Intensity-modulated therapy: Practical aspects

Clinical implementation of intensity-modulated radiotherapy (IMRT) needs all the work required to implement 3D conformal radiotherapy (CFRT) and more (see Chapter 39 and Chapter 40). Consideration must be given to important issues such as equipment and space requirements, time and personnel requirements, additional dosimetry verification and treatment quality assurance (QA), staff training and patient education and changes in treatment scheduling. It is essential for a clinic to designate an implementation team to think through the implications in advance, and to periodically update procedures as lessons are learned. Bringing the modality to the clinic is only the first step. Much effort is needed to keep it running smoothly and to keep pace with upgrades and future developments in IMRT technology. To achieve the full benefit from IMRT, various resources must be in place, and all persons involved in IMRT, not only physicists but also physicians and other personnel such as radiographers, service engineers and administrators, must be properly trained. Furthermore, IMRT is an integrated system. Every single technical/physical component and treatment step must be considered carefully. In this chapter, a brief description is provided, which details the requirements for clinical implementation and guidelines on IMRT treatments.