Image Guided Radiation Therapy (IGRT)

Photo of a patient preparing for IGRT treatment.

Radiation therapist works with a patient to prepare for treatment on MidMichigan Medical Center-Midland's IGRT equipment.

Image Guided Radiation Therapy (IGRT) scans tumors as they are being treated to focus more radiation directly on the tumor and less on surrounding healthy tissue. Tougher on tumors and easier on patients, image guided radiation therapy (IGRT) is available at only about 50 of the nation’s 2,500 radiation oncology centers in the U.S., including Memorial Sloan-Kettering, M.D. Anderson and the Mayo Clinic.  

“MidMichigan is at the forefront of cancer treatment technology, and with this system, we have the newest and most advanced treatment method available,” said MidMichigan radiation oncologist Rajesh P. Kotecha, M.D.  

Adjusts for Tumor Movement and Patient Breathing 

The goal of radiotherapy for cancer is to strike as little healthy tissue as possible with the treatment beam, while exposing the tumor as much as possible. When healthy tissue is protected, stronger doses of radiation can be used on the tumor.

“The logical result of combining lower exposure to healthy tissue and higher treatment dose is a double benefit of maximum impact on the tumor, with fewer side effects to manage down the road,” noted Dr. Kotecha. The system can be used to treat nearly all types of cancer.

To keep the tumor in range, image-guided radiation therapy combines computer automation with advances in CT imaging (CAT scan) to track internal movement that occurs when a patient breathes during treatment. It turns the treatment beam on only when the tumor is in perfect position, and turns it off during other times in the breathing cycle.

In addition, before every treatment, the system checks for internal changes that can occur over the course of therapy, such as when tumors shrink or patients lose or gain weight, and readjusts the patient’s position.

The system is synchronized with MidMichigan’s treatment planning and information management systems, a step that streamlines imaging and treatment for additional precision, convenience and patient safety.

Acquisition of the equipment required the State’s approval. The Medical Center invested $3.3 million to acquire and install the equipment, synchronize information management systems to the advanced features, and make required alterations to the treatment room. 

The new technology enhances intensity-modulated radiation therapy (IMRT), which has been used at MidMichigan Medical Center - Midland since 2003.


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