For treatment with EBRT for H&N cancers, what is the consensus for CT simulation?

I agree with Dr. @Dr. First Last regarding the impact of CT contrast on IMRT/VMAT-based planning. Although I do not routinely perform a contrast and a non-contrast scan on H&N patients. The impact of IV contrast on IMRT dose distribution has been extensively studied, and the impact on the H&N region...

We have struggled with IV contrast for years as a rural provider of RT and CT simulation. We have been concerned about contrast reactions, and about IV access and all of the technical challenges. While this may not seem like a big deal, it is a barrier to CT simulation for us.

Our solution has been ...

CT contrast introduces <1-3% error depending on the publication. Certainly, some practices will accept that. There is some anatomical change with venous distention.

We approach this by first doing a non-contrast scan immediately followed by the contrast scan. We use 100 mL of 300 mg/mL IV contrast a...

I use IV contrast for all head and neck cancer patients. The only exception is if they have a documented allergy to iodinated contrast agents or compromised renal function. Most patients know if they have this allergy as they have undergone diagnostic scans in the past. I have occasionally picked up...