Contrast-enhanced CBCT With C-arm HyperSight Technology

This is a single-arm prospective, feasibility study evaluating the intravenous contrast-enhanced cone beam computed tomography (IV CBCT) for image guidance during radiotherapy. Patients treated with SFRT will receive IV-contrast enhanced CT and fMRI before treatment for simulation purposes. Additionally, patients will receive mpMRI just before and IV-contrast enhanced CBCT during their second and last fraction of RT, in addition to the standard of care CBCT that is acquired for daily image-guided patient positioning. Patients will undergo both IV-contrast enhanced CBCT and treatment on the TrueBeam with HyperSight imaging capability. We hypothesize IV contrast enhanced CBCT is feasible, well-tolerated by patients and improves the visibility of the target.

Inclusion Criteria: * Primary biopsy-proven cancer * Planning to undergo spatially fractionated radiation therapy * Able to provide informed consent * Willingness to participate in follow-up * ECOG less than or equal to 3 * Normal creatinine (below 109mmol/L), normal eGF Exclusion Criteria: * Unable to understand/provide consent * History of allergic reaction to iodinated IV contrast dye (allergy to MR contrast is not an exclusion criteria) * Known renal disease * Single kidney * Kidney transplant * Dialysis * Contraindication to MRI