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Po‐Thur Eve General‐29: Clinical Implementation of Helical Tomotherapy
Author(s) -
MacPherson M,
Gerig L,
Malone S,
MacRae R,
Fox G,
Carty K,
Montgomery L,
Clark B
Publication year - 2006
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.2244656
Subject(s) - tomotherapy , contouring , medical physics , medicine , nuclear medicine , staffing , computer science , radiology , radiation therapy , nursing , computer graphics (images)
In March 2005 The Ottawa Hospital Regional Cancer Center took delivery of a helical TomoTherapy Hi‐Art machine. We report our experience for installation, commissioning and training for tomotherapy relative to a conventional single energy linac as well as our experiences regarding throughput, process change and implementation of a radically different staffing model. Tomotherapy implementation was faster than a conventional single energy linac (23 vs. 31 days), but additional training requirements for tomotherapy made the overall times comparable (28 vs. 31 days). Presently, the tomotherapy team includes two physicists and two physicians, and dedicates three therapists to tomotherapy per 8 hour shift. The therapists are given responsibility for data transfer, structure contouring, planning and delivery. Mean total effort for treatment preparation per patient is 8.9 hours (median 6.6, range 3.4 to 33). We find daily machine QA for tomotherapy is more demanding than for a conventional linac, requiring approximately 1 hour for machine warm‐up, safety system testing and CT detector calibration. In addition we require approximately 45 minutes of physics time to establish output, energy, and geometric consistency. Overall system performance is verified by a daily delivery QA. The mean overall time for patient setup, MVCT, registration and treatment is 26.5 minutes (median 25.0). Eliminating the MVCT and registration reduces the mean to 18 minutes. For an 8 hour shift we anticipate that a single team (3 therapists) can maintain a patient load of at least 16 patients with daily MVCT and 24 patients with weekly MVCT.