Guidelines for best practices for IGRT

THE American Society for Radiation Oncology (ASTRO) has issued a new white paper, “Assuring Safety and Quality in Image Guided Delivery of Radiation Therapy,” that recommends best practices to improve the safety and effectiveness of image guided radiation therapy (IGRT), according to the manuscript published as an article in press online in Practical Radiation Oncology (PRO), the official clinical practice journal of ASTRO.

The executive summary and supplemental material are available online immediately as open-access articles and will be published in a 2013 print edition of PRO.

Commissioned by the ASTRO Board of Directors as part of ASTRO’s Target Safely campaign, the white paper recommends a set of 10 fundamental elements of IGRT safety in clinical programs and provides an additional list of recommended activities for the broader radiation oncology community to consider.

IGRT is the use of dedicated devices for fraction-by-fraction imaging and guidance of radiation treatment delivery that localizes the target and normal structures to ensure precise and accurate placement of the radiation. IGRT-enabled accuracy and precision allows for highly conformal dose distributions, higher dose prescriptions and shorter fractionation schedules for patients. This requires a strong link between IGRT practices and planning target volume (PTV) design of a patient’s treatment protocol, which is central to high quality, safe radiation therapy.

The manuscript recommends the four major categories for consideration in assuring safe, high-quality radiation therapy using IGRT technologies as:

1) commissioning and continuing quality assurance (QA) of the systems;

2) protocols for image acquisition and interpretation;

3) the link between image guidance practices and PTV margin; and

4) education, training and human resources.

The 10 foundational elements for safe and effective IGRT practices prescribed by the study are:

1) establish a multi-professional team responsible for IGRT activities;

2) establish and monitor a program of daNike Special Forces Air Force 1 Boots