Tomotherapy ( TomoTherapy Hi-Art System ) is the most recent and sophisticated technology for radiation treatment using external beams. It has been developed at Madison University (Wisconsin, USA) and it is now operating in twenty-five Medical Centers in Canada and United States.

The equipment installed at San Raffaele Hospital is the first one not only in Europe but also outside Canada and United States. The installation began in July 2004 and first treatments were carried out in November 2004 setting up new clinical protocols. At San Raffaele Hospital the System is connected to a PET/CT scanner ( in order to obtain accurate volumes to be treated ) and to adequate techniques to check patient’s position and organ respiratory movement, thus setting up a system which is unique of its kind ( Metabolically Guided Tomotherapy ). Compared to conventional treatments ( conformal 3-D or serial IMRT ) where 60-70 Gy doses are usually administered in 30-35 treatment fractions, this system, due to the helical intensity modulation of the dose ( helical IMRT ), allows a much more selective irradiation of cancer and a sparing of healthy tissues, together with the possibility of delivering higher doses in a number of fractions definitely reduced ( 1-15 fractions according to type of treatment ). Metabolically Guided Tomotherapy may be considered one of the most recent and sophisticated technology for the execution of high–precision radiation treatment .





Department of Radiation Oncology

Scientific Institute San Raffaele

Via Olgettina 60

20132 Milan



Tel. +39-02-26433539

Fax +39-02-26435451