Requirements for IGRT include:

• The treatment planning must be imaged-based (CT) with the capability of transferring the treatment data to a verify/record system.
• The treatment unit must have "on-board" (or "in-room") imaging (including the placement of a diagnostic CT unit in the treatment room) that has a fixed frame-of-reference with an origin that is precisely related to the frame-of-reference origin for the treatment device (isocenter).
• The treatment unit must have software that allows registration of the images and calculates required shifts.

For IGRT credentialing each institution must complete the IGRT Questionnaire and submit IGRT datasets for two sequential fractions for a patient in each of the following three disease sites:

• HN or Brain.
• Pelvis (This case is required in addition to the other cases).
• Lung or Liver or Pancreas.

The datasets will be submitted via TRIAD in DICOM format.

Data Submission:

The following items should be submitted via TRIAD for EACH* of the three disease sites listed above:

• Planning CT scan, in DICOM format, for a single patient
• DICOM RT Structure Set
• DICOM RT Plan File
• DICOM RT Dose File
• Localization images (e.g. cone beam CT (CBCT) or MRI) in DICOM format for two sequential fractions
• DICOM spatial registration file (SRO or REG) associated with the CBCT
• Screen captures of CT and IGRT images showing shift
• Completed DDSI once data is uploaded to TRIAD
• Completed IGRT Questionnaire

*If the site is only interested in obtaining credentialing for soft tissue IGRT, the HN/Brain submission can be omitted. Likewise the Liver/Lung/Pancreas submission can be omitted if only boney anatomy credentialing is required. However, IROC strongly suggests that all images are submitted at one time to ease the credentialing process.

* The pelvis case is required for both boney and soft tissue approval.