Question 1

Q. What is IGRT?

Accepted Answer

A. Image-guided radiation therapy (IGRT) is a kind of treatment for cancer in which different imaging techniques are used for accurate and safe delivery of radiation to cancer cells, ultimately destroying them.

Question 2

Q. Why is IGRT performed?

Accepted Answer

A. IGRT is generally used for the treatment of all types of cancers, but it is particularly useful for the treatment of the following tumors:
Tumors very close to the vital organs and tissues
Tumors that are more prone to movement in between or during treatments

Question 3

Q. What are the different types of cancers treated using IGRT?

Accepted Answer

A. The different types of cancers that can be treated using IGRT are:

Lung cancer
Liver cancer
Lymphoma
Esophageal cancer
Breast cancer
Brain cancer
Bone cancer
Bladder cancer
Prostate cancer
Spine cancer

Question 4

Q. Who performs IGRT?

Accepted Answer

A. IGRT is generally performed by a radiation oncologist.

Question 5

Q. What are the diagnostic tests performed before IGRT?

Accepted Answer

A. The doctor recommends the following diagnostic tests before an IGRT procedure:

Physical examination: The physical health, medical history, and symptoms of the patient are checked.
Imaging tests: Imaging tests like CT scans, MRI scans, PET scans, and ultrasounds are performed before an IGRT procedure to obtain a clear image of the tumor and aid in treatment planning.
Blood tests: Some underlying medical conditions can be checked using blood tests.
Endoscopy: An endoscope (a tube having a camera on one end) is used for checking the internal part of the organ.
Biopsy: The surgically removes the affected tissue growth and sends it to the laboratory to check if cancer cells are present.

Question 6

Q. How is IGRT performed?

Accepted Answer

A. An IGRT procedure is performed in the following way:
The patient is positioned on the treatment table according to the findings of the simulation procedure.
Diagnostic scans are then performed, making sure that the body is positioned correctly.
Additional imaging tests like CT scans, MRI scans, and PET scans may be required and the patient may be repositioned during the treatment to deliver the radiation at the exact tumor location.
IGRT treatment sessions are more time-consuming than other radiation therapy techniques due to the time needed for collecting and viewing the scans.
The imaging tests performed during treatment help in the continuous monitoring and adapting to changes that may occur in the tumor, like shrinkage, growth, or changes in the tumor shape.
Machines like a linear accelerator to deliver photon or x-ray radiation therapy, or synchrotron/cyclotron to deliver proton energy are used to provide radiation beams to the tumor accurately.
The doctor’s team is in an adjacent room monitoring the patient’s treatment.
IGRT needs several sessions to treat cancer. Usually, IGRT is provided five days a week for many weeks. The total number of treatment sessions needed depends on the size and location of the tumor.
Each IGRT session may last for up to two hours.

Question 7

Q. What are the advantages of IGRT?

Accepted Answer

A. The following advantages are associated with IGRT:
Accurate delivery of radiation
Targeted radiation to the tumor
Higher dose of radiation delivered to the tumor
Lesser radiation exposure to the surrounding tissue around the tumor
Size, shape, and position of the tumor can be monitored and localized before and during cancer treatment

Question 8

Q. How to prepare for IGRT?

Accepted Answer

A. The following preparation may be needed before an IGRT procedure:

The medical history of the patient is evaluated by the doctor.
The doctor should be informed about any supplements, medications, or herbs that the patient is taking.
If the patient has any known sensitivities or allergies, the doctor should be informed about the same.
The doctor should be informed if the patient is pregnant, planning a pregnancy, or is a breastfeeding mother.
If the patient has any pacemaker devices or metal in his/her body, the doctor should be told about the same.
The patient should quit smoking as early as possible.
If the patient has prostate cancer, the patient is instructed to drink lots of water to make the bladder full approximately one hour before the therapy session. This helps in clearly visualizing the prostate gland on an ultrasound.
The doctor performs a procedure, known as simulation, before the IGRT session. It involves preparing the patient for the actual procedure and increasing the treatment effectiveness by pinpointing the precise location for radiation delivery.
The patient is first made to lie down on the examination table in an appropriate position for treatment. Several imaging scans are then performed to locate the tumor and determine the best approaches for radiation dosing.
The patient is repositioned in a series of molds or frames to get the best possible views for scanning.
The patient’s body is then marked by the doctor at different target points for radiation therapy.
Small dots known as fiducial markers, which are made up of gold, plastic, or other materials, may be placed in the patient’s body adjacent to or inside the tumor using an injection. This procedure is generally performed one week before the simulation procedure to locate the cancer site.
The patient’s first IGRT session is scheduled after completing the simulation procedure.

IGRT- Image Guided Radiation Therapy

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