TomoTherapy - CHI Health, Nebraska (NE) - Southwest Iowa (IA)

TomoTherapy® Hi·Art® (Highly Integrated Adaptive Radiotherapy) System, located at Immanuel Medical Center, allows doctors to check the location of tumors before each treatment, then deliver painless, precise radiation therapy resulting in unmatched accuracy for cancer patients, especially those with breast, lung and prostate tumors.

How it works

TomoTherapy combines Intensity Modulated Radiotherapy (IMRT) with a computerized tomography (CT) scanner allowing doctors to view the treatment area in three dimensions. This 3D technology allows physicians to verify the position of the tumor before each treatment session, so adjustments can be made on the spot to make sure that radiation is delivered exactly where it should be.

The unique CT scanner design delivers radiation continuously from every angle, unlike traditional radiation therapy equipment which projects radiation from only a few directions. TomoTherapy transforms a single beam of radiation into tens of thousands of tiny beamlets aimed directly at the tumor in a 360 degree delivery pattern. This helical delivery allows for unprecedented precision, meaning less damage to surrounding healthy tissue.

The TomoTherapy Process


Before beginning a TomoTherapy treatment, the doctor uses 3D images from a combination of scanning technologies (such as CT and MRI) and special software to establish the precise contours for each treatment volume (tumor) and any regions at risk (sensitive organs or structures). The doctor then decides how much radiation the tumor should receive, as well as acceptable levels for surrounding structures. The Hi-Art treatment system calculates the appropriate pattern, position and intensity of the radiation beam to be delivered, to match the doctor’s prescription as closely as possible.

Patient Positioning

As both a treatment delivery machine and a CT scanner, the Hi-Art system allows doctors to take a CT scan just before each treatment. With the scan, they can verify the position of the tumor and, if necessary, adjust the patient’s position to help make sure radiation is directed right where it should be.

Radiation Delivery

The Hi-Art treatment system delivers intensity-modulated radiation therapy (IMRT) with a helical (spiral) delivery pattern. Photon radiation is produced by a linear accelerator (or linac for short), which travels in multiple circles around the patient and moves in unison with a device called a multi-leaf collimator, or MLC. Meanwhile, the couch is also moving—guiding the patient slowly through the center of the ring. Each time the linac makes a loop around the patient it directs a unique, optimized set of radiation beamlets at the tumor.

Benefits of TomoTherapy

  • Does not require a lengthy set-up process
  • Targets large, small and multiple lesions
  • Thousands of rotating beamlets allow for precise delivery treatment
  • Locates tumors before each treatment
  • Minimizes radiation to surrounding healthy tissue