TBI STEP

The TBI STEP system allows the patient to be rotated 180° during volumetric modulated arc therapy (VMAT) for total-body irradiation (TBI).

Many TBI techniques use special couches, translational tables, or self-made immobilization devices for dose delivery. This is where TBI STEP comes in; a newly developed rotatable tabletop designed for VMAT-TBI. TBI STEP easily attaches to the original Linac couch top. The VMAT-TBI technique theoretically allows the use of any standard positioning device at the Linac. However, the main problem is that adult patients cannot be treated in one position due to the limited cranial-caudal couch shift capacities of the linac. Therefore, patients are usually turned from a head-first supine position (HFS) to a feet-first supine position (FFS) to overcome this limitation.

The newly developed rotatable tabletop consists completely of carbon fiber, including the ball bearing within the base plate of the rotation unit. The patient can be turned 180° from a HFS to a FFS position within a few seconds, without the need of repositioning.

Benefits of the rotatable table-top:

• Homogeneous dose distribution over the entire PTV using VMAT-technology
• Excellent protection of healthy tissue and OARs without the use of external shields
• No active participation of the patient from HFS to FFS needed
• Simple rotation of the TBI STEP in a few seconds by means of hand grips
• Minimization of unexpected patient movement through use of conventional positioning devices
• Precise and reproducible positioning of the patient
• Elimination of incorrect isocenter shifts
• Avoidance of gantry-couch collision by using permitted isocentric coordinates

Orfit is the official distributor of IT-V’s TBI STEP the USA and Canada.