1. TOMOTHERAPY

2. 목 차
토모테라피의 역사
토모테라피의 구조 및 특징
토모테라피의 발전

3. Co-60 원격치료기
선형가속기
선형가속기

4. 선형가속기
감마나이프
사이버나이프
선형가속기
(다엽콜리메이트)
최신 선형가속기
토모 치료기

5. External Beam Therapy’s Evolution
Radiotherapy History – C-Arm Gantries
Commercial Availability
Early 1900s
1955
1968
1988
1992
1995
1996
2001
2003
2005
2008 3D
Treatment
MLC
Serial
tomotherapy
(1st commercial IMRT)
IMRT CT
Guided
IG-IMRT
(TomoTherapy)
RapidArc
IMAT
C-Arms invented
for diagnostic X-Rays
CO 60
Clinac 4
EPID
CBCT
2003
2005
2007
2008
Helical TomoTherapy
2003
Adaptive
Planning
DGRT
Dose Verification
StatRT
Throughput and Reliability Enhancements
Imaging History – Ring Gantries
1972
1983
1992
1995
2002
(commercialized versions) CT
MRI
Helical CT
Helical
Multi slice CT
PET/CT use
common
In RT
TomoTherapy evolved from CT scanners (newer style slip ring gantries).
C-Arms evolved from classic diagnostic X-Ray machine designs.
TomoTherapy is the new paradigm in IG-IMRT.

6. 구조
터치스크린 조절판
직경 85 cm
IMRT 치료 범위 : 40 cm X 160 cm
외부구조

7. 구조
내부구조

8. Tomo
Therapy
어떤 물체의 단층을 뜻하는 ‘토모(Tomo)’
치료를 뜻하는 ‘테라피(Therapy)’

9. 방사선치료기기 CT

10. 특 징
MVCT (MegaVoltage CT)
MLC
Helical Treatment

11. MVCT
adaptive radiotherapy 가능

12. MVCT

13. MVCT
판정시 표시된 암덩어리
15회 치료후 모습
25회 치료 종양제거 모습

14. MVCT
Perfect IGRT

15. HELICAL
360˚
Helical

16. HELICAL
종양의 모양, 수에 관계없이 여러 군데 흩어져있는 암 덩어리를 한 번에 치료 가능

18. MLC (Multileaf Collimator)

19. MLC (Multileaf Collimator)
Perfect IMRT

20. 1m 10 cm 1 cm Circular Highly Irregular Complexity 치료범위 SRS
Stereotactic
Radiosurgery

21. 1m 10 cm 1 cm 1 mm Circular Highly Irregular Complexity 치료범위 Robotic
Stereotactic Radiosurgery
Robotic
Therapy

22. 1m Highly Irregular Complexity 10 cm 1 cm Circular 치료범위 기존MLC
Stereotactic Radiosurgery
Conventional MLC
Robotic
Therapy

23. Highly Irregular Complexity 1m 10 cm 1 cm 1 mm Circular 치료범위 미니MLC
Stereotactic Radiosurgery
Conventional MLC
Mini-MLC
Robotic
Therapy

24. 1m 10 cm 1 cm 1 mm Circular Complexity Highly Irregular 치료범위 SRS
Robotic
기존MLC
미니MLC
TomoTherapy
치료범위
Complexity 1m
10 cm
1 cm
1 mm
Circular
Highly Irregular
Stereotactic Radiosurgery
Conventional MLC
Mini-MLC
Helical
Tomotherapy
Robotic
Therapy
Intensity-
Modulated
Protons

25. 1 cm 1 cm 1 mm 1 mm 치료범위 Whole Bone Mantle Head and Lung Neck Prostate
SRS
Robotic
기존MLC
미니MLC
TomoTherapy
치료범위 1m
10 cm
1 cm
1 mm
Complexity
Circular
Stereotactic
Radiotherapy
Head and
Neck
Lung
Prostate
Mantle
Whole Bone
Highly Irregular
Complexity 1m
Circular
Conventional MLC
Mini-MLC
Robotic
Therapy
Helical
Tomotherapy
10 cm
1 cm
모든 종류의 암 다 치료 가능.
1 mm
Highly Irregular

26. 모든 종류의 암 치료
From 넓은 부위 치료 (TBI 등)
To 좁은 부위 치료 (Head & Neck 등)

27. Conventional Linacs VS. TomoTherapy system

28. Conventional Linacs VS. TomoTherapy system

29. = + + Fast Binary MLC Continuous Rotation Helical Delivery
MLC designed for IMRT
10 times less transmission and leakage then conventional MLCs; 10 times faster MLC Speed
Slip-ring gantry designed for IG-IMRT. Continuous rotation with variable speeds
( seconds)
Tens of thousands of beamlets produced in standard treatment times =

30. 기존에 시행해왔던 선형가속기를 기반으로 한 세기조절방사선치료보다 더욱 정밀하여 치료 오차를 획기적으로 감소시킨 장비이다
기존에 시행해왔던 선형가속기를 기반으로 한 세기조절방사선치료보다 더욱 정밀하여 치료 오차를 획기적으로 감소시킨 장비이다. 기존 방사선 암치료 장비의 장점만을 하나로 집약한 암치료기라서 꿈의 암치료기라 불리우며 현존하는 방사선 치료기 중 최첨단 장비라 할 수 있다.

31. Breast Cancer Treatment

32. Prostate Cancer Treatment

33. ♡ ♡ 감사합니다^.^♡ ♡