At the end of September, our department upgraded our TomoTherapy machine to a TomoHD configuration. This upgrade significantly improves the system’s capabilities and will increase our treatment options for patients. The TomoHD system includes traditional helical treatments (3D and IMRT) and TomoDirect. TomoDirect allows for 3D discrete angle treatments up to 135 cm in length. In addition the system includes a new 14 Blade computer server and the VoLo planning system which allows for faster treatment planning. Additional improvements in treatment delivery control will translate to faster patient treatment times. Both of these improvements will allow for greater patient volume and enhance the patient’s experience in our department. Other improvements include greater dose delivery accuracy, more quality assurance options and remote software solutions that will improve treatments and staff workflow. All of these improvements are now available to all of patients.