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Hello everyone. I tell you, this is the most supportive online community I have ever seen! Thank you all for being here for me. I can feel it..

Anyhow, I am curious if anyone knows if Tomo Therapy is the same as the gamma knife procedure. When we asked the radiologist if he recommended The Cancer Care Institue in Chicago, he said it is a very reputable place, but that using the stereotactic radiation he offered us here in Cincinnati is the same as the Tomo Therapy and the same as the gamma knife procedure. Is this true?

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I've not heard of Tomo Therapy, but maybe someone else has. Dr. Woodburn has posted on here in the past, although not for a while, and he posted a good answer to me a while back about stereotactic treatments. Here's the link so you can maybe send him a PM or email, but I've also copied his response here, which I thought was very thorough.

You could also post your question on Ask the Experts, and even though oncodoc isn't here right now, maybe one of the other docs can give you more info on Tomo Therapy.

Here's the link & the copy of the post:


The following is a response to your request to describe the types and advantage of radiosurgery devices.

Gamma Knife - Gamma Knife is the gold standard for radiosurgery. The GK was developed in Sweden in the 1970's. The Gamma Knife is still undesputedly the most precise radiosurgery device. It has no moving parts which enables the high degree of precision

Linear accelerator based systems - novalis is an example of Linac based systems. They are generally not as precise as the Gamma Knife because they have a heavy head that rotates on a gantry. Moving parts always lead to some decrease in precion. The heavy head cause some bending leading to some decreased precision. Novalis has been able to effectively market there device on radio ads. I know that there have been a lot of ads on the radio in Indianapolis and I really think that they are unfortunately misleading. Novalis is a good tool but offers no advantage over Gamma Knife and one could argue that Gamma knife is better because of its increased precision. In fact there is one controversial study demonstrating better results for the gamma knife compared to linear accelerator systems.

Cyberknife - the Cyberknife is a robot that has a linac attached to it. The cyberknife claims to be able to perform radiosurgery without an invasive head frame due to its sophisticated imaging/tracking system. The ability to not use a head frame is certainly an advantage. However, there has to be a loss of precision with this method. Also, there is some loss of precision secondary to moving parts and weight as seen in linacs.

Now, having critiqued the devices, I must say that the precision that I am talking about probably makes no difference for brain metastasis. The Gamma Knife is accurate to withing 0.1 mm. The linacs are probably accurate to within 1.0 mm. However, the Gamma Knife precision is important when there is a tumor a few mm away from the optic nerves or other critical structures.

Hope this helps.

Robert Woodburn M.D.

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http://www.cyberknifesupport.org/forum/ ... =16&m=1172

I think the one main difference with tomotherapy is that a lot of the planning is done by an integrated computer vs separately.

I think Tomo is used for brain mets, but since the planning is done with a CT scanner versus an MRI will this work that well for brain mets?

Maybe something to ask the Dr

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