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Related Experiment Video

Updated: Jan 26, 2026

PET and MRI Guided Irradiation of a Glioblastoma Rat Model Using a Micro-irradiator
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Implementing safe and robust Total Marrow Irradiation using Helical Tomotherapy - A practical guide.

André Haraldsson1, Jacob Engellau1, Stig Lenhoff2

  • 1Medical Radiation Physics, Lund University, Lund, Sweden; Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden.

Physica Medica : PM : an International Journal Devoted to the Applications of Physics to Medicine and Biology : Official Journal of the Italian Association of Biomedical Physics (AIFB)
|April 20, 2019
PubMed
Summary
This summary is machine-generated.

Total Marrow Irradiation (TMI) using Helical Tomotherapy provides a safe and reproducible radiotherapy workflow for patients undergoing stem cell or bone marrow transplantation. This technique improves dose homogeneity and reduces organ at risk doses compared to traditional methods.

Keywords:
HelicalIrradiationMarrowRadiotherapyTMITomotherapyTotal

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Hematology

Background:

  • Total Marrow Irradiation (TMI) is a critical radiotherapy technique preceding stem cell or bone marrow transplantation (SCT/BMT).
  • Implementing TMI requires careful attention to dose homogeneity, target margins, and planning integrity.

Purpose of the Study:

  • To present a robust and reproducible workflow for Total Marrow Irradiation using Helical Tomotherapy.
  • To evaluate the safety and efficacy of this TMI methodology in a patient cohort.

Main Methods:

  • Patients underwent TMI using Helical Tomotherapy with immobilization via vacuum cushion and thermoplastic mask.
  • Treatment involved two parts with field matching, defining marrow-containing bone and sanctuary sites as targets.
  • Organs at risk (OARs) were delineated, and a surface scanning system was used for patient positioning and treatment time reduction.

Main Results:

  • All 23 patients successfully completed TMI and proceeded to SCT/BMT.
  • Significant reductions in OAR doses and improved target dose homogeneity were observed compared to Total Body Irradiation (TBI).
  • Robustness tests confirmed the adequacy of the field junction technique, and optical surface scanning reduced treatment time by 25 minutes per fraction.

Conclusions:

  • The presented methodology offers a safe, robust, and reproducible approach for Total Marrow Irradiation using Tomotherapy.
  • This workflow facilitates successful patient treatment prior to SCT/BMT.