7. Application principles and limits

7.1 Protocols

IGRT protocols must specify the persons authorized to carry out IGRT controls (doctors, interns, physicists, manipulator technicians, etc.), the thresholds and tolerances linked to the precision of the equipment and table, as well as to the computer equipment, the IGRT modality required for each clinical situation, the frequency of controls and any specificities (mobile tumors, children, the elderly, agitated states, etc.). Procedures are established, and protocols must be evaluated and structured in the same way as any transfer of skills to avoid errors: accuracy, tolerances/alerts, additional dose, etc. These protocols must be evaluated, validated (self-assessment/feedback/CREX), communicated and included in a quality assurance process.