What do you do for physician approval of IGRT images?

Our philosophy is as above with the only difference being for CBCT one of the physicians always tries to be there at machine to approve films prior to treatment.

Discussing and explaining with the therapist the area of match for each individual case is part of the process.

This is a very timely question. IGRT accuracy depends on us assuring that the set up fields and plans are replicates every day. This is what I do for head and neck.

During planning for daily CBCT verification I get GTV,CTV,PTV, 45,50,66,70 Gy isodose line. I verify these everyday

1. I see all patie...

Our department policy has been to have the physician present for on-line review of CBCT images and port films (if applicable) at the time of block check verification. At this time the objectives of the IGRT written directive for subsequent imaging are reviewed. These objectives include the 1. modali...

We review kV igrt at the time of V sim prior to starting treatment as well as any port films at that time.

Otherwise, we review kVs after treatment unless there is a question. CBCT is always reviewed by a physician prior to treatment.

I don't see this issue as something that can be simplified to guidelines. I suggest the MD go to the machine for the first 5 fractions of CBCT to get a sense of 1. How well the SIM aligns to the treatment table set up (never perfect) 2. How well your plan has translated into a daily set up (e.g., be...