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IGRT: Image-Guided Radiation Therapy

    About the Treatment

    Image-guided radiation therapy (IGRT) incorporates imaging techniques during each session of radiation therapy where high-energy beams of radiation are used to control cancer and noncancerous tumours. The benefit of using imaging technique is that the powerful radiation is narrowly focused on the treatment area only minimizing the harm to healthy cells and organs & results in shorter treatment schedules.
    Image-Guided Radiation Therapy uses a variety of 2D, 3D and 4D imaging techniques. Imaging tests are used either before or sometimes during each treatment session which enables the radiation therapy team to compare these images to ones taken previously to target tumour more precisely.
    For IGRT, Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US) and X-ray imaging may be used. Along with this, markers placed on or implanted within the patient's body may be utilized.
    IGRT is used in conjunction with external radiation, specifically 3D conformal radiation therapy, intensity-modulated radiation therapy (IMRT) or stereotactic body radiotherapy (SBRT)

    Indications

    • For tumours and cancers located very close to sensitive organs
    • For tumours located close to the organs that are likely to move during or between the treatments such as the lungs, liver and prostate gland.

  • Patient’s medical history is evaluated by physician
  • Fasting may be required several hours before the test
  • Any allergies, especially related to barium or iodinated contrast material should be informed.
  • An Informed Consent Form is filled
  • If the patient is breastfeeding or might be pregnant, do inform the doctor.
  • If MRI is used for IGRT, then patients with pacemakers or loose metal in their bodies should inform the doctor.
  • For a few IGRT procedures, fiducial markers or electromagnetic transponders may be placed at least one week before the first radiation therapy treatment inside the body near or in the tumour to help the treatment team identify the area.
  • The patient's skin may be marked with coloured ink to target the radiation equipment.
  • Prostate patients must drink enough water before each treatment if they undergo IGRT using ultrasound
  • Depending on the procedure certain bowel or bladder preparations are essential.

  • The patient is positioned carefully according to the marks on the skin defining the treatment area.
  • To maintain the proper position of the patient devices may be used.
  • Images are taken using imaging equipment built into the radiation delivery machine or mounted in the treatment room.
  • Physician compares these images to ones taken previously.
  • After making all necessary adjustments to the patient positioning & treatment plan, radiation therapy is given.
  • You may see a coloured light or hear equipment moving around you during the imaging procedure.
  • You may sometimes smell an odd smell caused by the ozone produced by the linear accelerator.

  • No specific post-operative care is needed.
  • The patient may require medications to overcome the side effects of radiation therapy.

  • Tiredness or fatigue
  • Skin problems
  • Hair loss in the treatment area
  • Swallowing, eating and digestion problems
  • Diarrhoea
  • Nausea and vomiting
  • Headaches
  • Soreness and swelling in the treatment area
  • Urinary and bladder changes
  • Brain changes
  • Spinal cord changes
  • Lung changes
  • Kidney changes
  • Colon and rectal changes
  • Infertility
  • Joint changes
  • Lymphedema
  • Secondary cancer

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