Image Guided Radio-Therapy (IGRT) is a revolutionary new procedure that is helpful in the treatment of cancer. It’s far superior to the current procedures that use imaging techniques such as ultrasonogram and electronic portal imaging. It uses on board kilo-voltage cone beam CT scan for precise positioning of tumors.
Under this procedure, the image of the tumor area is taken and the radiation administered simultaneously in real time, thereby allowing the physician to target the radiation at the exact location of the tumor. This means radiation kills only cancerous cells and not the surrounding healthy tissues.
In more than sixty percent of the patients with lung cancer, the disease is diagnosed in advanced stages, in which the radiotherapy and chemotherapy is the standard of care. To achieve cure with minimal side-effects, it is important to deliver the radical dose of radiation to the tumour. But lungs move with respiration and so as not to miss the tumour, a bigger volume is treated leading to high doses of radiation to normal lung, so Image Guided Radio-Therapy ( IGRT) can be advantageous to save uninvolved lung.
In the current scenario, breast cancer is diagnosed in early stage and in most of the women, the breast can be preserved. In preservation of the breast, the cosmesis should be maintained. The radiotherapy of the breast involves the irradiation of the whole breast and higher dose to the tumour bed. But at the same time the lung and the heart also will be irradiated. These patients are going to be the long term survivors, hence the late toxicities of radiation should be minimised. Lungs and heart being mobile organs, Image Guided Radio-Therapy ( IGRT) can be solution to overcome their mobility.
Prostate cancer is curable with radiation. Very high dose of radiation is required for the treatment. The prostate is surrounded by two dose limiting critical structures, the rectum and the urinary bladder. The prostate is situated under the urinary bladder and its position varies with the bladder filling and also to a certain extent by distension of the rectum. With Image Guided Radio-Therapy (IGRT), these volumes can be reduced, so that a higher dose of radiation is delivered to the tumour and minimising the dose to the bladder and the rectum both.
The brain is enclosed in the compact cranial cavity and brain does not move on its own within this cavity, but the irradiation volumes are very prone for set-up errors and this is very risky in the era of IMRT. The movements of neck and chin can alter the position of targets within the cranial sphere to a large extent. The margins of the treatment volumes are kept very tight to save the normal brain and other critical structures and the gradient between the high dose and low dose at the periphery of tumour volume is very sharp. These errors can be minimised with Image Guided Radio-Therapy ( IGRT).
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