A Personalized Image-Guided-Radiotherapy Workflow Based on Subtypes of Diagnostic Site

Cone beam CT (CBCT) is one of the main imaging devices adopted in image guided radiotherapy (IGRT). However, as a respective advanced radiotherapy technology, it limits the contribution of IGRT when the IGRT is performed in default IGRT workflow, since the imaging characteristics, registration methods, evaluation criterion, and even crucial organs at risks (OARs) are different as the tumor site changes. In this paper, we propose a novel specialized IGRT workflow based on the subtypes of diagnosis site. Three site-specific IGRT workflow, for head and neck site, chest site and abdomen site are stated separately, organized with preparation of reference images and structures, parameters setting of image acquisition and reconstruction, image registration, registration results assessment, positioning correction, changing frequency of IGRT practice, as well as review and analysis of IGRT data. The responsibilities of radiotherapy team (oncologists, medical physicists and radiotherapy therapists) in site-specific IGRT workflow are also demonstrated.