Radiation Oncology Technologies

In addition to standard radiation therapy delivery options, City of Hope offers a wide range of advanced technologies and specialized services to ensure precise treatment delivery for optimal outcomes. This includes:

Helical TomoTherapy

The TomoTherapy HI-ART System® offers City of Hope oncologists the ability to deliver radiation therapy with surgical precision. Using guided imaging paired with dynamically rotating beamlets of radiation, oncologists can now shape or sculpt the radiation area to fit the exact shape of each patient's tumor. This means a more effective and potentially curative dose to the cancer, with reduced damage to normal tissues and fewer complications.

Learn More About Helical TomoTherapy


Varian Calypso System for image and motion management

The Calypso® System uses GPS for the Body® technology to enable City of Hope physicians to keep the targeted cancer cells in the path of the radiation beam at all times. By detecting the slightest tumor movement—and enabling the patient to be repositioned if necessary—the Calypso System helps us in delivering the maximum radiation directly to the tumor while avoiding healthy tissues and organs nearby.

Four-Dimensional Computed Tomography (4D CT) Scanning

City of Hope’s 4D CT technology can significantly enhance cancer treatment by capturing not only the tumor’s location, but also its movement within the body. This is particularly useful for treating lung cancer, since the tumor is in constant movement as the patient breathes.

By capturing both location and movement, 4D CT allows our treatment team to better plan a regimen to tumor more effectively, such as programming the radiation beams to adjust in coordination with patient and tumor movement.

Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT)

SRS and SBRT are procedures that focus high-energy radiation onto a small area of the body, using several advanced technologies to accurately pinpoint treatment sites and coordinate radiation delivery. This procedure allows the care team to precisely treat tumors with minimal impact to nearby healthy tissues. SRS is used for treating brain tumors, while SBRT is used to treat tumors in other areas of the body (thoracic and abdominal organs, spine and prostate.)

Because they are non-surgical procedures that do not require any incisions, SRS and SBRT may be recommended to treat cancers that are too high risk for surgeries. This includes tumors that are hard to access, located on or near vital organs and tissues (such as the brain or major blood vessels) and/or subject to movement in the body. They may also be recommended if the patient is too weak to undergo surgery.

MRI Guided Focused Ultrasound (MRGFUS)



MRGFUS combines several advanced technologies for novel cancer therapy. First, MRGFUS uses magnetic resonance imaging to capture a precise image of the tumor for therapy targeting. It then delivers focused ultrasound waves to the targeted area to heat up and destroy cancerous cells while avoiding adjacent healthy tissues. The temperature and energy accumulation is measured in realtime, so the therapy can be adjusted instantly for safety and effectiveness.

MRGFUS is recently approved by the FDA for bone cancer, but is also currently being tested for other malignancies as well. It is particularly promising for patients with recurrent cancers or those who are too weak or frail to withstand standard radiation therapy.

City of Hope is the first U.S. institution to use focused ultrasound to treat prostate cancer. Unlike other forms of therapy — such as surgery or radiation — only the portion of the prostate gland containing biopsy-proven cancer is targeted with MRGFUS. Although still under investigation, this approach holds promise to reduce the risk of impotence and incontinence associated with other forms of prostate cancer therapy.

Varian High-Dose-Rate (HDR) Brachytherapy

HDR brachytherapy involves the internal delivery of high-dose radiation in or near the tumor. Applying higher doses of radiation for a shorter period of time (a few minutes) can be more effective in treating some cancers, while minimizing the duration of exposure for nearby normal tissues — reducing the likelihood and severity of side effects.

Intraoperative Radiation Therapy (IORT)

Intraoperative Radiation Therapy (IORT) delivers high dose radiation treatment at the time of breast cancer surgery in select patients. By delivering a concentrated beam of radiation to cancerous tumors while they are exposed during surgery, IORT patients can forgo the typical six weeks of post-surgery daily radiation treatment that typically follow surgery.

Advantages of IORT include:

  • Reduce or even eliminate the need for whole breast irradiation
  • Direct visualization of target tissue
  • Allow more patients to opt for breast-conserving surgery rather than mastectomy
  • Potential to significantly reduce normal tissue toxicity

RefleXion radiotherapy device

City of Hope has treated its first patients using a novel radiation machine that one day might achieve the evasive goal of delivering tumor-destroying radiation in “real time” to multiple tumors. It could be a revolutionary step forward for people with advanced cancers who previously wouldn’t have been considered for such therapy.

The device offers a broader ability to shape the radiation beamlets aimed at tumors and to account for body and organ movement, which can help doctors shape radiation dosages and exposures in ways that limit damage to surrounding tissue.

Read about the RefleXion radiotherapy device.