[Image-guided radiation therapy. Paradigm change in radiation therapy].

CLINICAL ISSUE

The introduction of image-guided radiotherapy (IGRT) has changed the workflow in radiation oncology more dramatically than any other innovation in the last decades.

STANDARD TREATMENT

Imaging for treatment planning before the initiation of the radiotherapy series does not take alterations in patient anatomy and organ movement into account.

TREATMENT INNOVATIONS

The principle of IGRT is the temporal and spatial connection of imaging in the treatment position immediately before radiation treatment.

DIAGNOSTIC ASSESSMENT

The actual position and the target position are compared using cone-beam computed tomography (CT) or stereotactic ultrasound.

PERFORMANCE

The IGRT procedure allows a reduction of the safety margins and dose to normal tissue without an increase in risk of local recurrence.

ACHIEVEMENTS

In the future the linear treatment chain in radiation oncology will be developed based on the closed-loop feedback principle.

PRACTICAL RECOMMENDATIONS

The IGRT procedure is increasingly being used especially for high precision radiotherapy, e.g. for prostate or brain tumors.