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Yet a third analogy is that IMRT is like applying heat to a cup of coffee in such a way as to heat the cup but not the coffee. The expected performance of IMRT in future years is opined by Carol (1997b) in a tract subtitled ‘IMRT in 2003’. As 2003 arrives and passes, it will be interesting NOMOS MIMiC delivery 43 to observe whether his foretellings are borne out, just as those of us who studied George Orwell’s book ‘1984’ passed though that year noting some predictions to have materialized and others to have been short of the mark.
These could be classified as ‘rotation IMRT’ and share similar features albeit with important distinctions. The first method is IMRT via the use of the NOMOS MIMiC equipment and the second is the development of the University of Wisconsin machine for ‘tomotherapy’. Given that the word ‘tomotherapy’ means ‘slice therapy’ it could also be used generically to embrace the first method. 1. NOMOS MIMiC DELIVERY PEACOCK is the name of the IMRT system marketed by the NOMOS Corporation whose founding scientist and former Managing Director was Dr Mark Carol.
Some of the beams will be beneficial from all directions. Thus, the question of how many IMBs are needed for an optimum treatment must be rephrased to how many are needed to ensure that the dose distribution is little short of optimum. It might be expected that the situation is one of diminishing returns, with ‘most conformality’ achieved by determining the orientation of the first few beams, and then additional beams adding little more improvement (Boyer and Bortfeld 1997). Stein et al (1997b) have studied the optimization of the number and location of IMBs for treatment of cancer of the prostate.