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What do you use for IGRT for definitive H&N IMRT treatments?

What are the advantages and disadvantages or using films vs. CBCT? What are you looking for in each case? How often should you CBCT, and what are the most common things that are picked up that change practise?
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What is your preferred IGRT method for Head and Neck cancer IMRT?

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3 Answers
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Radiation Oncology · Henry Ford Health System
Answered on

I use daily CBCTs for H&N setup. This is used mainly to line up bony landmarks prior to daily radiation delivery. However, this also allows me to track changes in body contours due to weight loss or reduction in nodal GTV. I use this information for adaptive RT planning when needed such as when the ...

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Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on

"IGRT" for head and neck can encompass a lot of concepts, so matching the application to the technology is useful.

Briefly, for head and neck, IMHO:

A) Non-adaptive bony isocentric alignment with stable anatomy (e.g. most-post-op) - KVX>= CBCT

B) Patients with multiple CTVs/OARs who are at risk for we...

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Radiation Oncology · Radiation Oncology Associates
Answered on

We have been starting with daily SGRT (i.e. OSMS or VisionRT) with an open-faced mask. It helps the therapists get chin tilt and rotations right. After SGRT looks good, they get a daily CBCT. Daily SGRT has helped our setups tremendously. It has also helped save time due to getting better setups on ...

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