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Program Information

Initiating An IGRT Program


J Kruse

J Sonke



J Kruse1*, J Sonke2*, J Balter3, (1) Mayo Clinic, Rochester, MN, (2) Netherlands Cancer Institute,(3) Univ Michigan, Ann Arbor, MI

TU-C-BRCD-1 Tuesday 10:30:00 AM - 12:30:00 PM Room: Ballroom CD

The demands for precision of modern radiation therapy approaches (IMRT, SBRT) require a comprehensive understanding of the application of Image-Guided Radiation Therapy (IGRT) systems and their utilization. Modern IGRT systems provide unprecedented visualization of anatomy over the recent state-of-the art (MV portal imaging), with modern image guidance hardware (kV X-Ray, in-room CT, emerging external and internal imaging systems). They furthermore integrate advanced image registration methods as well as integrated couch control systems.
While significantly empowering precision therapy, IGRT comes at a cost. Not only does the IGRT equipment require specific attention for commissioning and quality assurance, in many instances the physicists will need to re-learn or acquire new knowledge about imaging-specific issues. In all cases, a significant change to the operational procedures of the department will occur, and both extensive staff training, as well as implementation of new policies, procedures, and workflow models for treatment, will be necessary. The relationship between information gathered at simulation, tradeoffs made during treatment planning, and plan sensitivities will influence the use of image guidance, and uncertainties in imaging at the treatment unit may require re-consideration of margins and planning strategies.
This course will help guide a physicist through the process of initiating an IGRT program. The overall concept of implementing IGRT from a departmental perspective will be briefly overviewed. A detailed discussion of IGR T technologies and the details of their commissioning and quality assurance needs will be provided. The development of IGRT strategies, policies, training, and process quality control will be described.
Objectives:
1. Understand the technical and procedural components involved in initiating an IGRT program
2. Understand the costs and benefits of various levels of IGRT use
3. Understand the needs for quality assurance tied to IGRT implementation
4. Understand the relationships between IGRT and decisions made in simulation and treatment planning
5. Gain sufficient knowledge to proactively plan new iGRT utilization paradigms in the clinic


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