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Image-Guided Radiation Therapy (IGRT) combines imaging techniques, such as computed tomography (CT), with radiation therapy during each treatment session. The ability to adjust the position before applying the radiation beam is simply remarkable, as it reduces side effects while targeting the tumor in the exact location each day.

 

It allows:

  • Confirming and tracking the tumor’s movement at the time of treatment.
  • Minimizing the risk of side effects.
  • Delivering higher doses of radiation, ultimately leading to greater healing rates.
  • Correcting changes in the patient’s anatomy, such as weight fluctuations over the 25 to 35 days.
  • Adjusting daily positioning, as tumors can shift several centimeters when patients breathe during treatment.

Who participates in this procedure?

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The delivery of radiation therapy requires a treatment team, which includes a radiation oncologist, medical physicist, dosimetrist, and imaging technologists. The radiation oncologist is a physician who evaluates the patient and determines the appropriate therapy or combination of therapies and the type of IGRT to be used. The doctor decides which area needs treatment and the dosage to be administered. Together with the medical physicist and dosimetrist, the physician determines which techniques should be used to deliver the prescribed dosage. The physicist and dosimetrist then perform detailed treatment calculations. The imaging technologists are specially trained technologists who acquire images and deliver daily treatments. The radiation oncology nurse assesses the patient and provides additional information about the treatment and potential side effects. The radiation oncology nurse, in collaboration with the physician, also helps manage any reactions or side effects that may occur due to the treatment.

The equipment is operated by an imaging technologist, a highly trained technician. The overall treatment plan is created and monitored by the radiation oncologist, a highly trained physician who specializes in treating cancer with radiation therapy.

FAQ

Special preparations required for the procedure

Or technologist if there is any possibility that they are pregnant or if they are breastfeeding their baby.

Regarding pregnancy, breastfeeding, and imaging.
Patients with pacemakers or loose metal in their bodies should inform the treatment team if MRI is used for simulation or IGRT.

Reference markers or electromagnetic transponders may be placed inside the body, near or within the tumor, to help the treatment team identify the area.

Or tattooed with colored ink to help align and direct the radiation equipment.

Using ultrasound should drink enough water about an hour before each treatment to keep the bladder full so that the prostate can be imaged or “seen” by the ultrasound machine.

Aside from the routine preparation for radiation therapy, which may include three-dimensional conformal radiation therapy, intensity-modulated radiation therapy, proton beam therapy, or stereotactic body radiation therapy (SBRT).

The Proton Beam Therapy page, or the SBRT page for more information.

pecial preparations needed for the procedure

Generally, procedures are performed on an outpatient basis. However, it is advisable to prepare for spending half a day or more in the imaging department. You will be informed whether you will need someone to accompany you and take you home after the procedure.

You may be notified not to eat or drink anything after midnight before the treatment. Ask your doctor if you should continue taking your usual medications on the day of treatment and if you should bring your medications with you to the procedure.

 

How is the procedure performed?

  • At the beginning of each radiation therapy session, the patient is carefully positioned guided by the marks on the skin that define the treatment area. Devices may be used to help the patient maintain the correct position. Then, images are taken using the imaging equipment incorporated in the radiation delivery machine or mounted in the treatment room. The doctor then reviews the images and compares them with those taken during simulation. The patient may be repositioned, and additional images may be taken. After making any adjustments to the treatment plan and patient positioning, radiation therapy is then delivered. It is expected that the imaging guidance process will add extra time to each radiation therapy session.

What does it feel like during and after the procedure?

Radiation surgery treatments are similar to taking X-rays. Generally, X-rays cannot be seen, felt, or heard, except for patients receiving treatment in the brain, who may see lights while the machine is on, even with their eyes closed. The treatment itself does not cause any pain or discomfort. If you experience pain for other reasons, such as back pain or discomfort from the head device or immobilization device, please inform the medical or nursing staff.

Imaging performed before or during radiation therapy sessions is painless. During the radiation therapy session, you may see or hear the equipment moving around you during the imaging procedure. Patients sometimes notice a strange smell caused by the ozone produced by the linear accelerator. Some patients may also see colored lights when receiving their treatment; this is especially true for patients receiving brain treatment.
The side effects of radiation therapy include problems that occur as a result of the treatment itself as well as damage done to healthy cells in the treatment area. The number and severity of side effects you experience depend on the type of radiation and dosage you receive, as well as the part of the body being treated. You should talk to your doctor and nurse about any side effects you experience so they can help you manage them.
Radiation therapy can cause early and late side effects. Early side effects occur during or immediately after treatment and typically go away within a few weeks. Common early side effects of radiation therapy include tiredness or fatigue and skin problems. The skin in the treatment area may become more sensitive, red, irritated, or swollen. Other skin changes may include dryness, itching, peeling, and blistering.
Depending on the area being treated, other early side effects may include: hair loss in the treatment area, mouth problems and difficulty swallowing, eating and digestion problems, diarrhea, nausea and vomiting, headaches, tenderness and swelling in the treatment area, urinary and bladder changes. Late side effects, which are rare, occur months or years after treatment and are often permanent.
They include: brain changes, spine changes, lung changes, liver changes, changes in the colon and rectum, infertility, joint changes, lymphedema, mouth changes, and secondary cancer. There is a small risk of developing cancer due to radiation therapy.
After radiation therapy for cancer, you should undergo regular examinations by your radiation oncologist to detect recurrent and new cancers. Using techniques such as IGRT, imaging specialists are maximizing the capabilities of radiation therapy to destroy cancer while minimizing its effect on healthy tissues and organs and the side effects of the treatment itself.