The concept of intensity-modulated radiotherapy is now familiar to everyone working in radiotherapy in the UK. To date however, the majority of UK radiotherapy departments have yet to offer this technique clinically. Implementation of IMRT represents a significant change in practice from the delivery of conventional or conformal treatment, requiring careful planning and a full understanding of the issues and new technology involved.
This paper provides a review of the stages involved in the IMRT process; from localisation and immobilisation through inverse treatment planning and quality control to delivery and verification, highlighting those aspects that represent a significant change in practice or approach.
Current and future developments that are expected to enhance or provide alternatives to IMRT, such as developments in radiobiological modelling, functional imaging, tomotherapy and proton therapy are discussed.