1. IGRTat UCSF EPI & CBCT by Michèle Aubin MSEE

2. PrescribePlanSet upReview IGRT Steps Physicians Create and approve a prescription Place an order for daily or weekly imaging (EPI and/or CBCT)Dosimetrists Prepare the reference data in Site Setup for EPI and CBCT Send the Plan, DRRs, CT and ISO to Mosaiq Print out the CT with ISOTherapists Initialize and schedule imaging Associate a proto- col to MVCB Align the patient Associate the CBCT Archive & clean the databasePhysicians Review each images and shifts in Mosaiq before next treatment

3. Prescribe Place an Order in Mosaiq

4. Remind the dosimetrist Work done in Pinnacle and Mosaiq Type of Imaging (2D or 3D) If 3D, inform of which contours to send for alignment Plan Print out the CT and ISO

5. Assist the therapist Syngo Station Verify that Isocenter on the patient’s CT match the printout Guide the patient’s alignment on dry run Set up

6. Acquire and Align RTT Syngo Station Set up

7. Prostate Patient

24. H&N Patient

34. Align the Patient Syngo Station Set up Prostate + Markers: always performed by RTT Head&Neck: 5 mm : call attending

35. Align the Patient Syngo Station Set up Every moves (Lat, Long, Vert) are typed in Mosaiq by RTT

36. Align the Patient RTT Syngo Station Set up Prostate 4 MU to 6 MU H&N 3 or 4 MU Lung 4 to 6 MU

37. Verify the Images and Shifts Mosaiq Can verify and approve images in any Mosaiq station. In order to charge and be legal, all IGRT have to be approved before next treatment Review

38. Thank You!