title: Health technology assessment of image-guided radiotherapy (IGRT): A systematic review of current evidence.
abstract: BACKGROUND
  Image-guided radiotherapy used multiple imaging during the radiation therapy course to improve the precision and accuracy of health care provider's treatment.
  
  
  OBJECTIVE
  This study aims to assess the safety, effectiveness and economic aspects of image-guided radiation therapy for decision-making about this technology in Iran.
  
  
  METHODS
  In this study, the most important medical databases such as PubMed and Cochrane Library were searched until November 2014. The systematic reviews, health technology assessment reports and economic evaluation studies were included. The results of included studies were analyzed via the thematic synthesis.
  
  
  RESULTS
  Seven articles were included in the study. The results showed that image-guided radiation therapy, regardless of the imaging technique used in it, is associated with no major toxicity and has the potential to reduce the symptoms of poisoning. Using image-guided radiation therapy for prostate cancer resulted in substantial improvement in the quality of the received dose and optimal therapeutic dose of radiation to the targeted tumor while the radiation dose to the surrounding healthy tissues was minimal. Additionally, image-guided radiation therapy facilitated the diagnosis and management of exception deviations, including immediate changes and gross errors, weight loss, significant limbs deformity, systematic changes in the internal organs and changes in respiratory movements. Usage of image-guided radiation therapy for prostate cancer was associated with increased costs.
  
  
  CONCLUSIONS
  Current available evidence suggests that the image-guided radiation therapy can reduce the amount of radiation to healthy tissue around the tumor and the toxicity associated with it. This can enhance the safe dose of radiation to the tumor and increase the likelihood of destruction of tumor. The current level of evidence required conducting further studies on the costs and effectiveness of this technology compared with conventional technology.
authors.affiliation: PhD Candidate, Health Management and Economics Research Center, Iran University of Medical Sciences & Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. arabloo_j64@yahoo.com.
authors.forename: Jalal
authors.initials: J
authors.lastname: Arabloo
authors.affiliation: PhD Candidate, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. pejman.hamouzadeh@gmail.com.
authors.forename: Pejman
authors.initials: P
authors.lastname: Hamouzadeh
authors.affiliation: MSc in Health Technology Assessment, Tehran University of Medical Sciences, Tehran, Iran. mousavimary61964@gmail.com.
authors.forename: Seyedeh Maryam
authors.initials: SM
authors.lastname: Mousavinezhad
authors.affiliation: PhD Candidate, Young Researchers and Elites Club, Science and Research Branch, Islamic Azad University, Tehran, Iran. mr.mobini1986@gmail.com.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Mobinizadeh
authors.affiliation: Assistant Professor, National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran. arolyaee@gmail.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Olyaeemanesh
authors.affiliation: MD, PhD Student in Nutrition, Tehran University of Medical Sciences, Tehran, Iran. pooyandjoo@yahoo.com.
authors.forename: Morvarid
authors.initials: M
authors.lastname: Pooyandjoo
keywords: Health Technology Assessment; Image-Guided Radiotherapy; Systematic Review