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Updated: Jun 26, 2026

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

Published on: May 8, 2018

Helical tomotherapy for total lymphoid irradiation.

Kathryn W McCutchen¹, John M Watkins, Paul Eberts

¹Department of Radiation Oncology, Medical University of South Carolina, 169 Ashley Avenue, Charleston, SC 29425, USA.

Radiation Medicine

|January 10, 2009

Summary

Total lymphoid irradiation (TLI) using helical tomotherapy offers precise radiation delivery for transplant patients. This advanced technique minimizes dose to healthy organs, improving patient tolerance and outcomes in cardiac transplant rejection.

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Area of Science:

Radiation Oncology
Transplantation Immunology
Medical Physics

Background:

Total lymphoid irradiation (TLI) is a critical component in preparative regimens for transplantation and managing graft-versus-host disease.
Conventional linear accelerator-based TLI necessitates complex setups and delivers radiation indiscriminately to organs within the beam path.
Technological advancements are needed to improve precision and reduce toxicity associated with TLI.

Observation:

Megavoltage helical tomotherapy (MHT) offers a novel approach to TLI delivery with a continuously rotating fan beam.
MHT enables highly conformal target coverage and precise patient positioning using integrated megavoltage computed tomography (MVCT).
A case report details MHT-based TLI in an adult patient experiencing late-onset cardiac transplant rejection.

Findings:

Treatment planning with MHT allowed significant dose minimization to radiosensitive organs, including the spinal cord, kidneys, lungs, and intestinal compartment.
The patient tolerated MHT-based TLI well, experiencing no acute adverse effects.
This approach demonstrates the feasibility of precise TLI delivery for complex clinical scenarios.

Implications:

Helical tomotherapy represents a significant technological advance for TLI, enhancing treatment precision and patient safety.
MHT facilitates conformal radiotherapy, allowing for better sparing of organs at risk in transplantation protocols.
This case highlights the potential of MHT to improve the therapeutic ratio of TLI in managing transplant complications.