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Tomotherapy

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matching" and brings with it the possibility of a less-than-perfect match between two adjacent fields with a resultant hot and/or cold spot within the tumor. The second issue is that if the patient or tumor moves during this sequential delivery, then again, a hot or cold spot will result. The first problem is reduced by use of a helical motion, as in
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TomoTherapy Inc. which was a moveable truck; and Pioneer, developed by UK-based Oncology Systems Limited. The latter was developed to meet the requirements of UK and European transport law requirements and was a contained unit placed on a concrete pad, delivering radiotherapy treatments in less than five weeks.
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as it rotates around the patient, while they are moved through the bore of the machine. The name comes from the use of a strip-shaped beam, so that only one “slice” (Greek prefix “tomo-”) of the target is exposed at any one time by the radiation. The external appearance of the system and movement of
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The first implementation of tomotherapy was the Corvus system developed by Nomos Corporation, with the first patient treated in April 1994. This was the first commercial system for planning and delivering intensity modulated radiation therapy (IMRT). The original system, designed solely for use in
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and Paul Reckwerdt. A small megavoltage x-ray source was mounted in a similar fashion to a CT x-ray source, and the geometry provided the opportunity to provide CT images of the body in the treatment setup position. Although original plans were to include kilovoltage CT imaging, current models use
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or linac, their main component), a linear accelerator generates the radiation beam, but the external appearance of the machine, the patient positioning, and treatment delivery is different. Conventional linacs do not work on a slice-by-slice basis but typically have a large area beam which can also
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Gonzalez, Victor J.; Buchholz, Daniel J.; Langen, Katja M.; Olivera, Gustavo H.; Chauhan, Bhavin; Meeks, Sanford L.; Ruchala, Kenneth J.; Haimerl, Jason; Lu, Weiguo; Kupelian, Patrick A. (2006). "Evaluation of two tomotherapy-based techniques for the delivery of whole-breast intensity-modulated
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In general, radiation therapy (or radiotherapy) has developed with a strong reliance on homogeneity of dose throughout the tumor. Tomotherapy embodies the sequential delivery of radiation to different parts of the tumor which raises two important issues. First, this method is known as "field
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Due to their internal shielding and small footprint, TomoTherapy Hi-Art and TomoTherapy TomoHD treatment machines were the only high energy radiotherapy treatment machines used in relocatable radiotherapy treatment suites. Two different types of suites were available: TomoMobile developed by
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While helical tomotherapy can treat very long volumes without a need to abut fields in the longitudinal direction, it does display a distinct artifact due to "thread effect" when treating non-central tumors. Thread effect can be suppressed during planning through good pitch selection.
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the brain, incorporated a rigid skull-based fixation system to prevent patient motion between the delivery of each slice of radiation. But some users eschewed the fixation system and applied the technique to tumors in many different parts of the body.
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Goddu SM, Chaudhari S, Mamalui-Hunter M, et al. Helical tomotherapy planning for left-sided breast cancer patients with positive lymph nodes: Comparison to conventional multiport breast technique. Int J Radiat Oncol Biol Phys 2009; 73:
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Fixed-angle tomotherapy uses multiple tomotherapy beams, each delivered from a separate fixed gantry angle, in which only the couch moves during beam delivery. This is branded as TomoDirect, but has also been called topotherapy.
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Woo, Shiao Y.; et al. (June 1996). "A comparison of intensity modulated conformal therapy with a conventional external beam stereotactic radiosurgery system for the treatment of single and multiple intracranial lesions".
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treatment times. Tomotherapy treatment times can be as low as 6.5 minutes for common prostate treatment, excluding extra time for imaging. Modern tomotherapy and conventional linac systems incorporate one or both of
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In helical tomotherapy, the linac rotates on its gantry at a constant speed while the beam is delivered; so that from the patient's perspective, the shape traced out by the linac is helical.
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jaws. In static-jaw delivery, the field length remains constant during a treatment. In dynamic-jaw delivery, the field length changes so that it begins and ends at its minimum setting.
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Fenwick, John D.; Tomé, Wolfgang A.; Soisson, Emilie T.; Mehta, Minesh P.; Rock Mackie, T. (October 2006). "Tomotherapy and Other Innovative IMRT Delivery Systems".
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Non-helical static beam techniques such as IMRT and TomoDirect are well suited to whole breast radiation therapy. These treatment modes avoid the low-dose integral
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Holmes, Timothy W.; et al. (June 2008). "Stereotactic Image-Guided Intensity Modulated Radiotherapy Using the HI-ART II Helical Tomotherapy System".
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megavoltage energies. With this combination, the unit was one of the first devices capable of providing modern image-guided radiation therapy (IGRT).
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Franco P, Catuzzo P, Cante D, et al. TomoDirect: An efficient means to deliver radiation at static angles with tomotherapy. Tumori 2011; 97: 498–502.
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There are few head-to-head comparisons of tomotherapy and other IMRT techniques, however there is some evidence that a conventional linac using
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Murai, Taro; Shibamoto, Yuta; Manabe, Yoshihiko; Murata, Rumi; Sugie, Chikao; Hayashi, Akihiro; Ito, Hiroya; Miyoshi, Yoshihito (2013-03-21).
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by ensuring that the tumor control probability (TCP) significantly outweighs the associated normal tissue complication probability (NTCP).
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This risk is accentuated in younger patients with early-stage breast cancer, where cure rates are high and life expectancy is substantial.
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Squires, Matthew; Hu, Yunfei; Byrne, Mikel; Archibald-Heeren, Ben; Cheers, Sonja; Bosco, Bruno; Teh, Amy; Fong, Andrew (2017-06-04).
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The technology enables fixed beam treatments by moving the patient through the machine bore while maintaining specified beam angles.
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can provide faster treatment whereas tomotherapy is better able to spare surrounding healthy tissue while delivering a uniform dose.
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Bailat, Claude J; Baechler, Sébastien; Moeckli, Raphael; Pachoud, Marc; Pisaturo, Olivier; Bochud, François O (1 August 2011).
195:(IGRT). In tomotherapy, images are acquired in a very similar manner to a CT scanner, thanks to their closely related design. 3332: 1767: 1117:
Squires M, Hu Y, Byrne M, et al. Static beam tomotherapy as an optimisation method in whole breast radiation therapy (WBRT).
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Rao, M.; et al. (November 2009). "Evaluation of Arc-based Intensity Modulated Radiotherapy for Head and Neck Cancer".
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Colligan, S J; Mills, J (2012). "Beam therapy equipment". In Sibtain, Amen; Morgan, Andrew; MacDougall, Niall (eds.).
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Some research has suggested tomotherapy provides more conformal treatment plans and decreased acute toxicity.
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Stovall, Marilyn; Smith, Susan A.; Langholz, Bryan M.; Boice, John D.; Shore, Roy E.; et al. (2008).
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body radiotherapy (SBRT) are some examples of treatments commonly performed using tomotherapy.
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Mackie, T. Rockwell; Balog, John; Ruchala, Ken; et al. (January 1999). "Tomotherapy".
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and long treatment times associated with helical approaches by confining dose delivery to
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The treatment field's length (the width of the radiation slice) is adjustable using
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Patient undergoing tomotherapy, face and body covered, to prevent movement
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Principles and Practice of Image-Guided Radiation Therapy of Lung Cancer
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Kissick, M. W.; Fenwick, J.; James, J. A.; et al. (May 2005).
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Mallick, Supriya; Rath, Goura K.; Benson, Rony (25 November 2019).
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Mayles, Philip; Nahum, Alan; Rosenwald, Jean-Claude, eds. (2007).
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The tomotherapy technique was developed in the early 1990s at the
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the radiation source and patient can be considered analogous to a
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Beavis, A W (April 2004). "Is tomotherapy the future of IMRT?".
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Cai, Jing; Chang, Joe Y.; Yin, Fang-Fang (18 September 2017).
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International Journal of Radiation Oncology, Biology, Physics
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International Journal of Radiation Oncology, Biology, Physics
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International Journal of Radiation Oncology, Biology, Physics
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International Journal of Radiation Oncology, Biology, Physics
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Radiotherapy in practice : physics for clinical oncology
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http://onlinelibrary.wiley.com/doi/10.1002/jmrs.232/abstract
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treatment machine. In tomotherapy a thin radiation beam is
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Mackie, T R (7 July 2006). "History of tomotherapy".
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Handbook of radiotherapy physics theory and practice
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Tomotherapy treatment times vary compared to normal
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Practical radiotherapy : physics and equipment
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(June 2014). 169: 1111: 899: 817:"The helical tomotherapy thread effect" 217: 3325: 2876:Liquid-fluoride thorium reactor (LFTR) 1513: 1060: 1023: 732: 472: 357:. Boca Raton: CRC Press. p. 969. 3118: 2881:Molten-Salt Reactor Experiment (MSRE) 2290: 2277: 1487: 1354:Journal of Medical Radiation Sciences 1212: 1127: 963: 598: 313: 158: 3305: 2278: 679: 551: 15: 2886:Integral Molten Salt Reactor (IMSR) 705: 382:. Oxford: Oxford University Press. 205: 13: 2695: 1846:Positron-emission tomography (PET) 388:10.1093/med/9780199573356.001.0001 14: 3349: 1869:Neutron capture therapy of cancer 1768:Radioisotope thermoelectric (RTG) 1453: 788:Darafsheh, Arash (8 March 2021). 599:Hayat, M. A. (21 November 2007). 3304: 3293: 3292: 3280: 2969:Fast Breeder Test Reactor (FBTR) 1460: 475:The British Journal of Radiology 20: 2058:Historical stockpiles and tests 1406:"Radiation Therapy on the Road" 1026:Physics in Medicine and Biology 781: 646: 452:. 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CRC Press. p. 144. 292: 263:spiral computed tomography 191:imaging systems, enabling 155:be resized and modulated. 148:external beam radiotherapy 94:Tomotherapy Hi Art machine 3274: 3230: 3182: 3139: 3129: 3081: 3069:Stable Salt Reactor (SSR) 2982: 2964:Reduced-moderation (RMWR) 2929: 2912: 2852: 2779: 2771:Advanced gas-cooled (AGR) 2745: 2736: 2688: 2668: 2621: 2603: 2559: 2464: 2446: 2314: 2301: 2286: 2273: 2228: 2161: 2106: 2097: 2045: 1953: 1944: 1911: 1854: 1816: 1807: 1728: 1660: 1583: 1525: 1521: 117: 107: 99: 87: 82: 77:Type of radiation therapy 2974:Dual fluid reactor (DFR) 2590:Steam-generating (SGHWR) 1926:Electron-beam processing 757:10.1120/jacmp.v10i4.3068 577:10.7785/tcrt.2012.500374 150:(often referred to as a 3089:Organic nuclear reactor 2261:Nuclear power phase-out 2184:Nuclear decommissioning 2124:Reactor-grade plutonium 1874:Targeted alpha-particle 1753:Accidents and incidents 1410:Imaging Technology News 1086:10.1186/1748-717X-8-181 691:Imaging Technology News 230:Clinical considerations 1238:10.1186/1748-717x-8-68 989:10.1186/1748-717X-1-26 687:"VMAT vs. Tomotherapy" 303:Thomas Rockwell Mackie 175: 42:This is mostly jargon. 2251:Anti-nuclear movement 1436:medicalphysicsweb.org 1360:(4). Wiley: 281–289. 173: 3159:Reversed field pinch 2954:Traveling-wave (TWR) 2438:Supercritical (SCWR) 1936:Gemstone irradiation 863:radiation therapy". 487:10.1259/bjr/22666727 218:Fixed-angle delivery 47:improve this article 36:to meet Knowledge's 2324:Aqueous homogeneous 2119:Reprocessed uranium 1792:Safety and security 833:2005MedPh..32.1414K 529:2011RPPh...74h6701B 103:Helical tomotherapy 3238:Dense plasma focus 2153:Actinide chemistry 1618:Isotope separation 1515:Nuclear technology 1470:has a profile for 1225:Radiation Oncology 1073:Radiation Oncology 976:Radiation Oncology 314:Mobile tomotherapy 176: 159:General principles 152:linear accelerator 3320: 3319: 3270: 3269: 3266: 3265: 3217:Magnetized-target 3114: 3113: 3077: 3076: 2908: 2907: 2904: 2903: 2848: 2847: 2732: 2731: 2664: 2663: 2269: 2268: 2224: 2223: 2093: 2092: 2080:Weapon-free zones 1907: 1906: 1899:Radiopharmacology 1476: 1280:Medical Dosimetry 1032:(13): R427–R453. 841:10.1118/1.1896453 801:978-1-351-00537-1 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1858: 1852: 1851: 1849: 1848: 1843: 1838: 1833: 1828: 1826:Autoradiograph 1822: 1820: 1811: 1805: 1804: 1802: 1801: 1800: 1799: 1789: 1788: 1787: 1777: 1776: 1775: 1765: 1760: 1755: 1750: 1745: 1740: 1734: 1732: 1726: 1725: 1723: 1722: 1717: 1712: 1707: 1702: 1697: 1692: 1687: 1682: 1677: 1672: 1666: 1664: 1658: 1657: 1655: 1654: 1653: 1652: 1647: 1642: 1641: 1640: 1635: 1620: 1615: 1610: 1605: 1600: 1595: 1589: 1587: 1581: 1580: 1578: 1577: 1576: 1575: 1570: 1560: 1555: 1550: 1548:Atomic nucleus 1545: 1540: 1535: 1529: 1527: 1519: 1518: 1511: 1510: 1503: 1496: 1488: 1466: 1459: 1458: 1457: 1455: 1454:External links 1452: 1449: 1448: 1423: 1397: 1340: 1321:(1): 108–117. 1305: 1286:(2): 135–148. 1270: 1211: 1205: 1196: 1136: 1126: 1110: 1059: 1013: 962: 955: 937: 918:(3): 593–597. 898: 854: 807: 800: 780: 751:(4): 117–131. 731: 704: 678: 665:(4): 321–327. 645: 638: 618: 611: 591: 550: 500: 465: 458: 438: 419:(4): 199–208. 403: 396: 370: 363: 344: 343: 341: 338: 337: 336: 331: 324: 321: 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2935: 2934:Breeder (FBR) 2932: 2931: 2928: 2925: 2920: 2911: 2897: 2894: 2892: 2889: 2887: 2884: 2882: 2879: 2877: 2874: 2872: 2869: 2868: 2866: 2864: 2860: 2857: 2855: 2851: 2839: 2836: 2832: 2829: 2827: 2824: 2822: 2819: 2817: 2814: 2813: 2812: 2809: 2808: 2807: 2804: 2802: 2799: 2795: 2792: 2791: 2790: 2787: 2786: 2784: 2782: 2778: 2772: 2769: 2767: 2764: 2762: 2760: 2756: 2755: 2753: 2751: 2744: 2741: 2739: 2735: 2725: 2722: 2720: 2717: 2715: 2712: 2710: 2707: 2706: 2704: 2702: 2694: 2691: 2687: 2684: 2679: 2672: 2667: 2655: 2652: 2650: 2647: 2645: 2642: 2640: 2637: 2636: 2635: 2632: 2631: 2629: 2627: 2620: 2614: 2611: 2610: 2608: 2606: 2602: 2596: 2593: 2591: 2588: 2584: 2581: 2579: 2576: 2575: 2574: 2571: 2570: 2568: 2566: 2558: 2550: 2547: 2545: 2542: 2540: 2537: 2535: 2532: 2528: 2525: 2523: 2520: 2518: 2515: 2514: 2513: 2510: 2508: 2505: 2501: 2498: 2495: 2492: 2489: 2486: 2485: 2484: 2481: 2480: 2479: 2476: 2475: 2473: 2471: 2463: 2460: 2456: 2449: 2445: 2439: 2436: 2431: 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2001: 1999: 1996: 1992: 1989: 1988: 1987: 1984: 1982: 1979: 1977: 1974: 1972: 1969: 1967: 1964: 1962: 1959: 1958: 1956: 1952: 1949: 1947: 1943: 1937: 1934: 1932: 1929: 1927: 1924: 1922: 1919: 1918: 1916: 1914: 1910: 1900: 1897: 1895: 1892: 1890: 1889:Brachytherapy 1887: 1885: 1882: 1880: 1877: 1875: 1872: 1870: 1867: 1865: 1862: 1861: 1859: 1857: 1853: 1847: 1844: 1842: 1839: 1837: 1834: 1832: 1829: 1827: 1824: 1823: 1821: 1819: 1815: 1812: 1810: 1806: 1798: 1795: 1794: 1793: 1790: 1786: 1783: 1782: 1781: 1778: 1774: 1771: 1770: 1769: 1766: 1764: 1761: 1759: 1756: 1754: 1751: 1749: 1746: 1744: 1741: 1739: 1736: 1735: 1733: 1731: 1727: 1721: 1718: 1716: 1713: 1711: 1708: 1706: 1703: 1701: 1698: 1696: 1693: 1691: 1688: 1686: 1685:Cross section 1683: 1681: 1678: 1676: 1673: 1671: 1668: 1667: 1665: 1663: 1659: 1651: 1648: 1646: 1643: 1639: 1636: 1634: 1631: 1630: 1629: 1626: 1625: 1624: 1621: 1619: 1616: 1614: 1611: 1609: 1606: 1604: 1601: 1599: 1596: 1594: 1591: 1590: 1588: 1586: 1582: 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1836:Scintigraphy 1473:Tomotherapy 1472: 1439:. 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165:collimator 144:CT scanner 3164:Spheromak 2863:Fluorides 2527:IPHWR-700 2522:IPHWR-540 2517:IPHWR-220 2306:Moderator 1986:Explosion 1961:Arms race 1748:Economics 1700:Reflector 1695:Radiation 1690:Generator 1645:Plutonium 1598:Deuterium 1563:Radiation 1533:Chemistry 1475:(Q174387) 1374:2051-3895 1247:1748-717X 1173:0360-3016 982:(1): 26. 885:0360-3016 139:modulated 109:Specialty 3299:Category 3253:Polywell 3184:Inertial 3141:Magnetic 2896:TMSR-LF1 2891:TMSR-500 2871:Fuji MSR 2831:THTR-300 2671:Graphite 2534:PHWR KWU 2500:ACR-1000 2428:IPWR-900 2411:ACPR1000 2406:HPR-1000 2396:CPR-1000 2371:APR-1400 2162:Disposal 2114:Actinide 2107:Products 1966:Delivery 1809:Medicine 1638:depleted 1633:enriched 1603:Helium-3 1568:ionizing 1392:28580762 1335:10196402 1300:18456165 1265:23517931 1191:18556141 1134:1243–51. 1105:23866263 1054:31523227 1046:16790916 1008:16887031 893:16618583 849:15984692 775:19918236 586:24066951 545:53124638 495:15107318 433:17010902 323:See also 279:angles. 113:oncology 31:require 3311:Commons 3222:Z-pinch 3192:Bubble 3174:Tokamak 3037:FBR-600 3017:CFR-600 3012:BN-1200 2678:coolant 2605:Organic 2490:CANDU 9 2487:CANDU 6 2455:coolant 2416:ACP1000 2391:CAP1400 2329:Boiling 2294:Fission 2141:Fission 2085:Weapons 2025:Warfare 2008:Testing 1998:History 1991:effects 1946:Weapons 1856:Therapy 1831:RadBall 1818:Imaging 1710:Thermal 1675:Capture 1662:Neutron 1650:Thorium 1628:Uranium 1593:Tritium 1573:braking 1553:Fission 1543:Physics 1526:Science 1468:Scholia 1383:5715293 1256:3643840 1182:3782859 1096:3721992 999:1557668 932:8655384 829:Bibcode 766:5720582 525:Bibcode 293:History 33:cleanup 3122:Fusion 3082:Others 3022:PhĂ©nix 3007:BN-800 3002:BN-600 2997:BN-350 2826:HTR-PM 2821:HTR-10 2801:UHTREX 2766:Magnox 2761:(UNGG) 2654:Lucens 2649:KS 150 2386:ATMEA1 2366:AP1000 2349:Kerena 2229:Debate 1981:Ethics 1971:Design 1954:Topics 1785:rocket 1763:Fusion 1758:Policy 1720:Fusion 1680:Poison 1558:Fusion 1441:6 June 1416:6 June 1390:  1380:  1372:  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359:ISBN 200:VMAT 3131:by 3047:PFR 2838:PMR 2816:AVR 2738:Gas 2676:by 2644:KKN 2578:ATR 2493:EC6 2453:by 2401:EPR 2334:BWR 1378:PMC 1362:doi 1323:doi 1288:doi 1251:PMC 1233:doi 1177:PMC 1161:doi 1091:PMC 1081:doi 1034:doi 994:PMC 984:doi 920:doi 873:doi 837:doi 761:PMC 753:doi 722:doi 667:doi 572:doi 533:doi 483:doi 421:doi 384:doi 187:or 3329:: 2781:He 2747:CO 2623:CO 2544:R3 1434:. 1408:. 1386:. 1376:. 1368:. 1358:64 1356:. 1352:. 1329:. 1317:. 1294:. 1284:33 1282:. 1259:. 1249:. 1241:. 1227:. 1223:. 1185:. 1175:. 1167:. 1157:72 1155:. 1151:. 1139:^ 1121:, 1099:. 1089:. 1075:. 1071:. 1048:. 1040:. 1030:51 1028:. 1016:^ 1002:. 992:. 978:. 974:. 926:. 916:35 914:. 901:^ 887:. 879:. 869:65 867:. 843:. 835:. 825:32 823:. 819:. 769:. 759:. 749:10 747:. 743:. 718:75 716:. 689:. 661:. 657:. 580:. 568:13 566:. 562:. 539:. 531:. 521:74 519:. 515:. 489:. 479:77 477:. 427:. 417:16 415:. 390:. 265:. 245:, 241:, 2921:) 2917:( 2749:2 2701:O 2699:2 2697:H 2625:2 2565:O 2563:2 2561:H 2470:O 2468:2 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Index

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Specialty
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radiation therapy
modulated
CT scanner
external beam radiotherapy
linear accelerator
collimator

radiation therapy
megavoltage X-ray
kilovoltage X-ray
image-guided radiation therapy
VMAT
Lung cancer
tumors
breast cancer
prostate cancer
radiosurgery
stereotactic
spiral computed tomography
splay
tangential
therapeutic ratio
University of Wisconsin–Madison

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