Introducing SGRT into the Clinic

This chapter provides a perspective on the daily, hands-on use of a surface-guided radiation therapy (SGRT) system in a busy clinical setting. It also addresses how SGRT complements other treatment technologies and techniques in the process of typical treatments and special procedures, and provides information and lessons gained from the treatment teams using SGRT for some or all treatments of actual patients, including patient satisfaction. This chapter also details the observations and experiences of a radiation therapy department in the commissioning of six SGRT systems over five years of use. Recommendations for staff training, quality assurance procedures, and troubleshooting are also given. The clinic’s initial motivation for implementing SGRT was to accommodate physician requests for active, quantitative intrafraction motion management in procedures such as stereotactic body radiation therapy (SBRT) and deep inspiration breath hold (DIBH). However, in a short time, SGRT was integrated as a vital component of the radiotherapy toolbox available for the setup and monitoring of every patient for every fraction, including electron patients. With the powerful combination of SGRT and other image-guided radiation therapy modalities, the clinic implemented a skin mark-less radiotherapy program and collected data to compare this setup technique with the traditional approach (involving skin marks, isocentric lasers, and couch shifts) in terms of accuracy, efficiency, and radiographic imaging frequency.