Organised by IPEM's Radiotherapy Special Interest Group
Wind the clock forward to 2018. The demands on the radiotherapy delivery system have increased significantly with the introduction of new techniques and technologies. Tumours are no longer considered square and static, margins are tighter and there is a real need for validation and verification of treatment in real time, on an individual patient basis. Online monitoring is therefore becoming a desirable feature to be fully incorporated in modern radiotherapy, as a means to avoid errors, verify treatment delivery and highlight changes in machine performance. It also plays a major role in adaptive treatment where imaging can inform not only positioning but also the need for re-planning.
Many contemporary technologies may be employed to monitor radiotherapy treatment in real, or near-real time to provide assurance. These include systems such as:
Despite recommendations made in 2010 (Towards Safer Radiotherapy) and 2012 (NRIG IGRT Guidance for Implementation and Use), to use real time monitoring systems to reduce and correct uncertainty resulting from patient physiological movements, online monitoring technology for Radiotherapy Treatment is yet to mature and be fully integrated in clinical pathways in radiotherapy departments.
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