New SBRT practice parameters from ACR-ASTRO highlight SGRT as a technique ensuring accurate treatment

27 November 2019. The American College of Radiology (ACR) has teamed up with the American Society for Radiation Oncology (ASTRO) on updated radiation therapy parameters for clinicians. Together, seven practice parameters geared towards recommended procedures and considerations for clinicians to safely administer radiation by specific practice area were updated. The updated ACR–ASTRO practice parameter for the performance of stereotactic body radiation therapy (SBRT) included the mention of SGRT for setup and treatment monitoring stating, “External fiducials or optical surface imaging may be used for initial setup, as well as tracking during treatment delivery. For accurate SBRT treatment delivery, the target position should be confirmed with a radiographic imaging method when using optical surface imaging.” The previous practice parameter for SBRT (2014) did not mention surface imaging, highlighting the successes of recent clinical and research work on the benefits of surface guided radiation therapy with SBRT.

Dr. Heinzerling, radiation oncologist at Levine Cancer Institute, Atrium Health, says, “Our institutional experience and research has shown that surface guidance is an essential tool both in setup and monitoring of patients during SBRT treatments to ensure the highest precision throughout the entire treatment process. The ACR/ASTRO newly revised practice parameters for SBRT reflect this importance by specifically mentioning surface guidance as a valuable tool in ablative, high dose/fraction treatments.”

The SBRT practice parameter also describes breath-hold as a technique for motion management during treatment delivery. AlignRT®, using real-time 6 degree-of-freedom patient tracking, has been shown to provide an effective and accurate technique for breath-hold treatments across different treatment indications, including SBRT. This ACR-ASTRO Practice Parameters document describes recommended conduct in the specific area of SBRT clinical practice. “Each practice parameter and technical standard, representing a policy statement by the College, has undergone a thorough consensus process in which it has been subjected to extensive review and approval. The practice parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document”

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