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.