IGRT for Clinical Use: Making the Right Choice

With the availability of multiple approaches to Image-Guided Radiation Therapy (IGRT) technology and growing clinical experience in the field, Central Arkansas Radiation Therapy Institute (CARTI) decided in 2006 to review the options and determine which would work best in their environment.

“The decision-making process in selecting an IGRT solution for CARTI involved multiple disciplines,” said Larry Berkley, vice president of medical physics, engineering and I.S. “As with any new technology, we needed the buy-in of the radiation oncologists in the clinical efficacy, the confidence of the physicists in the accuracy and the acceptance of the dosimetrists and therapists in the practical implementation. With 10 high-energy linear accelerators at our seven facilities, making the right decision had a major clinical and financial impact on the organization. Because of CARTI’s commitment to bring new technologies to all

of our facilities, we based this decision primarily on the solution on the market that would allow us to treat the appropriate patients at each of our centers with IGRT precision.”

The selection process was accomplished by installing and comparing leading IGRT solutions on the market at two CARTI facilities. After eight months of clinically evaluating factors like set-up precision, workflow, integration, installation and training, CARTI decided that the ExacTrac X-Ray systems from BrainLAB best met their needs. A key aspect was that ExacTrac X-Ray combines targeting accuracy with fast IGRT workflow efficiency and ease of use — a clear advantage, which allows CARTI doctors to apply image guidance to most of their patients, not just a few. Furthermore, BrainLAB installed the systems with minimum machine downtime.

“The benefits of ExacTrac X-Ray have enabled physicians at CARTI to pinpoint radiation delivery with high accuracy and to treat a wide variety of indications such as lung, prostate, head and neck and gynecology,” said Ann Maners, M.D., radiation oncologist at CARTI. “With multiple centers and multiple linear accelerators, an optimized IGRT workflow and ease of use was mandatory for us. ExacTrac X-Ray is allowing us to confidently treat our patients with millimeter accuracy.”