Clinical Implementation and Efficiency of Kilovoltage Image-Guided Radiation Therapy

This paper describes measurements of clinical efficiency and time requirements associated with image-guided radiation therapy (IGRT). In June 2004, the authors' institution installed an integrated kilovoltage (kV) imaging system attached to a medical linear accelerator for radiographic target localization. Over the past year, 242 patients have been localized with the kV radiographic imaging system for a total of 2,700 fractions. Data were analyzed by reviewing the time required for each patient's IGRT session, broken into both image acquisition and image analysis time. Average IGRT procedure time was reviewed pertaining to months, treatment sessions, disease sites, and radiation therapists. Results showed that the average IGRT procedure time was reduced from 450 to 237 seconds from June 2004 to June 2005. Further analysis revealed that each therapist showed improvement in reducing the IGRT procedure time from the first month of use to the month of June 2005. The routine use of IGRT may ultimately be performed within 3 to 4 minutes, with minimal disruption to the clinical treatment process.