What is your IGRT motion management approach for liver SBRT?
Do you do fluoroscopy first, match motion of diaphragm or fiducials? CBCT? Repeat Fluoro/CBCT? Do you use breath hold or gaiting or compression? Do you use triggered imaging tracking? Do you have any standard training for therapists to streamline the process for new techs or covering docs?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Mayo Clinic, Rochester
Answered on
For liver SBRT, there are a number of ways to address IGRT. All patients should have been simulated with either a 4DCT scan (can consider 4DCT with a compression belt) to generate an ITV or motion management or most ideally, a breath hold technique to maximally limit tumor/liver motion. Trying to re...
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Mednet Member
Radiation Oncology · Sylvester Comprehensive Cancer Center
Answered on · Updated on
Concur with Dr. @Dr. First Last fully who is an expert.
Personally- I ask fasting 4 hours prior to all SBRT liver (even when far from the the GI structures) and 6 hours if it is closer to the duodenum.
Dome tumors, liver edge, or larger necrotic tumors themselves are easier to visualize and may not ...
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