What is IGRT (Image-guided radiation therapy)?

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What is the meaning of IGRT?

Image-guided radiation therapy or IGRT is a type of treatment for cancer that uses various imaging techniques to accurately and safely deliver radiation to cancer cells. Radiation therapy involves the use of high-energy radiation beams to control certain cancerous and non-cancerous tumors. IGRT uses x-rays and scans to make sure that the patient is in the correct position for radiation therapy. IGRT ensures that the radiation doses are precisely delivered to the tumor area and less damage is inflicted on the surrounding healthy tissues.

In this article, we will be discussing in detail about IGRT.

• What is the purpose of IGRT?
• What is the diagnostic procedure before IGRT?
• How to prepare for IGRT?
• What is the procedure for IGRT?
• How to care after IGRT?
• What are the risks of IGRT?
• What is the cost of IGRT in India?

What is the purpose of IGRT?

IGRT is used to treat cancers for the following reasons:

• It gives the doctor a clear picture of the location, size, and extent of the tumor.
• It delivers the radiation dosages more accurately.
• It causes less damage to the healthy surrounding tissues.
• Cancer is treated more effectively due to the use of higher dosages.
• It treats cancers near the sensitive tissues or organs of the body.
• It helps in better tracking of tumors that tend to move, like lung tumors, which may move due to breathing.

IGRT is used to treat the following types of cancers:

• Lung cancer
• Prostate cancer
• Breast cancer
• Brain cancer
• Spine cancer
• Liver cancer ( Know more about- What is Liver Cancer Treatment ? )
• Bladder cancer
• Bone cancer ( Know more about- What is Bone Cancer Treatment ? )
• Lymphoma
• Esophageal cancer 

What is the diagnostic procedure before IGRT?

The following diagnostic tests may be done before IGRT:

• Physical examination: The doctor will check the physical health of the patient and note down the patient’s medical history.
• Imaging tests: Ultrasounds, CT scans, MRI scans, or PET scans are the different types of imaging tests performed before the IGRT procedure to obtain a clear image of the tumor in a three-dimensional view and help the doctor in planning the IGRT procedure better.
• Blood tests: They can help in checking for any underlying medical conditions that the patient may be having.
• Endoscopy: An endoscope (a tube with a camera on one end) is used by the doctor for the internal examination of the affected organ. ( Know more about- What is Endoscopy? )
• Biopsy: The suspected tissue growth is surgically removed by the doctor and sent to the laboratory to check for the presence of cancer cells and the type of cancer cells that may be present.

How to prepare for IGRT?

• Inform the doctor if you have any medical illnesses.
• Inform the doctor if you are taking any supplements, herbs, or medications.
• If you have any known allergies, inform the doctor about the same.
• Inform the doctor if you are breastfeeding, pregnant, or planning to get pregnant.
• Inform the doctor if you have any metal or pacemaker in your body from other surgeries.
• In the case of prostate cancer, the doctor will ask you to drink enough water to fill the bladder an hour before the procedure. A full bladder can help the doctor to visualize the prostate clearly on an ultrasound.
• The doctor will perform a procedure before IGRT to prepare you for the actual procedure and increase the effectiveness of treatment by pinpointing the precise location for the delivery of the radiation dosage. This is known as simulation.
• During simulation, the doctor will tell you to lie on the table in an appropriate treatment position and take various imaging scans to locate the tumor and determine the best approaches for radiation dosing.
• You may be positioned in a series of frames or molds, to get the best possible views for the scanning.
• Your body will then be marked by the doctor at different target points for radiation treatment.
• For certain IGRT procedures, small dots known as fiducial markers, which are made up of plastic, gold, or another material, are placed in the body near or within the tumor via injection, a week before the simulation procedure to help the treatment team in locating cancer.
• Your first IGRT session will be scheduled when the simulation is completed.

What is the procedure for IGRT?

• You will first be positioned on the treatment table according to the findings of the simulation.
• Scans are performed to make sure that the body is positioned properly.
• Additional imaging tests may be performed, and the patient may be repositioned during treatment to deliver the radiation at the precise location of the tumor.
• IGRT sessions generally take longer than other methods of radiation therapies, due to the time required for collecting and viewing the scans.
• Imaging techniques like CT scans, MRI scans, and PET scans may be taken before and during IGRT to safely and precisely map the cancer location.
• The imaging tests performed during the course of treatment help in continuously monitoring and adapting to changes that may occur in the tumor, like growth, shrinkage, or changes in the shape of the tumor.
• Machines such as a linear accelerator, to deliver x-ray or photon radiation therapy, or synchrotron/cyclotron, to deliver proton energy, are used for giving radiation beams to the tumor precisely.
• The doctor’s team will be in an adjacent room monitoring your treatment.
• IGRT may need several sessions to treat cancer. Usually, IGRT is given five days a week for many weeks. The total number of treatment sessions needed depends on the location and size of the tumor.
• Each treatment session may last for up to two hours.

How to care after IGRT?

• IGRT does not involve placing the radiation source inside the body. Therefore, you will not be radioactive during or after IGRT treatment.
• The patient can normally go home on the same day after IGRT. 
• Side effects like skin irritation and fatigue are usually noticed only after a couple of treatment sessions.
• Regular follow-ups with the doctor are advised after the completion of treatment.
• The patient undergoes physical evaluation, imaging tests, and blood tests during the follow-up sessions to check if the cancer has been removed entirely or if additional treatment is required.
• Even if cancer has been completely cured, regular follow-ups with the doctor are a must to check for the recurrence of cancer.

What are the risks of IGRT?

The side effects associated with IGRT are:

• Weakness
• Fatigue
• Itchiness, irritation, redness, or swelling of the skin
• Loss of hair  ( Know more about- What are hair loss problems treatment ? )
• Headaches
• Changes in appetite
• Nausea
• Diarrhea
• Vomiting
• Digestion problems 
• Infertility
• Secondary cancers
• Lymphedema (swelling in the leg or arm caused due to lymphatic system blockage)
• Loss of hearing
• Memory loss ( Know more about- What is memory loss ? )
• Cataract

What is the cost of IGRT in India?

The total cost of IGRT in India can range from around INR 3,00,000 to INR 5,00,000 per session. However, many prominent hospital doctors in India specialize in IGRT. But the cost varies across different hospitals. 

If you are coming from abroad, apart from the cost of IGRT, there will be an additional cost of living in a hotel and the cost of local travel. So, the total cost of IGRT in India comes to a total of INR 3,90,000 to INR 6,50,000 per session.

We hope that we could answer all your questions regarding IGRT through this article.

If you need more information about IGRT, you can contact a Radiation Oncologist.

We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you good advice and the correct treatment plan.