Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2025 Nov 1;48(11):529-539.
doi: 10.1097/COC.0000000000001220. Epub 2025 Jun 20.

ACR-ARS Practice Parameter for Image-Guided Radiation Therapy (IGRT)

Adam Garsa  1 , Courtney R Buckey  2 , Brian J Davis  3 , Laura Freedman  4 , Sebastien A A Gros  5 , Christopher L Hallemeier  6 , Simon S Lo  7 , Michael T Milano  8 , Hina Saeed  9 , Jason C Ye  10 , William Small Jr  11 , Naomi R Schechter  12
Affiliations
Practice Guideline

ACR-ARS Practice Parameter for Image-Guided Radiation Therapy (IGRT)

Adam Garsa et al. Am J Clin Oncol. .

Abstract

Objectives: This practice parameter was revised collaboratively by the American College of Radiology (ACR), and American Radium Society (ARS). Image-guided radiation therapy (IGRT) uses various imaging modalities to maximize the accuracy and precision of radiation treatment delivery.

Methods: This practice parameter was developed according to the process described under the heading The Process for Developing ACR Practice Parameters and Technical Standards on the ACR website ( https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards ) by the Committee on Practice Parameters-Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS.

Results: This practice parameter for IGRT addresses qualifications and responsibilities of personnel, clinical IGRT implementation, documentation, quality control and improvement, safety, and patient education. Since the publication of the ACR-ASTRO Practice Parameter in 2019, there is now more clarity as to what criteria and parameters need to be documented in the medical record, a better appreciation of the large amount of imaging data, how to interpret such data, as well as the complex interactions of multiple systems in the implementation of IGRT.

Conclusions: This practice parameter assists practitioners in the clinical use of IGRT. IGRT should complement and be used in combination with other quality assurance processes. IGRT is a rapidly evolving field, and practitioners should have a thorough understanding of its strengths and potential limitations.

Keywords: American College of Radiology; American Radium Society; image guidance; image-guided radiation therapy; practice parameter.

PubMed Disclaimer

Conflict of interest statement

S.S.L. declares that he was a co-principal investigator on a research project funded by the Kuni Foundation and has received research funding in this capacity. He also serves as a member of the lead academic participating site for the Hutchinson Center under the NIH-funded grant UG1 CA 233328. Moreover, he serves as a member of the Board of Directors for the Radiosurgery Society and as the Medical Director of Distinction in the Stereotactic Radiotherapy Accreditation Program. In addition, he is a Councilor of the American College of Radiology (ACR) and Chair of the Nominating Committee of the Council of Affiliated Regional Radiation Oncology Societies of ACR. Dr W.S. is the Chair of the ACR Commission on Radiation Oncology and a member of the ACR Board of Chancellors, as well as a member of the Commission on Membership and Communications, the Bylaws Committee, and the Commission on Research. He is also the President of the Illinois Radiologic Society and President Elect of the American Radium Society. N.R.S. South Florida Proton Therapy Institute, Radiation Oncologist. Volunteer relationships: American College of Radiology, Immediate Past Chair of Practice Parameters, Radiation Oncology, Chair of CARROS Quality and Safety Committee, and CARROS Secretary; ASTRO, Chair of Patient Safety Scientific Committee. The other authors declare no conflicts of interest.

References

    1. European Society for Radiotherapy & Oncology. Positioning for radiotherapy and impact on survival in patients with lung or esophageal cancers. 2018. Accessed August 20, 2018. http://www.ascopost.com/News/58782
    1. FitzGerald TJ, Urie M, Ulin K, et al. Processes for quality improvements in radiation oncology clinical trials. Int J Radiat Oncol Biol Phys. 2008;71(suppl):S76–S79.
    1. Hartford AC, Palisca MG, Eichler TJ, et al. American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) Practice Guidelines for Intensity-Modulated Radiation Therapy (IMRT). Int J Radiat Oncol Biol Phys. 2009;73:9–14.
    1. American College of Radiology. ACR–ARS practice parameter for intensity modulated radiation therapy (IMRT). 2021. Accessed February 1, 2023. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/IMRT-RO.pdf
    1. American College of Radiology. ACR–ASTRO practice parameter for the performance of stereotactic body radiation therapy. 2019. Accessed February 1, 2023. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/SBRT-RO.pdf

Publication types