IMART+

It's not just about the machines.  It's about advanced radiation technologies, plus the people who bring them to our patients.

Optimized Planning

• MCO for IMRT: To find the best possible radiation plan for every patient
• Interactive navigation among different treatment options to identify the best clinical tradeoff
• Protect treatment plans against small uncertainties during the treatment delivery through robust optimization
• A group of optimization experts at MGH advises dosimetrists who prepare the treatment plans
• Cooperation with optimization experts at MIT and elsewhere in the world: the best for the best

Rigorous Quality Assurance

• Validation of IMRT dosing before the first treatment
• Independent verification of every patient’s treatment plan before the first treatment
• Review of every patient’s treatment plan by the treating physician and other expert physicians in the Department
• Daily QA of linear accelerators
• Written instructions by physicians to ensure accurate mapping and treatment planning
• A variety of QA committees and programs to review and monitor quality and safety throughout the entire MGH Radiation Oncology network
• A commitment of physicians, physicists, dosimetrists, radiation therapy technicians, nurses, and support staff to quality and safety for all of our patients

Personalized Delivery

Personalized delivery of IMRT means that we design your treatment specifically for you, including:

• Personalized care by our highly trained, professional, and compassionate radiation therapy technicians
• Image-guided radiation therapy (IGRT), an individualized approach to pinpoint tumor location, adjust for any motion, and fine tune patient positioning – all critical for precise IMRT delivery
• Adaptive radiation planning, a highly personalized approach to adjust radiation delivery to changes in a patient’s anatomy during the course of treatment

Best-In-Class Technology

We use the best equipment to plan and deliver high-precision radiation therapy:

• 10 state-of-the-art linear accelerators in our MGH network for the use of IMRT
• The next generation of IMRT planning systems with groundbreaking features including MCO and ultrafast computation speed
• Cutting edge software tools to visualize all cancer containing body parts and adapt to any changes during the course of treatment
• Surface-based optical guidance technology for safe and accurate radiation delivery
• WhiteBoard, a revolutionary information hub, developed in-house, for seamless radiation planning

Meet the Team

Meet the people who have been integral in the development of advanced radiation technologies such as Intensity Modulated Radiation Therapy (IMRT):

• Thomas Bortfeld, PhD, Chief of Radiation Physics, an IMRT co-developer, with the work beginning in 1988
• Multi-Criteria Optimization (MCO) for IMRT was developed by Mathematician David Craft, PhD, with the worldwide first clinical use at MGH in 2011
• Noah Choi, MD, Radiation Oncologist, and John Wolfgang, PhD, Physicist, were among the first to implement 4-dimensional CT planning to account for tumor motion, a prerequisite for IMRT, in the early 2000s
• Jan Unkelbach, PhD, Physicist, has pioneered the development of robust optimization, which makes treatment plans immune to uncertainties during radiation delivery
• Our expert physicians who continuously strive to optimize IMRT for many cancer types

Learn more

• IMRT [Intensity-Modulated Radiation Therapy]

  Is an advanced mode of high-precision treatment that “paints” radiation doses onto the tumor with pinpoint precision while at the same time minimizing dose delivery to important nearby organs. This is achieved by modulating - or controlling – the intensity of the radiation beam in numerous small volumes. While IMRT has become widely available in recent years, we view IMRT as both an art and a science that requires much more than just a radiation machine and a computer.

• MCO [Multi-Criteria Optimization]

  In conjunction with IMRT is a highly sophisticated computational process where the optimal treatment plan for an individual patient is identified among a virtually infinite number of possible solutions. This is based on criteria specified by the radiation oncologist to maximize radiation dose delivery to the tumor and minimize exposure of healthy organs.

• 4DCT Simulation [Four-Dimensional Computed Tomography]

  Is a prerequisite for accurate IMRT planning and delivery in body parts where there is breathing motion, i.e., the chest and upper abdomen. 4DCT simulation involves the acquisition of multiple CT scans during a patient’s breathing cycle, thereby logging the tumor position not only in space but also in time, so that the radiation beam will never miss the tumor.

• IGRT [Image-Guided Radiation Therapy]

  Involves the use of imaging technology, such as X-rays or ultrasound, to accurately deliver the desired radiation doses to the tumor on a regular basis. The benefits of IMRT can only be realized with daily IGRT.

• CBCT [Cone Beam CT]

  Is a form of IGRT where a CT scan is obtained right before the daily treatment, which allows the radiation therapy technicians and the treating radiation oncologist to fine tune a patient’s position for high-precision delivery of radiation doses.