2017_IGRT course book

IGRT: ‘Simple’ Practice

 ‘Gradual’ changes in anatomy & shape  Changes over weeks eg weight loss in H&N patients  Adapt XRT plans  E.g. Adapt treatment to shrinking parotid gland/tumor  ‘Daily’ changes eg organ filling or emptying  Eg bladder and rectum causing displacement or deformation, head and neck flexibility  Adjust treatment position ± adaptation  Use surrogates of target position or direct organ/target visualisation  ‘Fast’ changes or rapid moving targets  Eg lung XRT with respiration  Prevent base line shift (gradual), Track or gate XRT or freeze the ‘motion’

Radiotherapy