In Tomotherapy the couch sags during the treatment due to the weight of the patient. In this study, we developed a simple method to obtain the amount of the sag and the pitch angle of the couch using the image processing technique of MVCT images in Tomotherapy. Using the method we evaluated the sag and pitch of couch for 22 head and neck patients and one craniospinal irradiation (CSI) patient. The sag and the average pitch angle of couch were 0.40∼1.54 mm and 0.7^o for head and neck patients, respectively. For head and neck patients, the sag increased as the longitudinal length of the irradiation volume increased and the pitch angle showed no relationship with the longitudinal length. For the CSI patient the sag was 4.97 mm. Using the method the amount of the couch sag could be measured easily and the measured data could be useful in determination of margins considering the table sag error.

KeywordsTomotherapy, MVCT, Couch sag