My question was about the future.
VMAT/RapidArc/SmartArc will alter IMRT delivery greatly. Set up times are fairly constant between all treatment techniques, but VMAT reduces the IMRT delivery time greatly (1-2 minutes?).
What is the average set up time without IGRT manipulations?
What is the average set up time with IGRT manipulations?
What is the delivery time on a palliative 2 field? can a single gantry rotation VMAT deliver this more quickly
15-20% of our workload at present is IMRT and we are doing 40/day per machine from 7:30pm - 4:30pm. All of my radical intent and many of my palliative patients are now volumed - there isn't much extra workload for me. Individual verification of treatment is not required if you are using IMRT all the time. Sure it has to be undertaken frequently but EVERY plan? After the initial checking period, is it safe to continually check plans which are always in tolerance?
"I personally think "SmartArc IMRT for palliation" is a joke" - why? I know it is more work and lot of tech for a palliative problem, but so what? Won't be the first time we have taken a high tech solution to a low tech problem (e.g., prostate only IMRT??)
If VMAT for palliation means you can treat 2 more patients per day without extra resources, who can afford to ignore this?
Any role for the conveyor belt?
Any role for remotely moving couches (seen a video of this already!)? If patients are attached to beds entering the room and staff don't enter the room, can the speed of gantry rotation increase to e more than 6 degrees/second? Can a sufficiently high dose rate be produced to utilise this?