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American Society for Therapeutic Radiology and Oncology

American Society For Therapeutic Radiology And Oncology (ASTRO) And American College Of Radiology (ACR) Practice Guidelines For Image-Guided Radiation Therapy (IGRT)


Louis Potters, M.D., Laurie E. Gaspar, M.D., BRIAN KAVANAGH, M.D., JAMES M. GALVIN, D.SC., Alan C. Hartford, M.D., PH.D., James M. Hevezi, PH.D., Patrick A. Kupelian, M.D. Najeeb Mohiden, M.B., Michael A. Samuels, M.D., Robert Timmerman, M.D., Prabhakar Tripuraneni, M.D., Maria T. Vlachaki, M.D., PH.D.,Lei Xing, PH.D., And Seth A. Rosenthal., M.D


These guidelines are an educational tool designed to assist practitioners in providing appropriate radiologic care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the American College of Radiology cautions against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, an approach that differs from the guidelines, standing alone, does not necessarily imply that the approach was below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines. However, a practitioner who employs an approach substantially different from these guidelines is advised to document in the patient record information sufficient to explain the approach taken. The practice of medicine involves not only the science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these guidelines will not assure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.

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