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

Am J Clin Oncol. 2025 Nov 1;48(11):529-539. doi: 10.1097/COC.0000000000001220. Epub 2025 Jun 20.

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.

Publication types

  • Practice Guideline

MeSH terms

  • Humans
  • Neoplasms* / diagnostic imaging
  • Neoplasms* / radiotherapy
  • Radiation Oncology* / standards
  • Radiotherapy, Image-Guided* / methods
  • Radiotherapy, Image-Guided* / standards
  • Societies, Medical
  • United States