S. Jack Wei, MD
University of Pennsylvania School of Medicine
Last Modified: October 22, 2003
Moderator: Theodore L. Phillips, MD., University of California, San Francisco
Lynn J. Verhey, PhD., University of California, San Francisco
IMRT is now commonly used for patient treatment.
Compared to 3D conformal treatment (3DCRT), IMRT requires increased commissioning time, increased treatment time, increased physics and dosimetry time, and patient-specific quality assurance (QA).
Due to the increased number of fields and small monitor units used per field, specific commissioning is required.
Specific commissioning and QA is needed for the multi-leaf collimators to verify leaf position, minimize leakage, etc.
The varying linear accelerators each have their own requirements (e.g. leaf design, interleaf field constraints, field size, etc.) depending on their manufacturer, and these each must be commissioned and verified.
Patient immobilization and target definition must be carefully performed.
Improved imaging during treatment is important for improving QA and the emerging technology of cone-beam CT has the potential to determine patient translation and rotation relative to a pre-treatment CT scan.
In conclusion, IMRT is increasingly becoming mature and requires vigilant and extensive QA
Improved imaging will allow better delivery of QA.
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