Spare More Normal Tissue for More Cases

The TomoTherapy® System was designed around patients from the ground up. While the system is well-established in the oncology market, our continued investment in innovation enables us to continually bring new capabilities to market and set the standard for individualized and precise treatment of tumors anywhere in the body.

Designed with the functionality of a CT scanner, the TomoTherapy System uses integrated imaging to enhance treatment accuracy and patented beamlet-based delivery to ensure precision. Together, these features enable treatments to be customized for each patient, minimizing exposure to healthy tissue and measurably mitigating side effects. A unique helical design also enables treatment of a broader range of tumors and expands radiation therapy options for more patients.

TomoTherapy System Benefits

Highly effective treatments for a wide range of patients and disease types.

Treatment Delivery

The design of the TomoTherapy® System reflects the realities of radiation treatment — not only is every patient unique, but the exact location of their tumors and healthy tissue can change significantly from one treatment to the next. The TomoTherapy System achieves precision and efficiency despite these continuous changes by combining CT imaging with a radiation treatment delivery system. This unique design enables use of highly efficient daily 3CT imaging to perfectly position patients before each treatment delivery. The system’s unique ring geometry design enables state-of-the-art radiation treatments, including intensity-modulated radiation therapy (IMRT) and 3D conformal radiation therapy (3DCRT).

Radiation delivered by the TomoTherapy System is guided by an innovative multi-leaf collimator (MLC), a device that opens and closes quickly to permit or block the passage of radiation. This patented MLC also increases precision by dividing radiation beams into smaller beamlets to enable finer targeting. The pattern of movement is precisely calculated before treatment begins, so the intensity of the radiation beam delivered conforms to the patient’s tumor and avoids critical structures as the machine rotates 360 degrees around the patient.


TomoHelical™ Treatment Delivery, the TomoTherapy® System’s flagship helical mode of treatment, combines 360 degree fan-beam delivery of intensity-modulated radiation therapy (IMRT) and megavoltage CT (MVCT) imaging for gold-standard treatment and targeting of complex tumors. During treatment delivery, the linear accelerator completes multiple 360-degree rotations around the patient, while the couch passes through the center bore of the system. Continuous high-dose rate delivery enables for shorter beam-on times than most other radiation treatment systems.

TomoHelical™ Mode; Pediatric craniospinal treatment, using 5 cm TomoEDGE Dynamic Jaws; Target length: 69 cm; Beam-on time: 11.4 minutes.


The TomoTherapy® System’s TomoDirectTM modality offers a discrete-angle, non-rotational delivery option, with 3D conformal radiation therapy (3DCRT) capabilities, for highly efficient treatment of routine indications. It enables creation of treatment plans that include between 2 and 12 target-specific gantry angles, as well as user-defined levels of modulation for the plan, including a 3D delivery mode.

TomoDirect™ Mode; Left breast treatment, using 5 cm TomoEDGE™ Dynamic Jaws; Four beam angles; Beam-on time: 3.4 minutes.

Data Management

The TomoTherapy® Data Management System provides comprehensive storage and processing of patient data generated over the life of the TomoTherapy planning and treatment workflow.

Key capabilities include:
  • Import and store imaging studies
  • Store completed treatment plans; make them available for review and approval
  • Store a record of each day’s treatment procedures
  • Manage the flow of patient data throughout the system from a single location
  • Ensure the security of patient data with scheduled database backups and the use of multiple disk drives
OIS Connect, an optional TomoTherapy System feature, offers a convenient software solution for integrating the TomoTherapy System with compatible Oncology Information Systems (OIS).

Advantages of this integrated approach include:
  • Schedule treatments in a central calendar (held and managed in the OIS)
  • Systematically capture treatment procedures in the OIS
  • Facilitate charge capture and billing for treatments
  • Incorporate treatments in the Electronic Medical Record (EMR)

Treatment Planning

The TomoTherapy® Treatment Planning System enables users to quickly and intuitively create sophisticated IMRT or 3DCRT treatment plans for accurate treatment of simple and complex cases. The system is based on diagnostic CT and anatomical structure data that include specified dosimetric goals and constraints. Three-dimensional dose distributions and dose-volume histograms (DVHs) are available as analytical tools to either accept or modify—and re-optimize—the planned dose.

Key treatment planning tools include:
  • Remote Software Solutions — for anywhere-anytime access by authorized users through a secure Citrix-based website
  • Planned Adaptive™ software — the first commercially available solution that enables clinicians to account and adjust for day-to-day patient changes
  • VoLO™ Technology plan calculator — leverages high-end graphics processing unit (GPU) hardware and software capabilities to perform dose calculations and optimizations for multiple large plans in minutes



A robust and efficient planning technique was identified to produce plans of radiosurgical quality using the TomoTherapy treatment planning system. Dose calculation did not exceed a few hours and resulting delivery times were less than one hour, which allows the process to fit into a single day radiosurgery workflow. Plan conformity compared favorably with published results for gamma knife radiosurgery. In addition, plan homogeneity was similar to linac-based approaches.

March 2011

The aim of this case study is to evaluate the dosimetric influence of changing the fan beam thickness (FBT) in the treatment of a nasopharyngeal carcinoma (NPC) patient.

February 2010

In this initial experience with accelerated IMRT plus capecitabine for patients who had large HCC lesions, the results demonstrated acceptable toxicity with promising local control. The relatively low acute and late toxicity observed with this program suggested that dose intensification can be incorporated into the treatment regimen if needed. Cancer 2009. (c) 2009 American Cancer Society.

November 2009

TomoTherapy offers a more favorable dose distribution to the bladder and rectum, as well as improved target homogeneity in comparison with IMRT.

October 2009

This study evaluated whether helical tomotherapy (TOMO) planning could achieve better isodose distribution for the maxillary sinus while concomitantly sparing the adjacent _critical normal organs than linac-based step-and-shoot IMRT (s-IMRT) planning.

August 2009

The purpose of this study was to compare radiation treatment plans (RTPs) that used intensity-modulated radiation therapy (IMRT) with helical tomotherapy (HT) or three-dimensional conformal radiation therapy (3D-CRT) for nasal natural killer/T-cell lymphoma (NNKTL).

May 2009


System Options

The TomoTherapy® H™ Series offers interactive planning and efficient delivery of highly sculpted doses for personalized and consistent treatments. Integrated daily CT image guidance enables precise patient positioning, margin reduction, adaptive planning and pinpoint dose accuracy for every radiation therapy patient.

The TomoHDA™ System offers the ultimate flexibility in treatment delivery, enabling unrivaled dose conformality, faster treatments and faster concurrent treatment planning.

TomoEDGE™ spares more normal tissue while enabling increased throughput and unprecedented quality. It can help practices expand by providing efficient care to patients with difficult-to-treat tumors that are outside the capability of conventional radiation therapy systems.

The TomoHD™ System combines both TomoHelical™ and TomoDirect™ into a single, comprehensive solution that efficiently handles clinical indications of any complexity with ease. This integrated solution enables accurate and efficient treatment of tumors anywhere in the body.
The TomoH™ System is the gold standard for image-guided IMRT treatment delivery – it maximizes both conformality and target dose uniformity. CTrue™ image guidance provides daily 3D CT target localization and enables margin reduction while sparing healthy tissue. The ultra-fast, binary MLC enables unprecedented intensity modulation.

reNEW™ Certified Pre-Owned Program

Accuray is pleased to offer a Certified Pre-Owned option for hospitals and cancer centers ready to adopt the TomoTherapy® platform for advanced radiation therapy. Distinguished by its integrated image guidance and unique helical and direct delivery modes, TomoTherapy technology provides a true competitive edge, benefiting both your staff and patients.

An Exceptional Value

With the reNEW program, Accuray offers a special TomoTherapy TomoHD™ System which includes the same fast treatment planning and flexible delivery capabilities available on the newest TomoTherapy systems. These features help ensure workflow efficiency and consistency for departments, with high treatment quality for the full range of radiation oncology indications.

Certified Pre-Owned TomoHD System

Available only from the Accuray reNEW program
Key Features:
  • VoLO™ Treatment Planning
  • TomoHelical™ Delivery Mode
  • TomoDirect™ Delivery Mode
  • CTrue™ Daily Imaging
  • High Performance Couch
  • Operator Station Couch Control
  • Power Conditioner
  • Total Quality Assurance (TQA™) Essentials Software
  • 2.5 and 5 cm Beams

Key System Performance Upgrades:
  • Dose Control System (DCS)
  • Extended Life Magnetron
  • Multileaf Collimator (MLC) Enhancements
  • Fixed Target Linac (FTL)
Notable Options
  • High Performance VoLO™ Treatment Planning
  • Remote Software Solutions
  • Planned Adaptive™ Software
  • TQA Total Software
  • 1 cm Beam
*For complete configuration details, please contact your Accuray technology representative. Please note: The reNEW program is not available in all territories.

A Rigorous Certification Process

In addition to powerful clinical capabilities, reNEW TomoHD Systems bring peace-of-mind in knowing each has been prepared by Accuray technicians for optimal performance. Prior to shipment, Certified Pre-Owned systems must pass an initial inspection and meet strict eligibility requirements during a comprehensive certification process at the Accuray Manufacturing Center in Madison, Wisconsin.

Our Commitment to Your Satisfaction

TomoTherapy System user satisfaction has improved significantly over time, culminating recently in Accuray achieving the highest rating for a radiation oncology vendor to be reported by MD Buyline.

The sustained increase in user satisfaction is a reflection of progress made through investments in system performance and reliability, as well as training and service. Through the reNEW program, Accuray extends our commitment to meeting more customers' unique clinical and operational needs. Source: MD Buyline Radiation Treatment Delivery System Market Intelligence Briefing™ Q4 2016. Used with permission January 4, 2017.

For additional information, including details on service program offerings, please contact your Accuray technology representative.
The TomoTherapy System vs Conventional Linacs