technology can help his patients with brain cancer. “Linac-based brain tumor plans can be comparable to TomoTherapy plans, but the difference lies in the delivery of radiation,” said Dr. Mehta. “The Hi·Art System can easily generate plans, efficiently deliver treatment and increase throughput at the clinic.”
Dr. Mehta added that his brain tumor patients benefit from the conformal avoidance that the Hi·Art System allows. Conformal avoidance is used in cases where the tumor boundary cannot be easily defined. Rather than trying to map the precise area to be treated, clinicians instead map out critical structures that must be avoided. “Helical delivery allows for superior dose conformance and critical structure avoidance. The TomoTherapy unit is capable of delivering helical fan-beam IMRT projected through 51 beam angles.”
Dr. Mehta and Deepak Kuntia, M.D., along with Hazim Jaradat, Ph.D., are pioneering optimal conformal avoidance to critical structures in the brain. Specifically, they are developing TomoTherapy treatment plans to conformally avoid the hippocampus, the structure that houses memory function in the brain. Dr. Mehta not only wants to eliminate his patients’ cancer, he wants to preserve their quality of life for the future, sparing patients’ memory, speech, vision and hearing as much as possible. He believes that conformal avoidance with helical IMRT can do just that.

Related Content

Lightvision near-infrared fluorescence imaging system
News | Women's Health | September 11, 2018
Shimadzu Corp.
The Siemens Biograph Vision PET-CT system was released in mid-2018.

The Siemens Biograph Vision PET-CT system was released in mid-2018.

Feature | Nuclear Imaging | September 07, 2018 | By Dave Fornell
Nuclear imaging technology for both single photon emission computed tomography (SPECT) and positron emission tomography...
PET Imaging Agent Predicts Brain Tau Pathology, Alzheimer's Diagnosis
News | PET Imaging | September 05, 2018
Eli Lilly and Co. and Avid Radiopharmaceuticals Inc. announced a Phase 3 study of positron emission tomography (PET)...
Brain Study of 62,454 Scans Identifies Drives of Brain Aging
News | SPECT Imaging | August 27, 2018
In the largest known brain imaging study, scientists from five institutions evaluated 62,454 brain single photon...
Abnormal Protein Concentrations Found in Brains of Military Personnel With Suspected CTE

Researchers are using the tracer, which is injected into a patient, then seen with a PET scan, to see if it is possible to diagnose chronic traumatic encephalopathy in living patients. In this image, warmer colors indicate a higher concentration of the tracer, which binds to abnormal proteins in the brain. Credit UCLA Health.

News | PET Imaging | August 24, 2018
August 24, 2018 — In a small study of
PET Tracer Identifies Estrogen Receptor Expression Differences in Breast Cancer Patients
News | PET Imaging | August 09, 2018
In metastatic breast cancer, prognosis and treatment is largely influenced by estrogen receptor (ER) expression of the...
Novel PET Imaging Method Could Track and Guide Type 1 Diabetes Therapy
News | PET Imaging | August 03, 2018
Researchers have discovered a new nuclear medicine test that could improve care of patients with type 1 diabetes. The...
Researchers Trace Parkinson’s Damage in the Heart
News | PET Imaging | July 17, 2018
A new way to examine stress and inflammation in the heart will help Parkinson’s researchers test new therapies and...
Siemens Healthineers Announces FDA Clearance of syngo.via VB30 Molecular Imaging Software
Technology | Nuclear Imaging | July 16, 2018
At the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), June 23-26 in Philadelphia...