IGRT | Image Guided Radiation Therapy


Image Guided Radiation Therapy (IGRT) represents the pinnacle of targeting precision in cancer treatment. By utilizing advanced imaging techniques to track the tumor’s position, IGRT enables the physicians to pinpoint areas of treatment, and then deliver to treatment with unparalleled accuracy, sparing surrounding healthy tissues. This meticulous approach reduces radiation exposure to non-cancerous areas, significantly decreasing side effects and enhancing treatment efficacy. IGRT is typically “married” to a delivery technology, such as VMAT, SBRT, SRS, IMRT, etc.

What about Proton Therapy?

Proton therapy is also a type of external beam radiation, but a particle (a proton) rather than an x-ray (a photon) is used to deliver the radiation. Up until just a few years ago, there were only two locations in the US, and only a handful in the world, where proton therapy was being used because a very large accelerator was required to create the proton beam, requiring a facility that was larger than a football field. These facilities were typically part of a scientific and academic university setting. Protons have an interesting inherent property in that they can be stopped at basically any depth within the body. This made it an excellent treatment for certain tumors, mostly those affecting children or certain tumors of the eye.

In the last few years there has been a renewed interest in using proton therapy for prostate cancer therapy to take advantage of the shift occurring toward radiation for prostate cancer, as a less invasive treatment for prostate cancer than surgery.  This greatly increased the overall market for prostate radiation and this in turn attracted the venture capital community, which has billions of dollars to invest – and what better place for them to invest than in a $200-million proton therapy facility.  With Wall Street behind it, several more proton centers opened in the 2010’s from this inflow of cash. However, treatment with proton therapy for prostate cancer has never been shown to be better than photon/x-ray based radiation but is tens of thousands of dollars more expensive. This “smoke and mirrors,” which is fueling the proton therapy business has been the subject of many investigative reports in the New York Times and other print media, as well as medical journals (see our website for the articles), which clearly state that there is no benefit to protons over photons, and at the expense of the taxpayer, Wall Street is pushing a high cost therapy when a much more cost-effective, and equally effective therapy exists in IGRT.  The jury is still out as to the efficacy of protons as a treatment for prostate cancer.