Concierge radiation oncology · UK
Image-guided radiation therapy — the standard for modern UK radiotherapy.
Daily on-treatment imaging — CBCT, MR-linac, surface guidance, fiducial tracking — that verifies your tumour’s position before every beam. It is what makes VMAT, SBRT and proton therapy safe, accurate, and shorter.
Why patients choose us
- 01
A consultant clinical oncologist, not a booking desk
A named consultant oncologist plans, verifies and delivers your radiotherapy — with the imaging modality that fits the tumour.
- 02
The right IGRT for the tumour
CBCT for most, MR-linac for soft-tissue targets, surface-guided DIBH for left breast, fiducial-tracked for prostate. We match the modality to the case.
- 03
Independent, and free
We are paid by no centre, so the recommendation between Christie, Marsden, UCLH or GenesisCare is impartial and costs you nothing.
Indicative pricing
What image-guided radiotherapy costs in the UK private sector.
Indicative ranges across our partner centres. Send the details and we quote firm figures across two or three options.
In short
A 5-fraction prostate SBRT with CBCT and fiducials: £15,000–£25,000, over two weeks.
| Course | Indicative range | Typical duration | Per-fraction time |
|---|---|---|---|
| Consultant clinical oncology consultation | £250–£450 | 45 min | Same visit |
| Planning CT simulation (with IGRT set-up) | £600–£1,200 | 30–45 min | Plan in 5–10 days |
| Prostate SBRT (5 fractions, CBCT + fiducials) | £15,000–£25,000 | 2 weeks | Per fraction 15 min |
| Lung SBRT (3–8 fractions, 4D-CBCT) | £12,000–£22,000 | 1–2 weeks | Per fraction 20 min |
| Breast VMAT with DIBH surface guidance | £8,000–£16,000 | 3–4 weeks | Per fraction 10 min |
| MR-linac adaptive course (per fraction) | £2,500–£4,500 | 45–60 min | Same visit |
Prices vary by centre, by the consultant clinical oncologist, by machine type (conventional linac, MR-linac, proton), and by whether markers, spacers or DIBH set-up are needed. We come back with a firm quote within one working day.
The problem
The right centre, the right technique, the right image guidance.
Modern radiotherapy — VMAT, SBRT, proton therapy — needs sub-millimetre accuracy. Tumours move, bladders fill, weight drops. Image guidance is what turns a plan into a delivered dose, and centres vary in how well they do it.
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Not sure which centre?
Christie, Marsden, UCLH, Guy’s, GenesisCare, HCA — different machines, different strengths. We match the tumour to the technology.
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Worried about side effects?
IGRT allows tighter margins (3–5 mm), so less bowel, bladder, heart or lung sits in the high-dose region.
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Want a shorter course?
Hypofractionation (5–8 fractions) needs IGRT to be safe. We arrange SBRT / SABR where clinically appropriate.
The journey
From diagnosis to follow-up — what happens, in order.
One consultant oncologist from first message through the last fraction and into follow-up.
Phase 1 · Before your course
Concierge, off-stage for you
Phase 2 · On treatment
Daily visits at the centre
Phase 3 · After
Concierge, back on
- 01
Before
You tell us about the diagnosis
A short, confidential form. Tumour type, stage, previous treatment, and whether you have a planning CT booked already.
- 02
Before
We come back with a recommendation
Within one working day: the right centre, the right technique (VMAT, SBRT, MR-linac, proton), and whether adaptive planning is worth it. If radiotherapy is not the right step, we say so.
- 03
Before
Planning CT and marker placement
A CT simulation in the treatment position, occasionally with a planning MRI. Fiducial markers or a rectal spacer are placed beforehand for prostate cases.
- 04
On treatment
Daily set-up and imaging
On each treatment day: surface guidance or laser set-up, then a CBCT or kV pair to verify position before the beam is turned on.
- 05
On treatment
Verification and adjustment
The radiographers match the day’s image to the plan and shift the couch — sub-millimetre — so the tumour, not yesterday’s tumour, is treated.
- 06
On treatment
Treatment delivery
VMAT arcs, SBRT bursts or MR-guided beams — typically 5 to 15 minutes on the couch. You go home the same day.
- 07
After
Adaptive review and follow-up
Weekly review with the oncologist; offline or online adaptive re-planning if the tumour shrinks or anatomy changes. Late-effect follow-up is scheduled.
Typical end-to-end: 2–3 weeks from enquiry to first fraction. Course length: 1 day to 8 weeks depending on tumour.
When it helps
Where daily image guidance changes the outcome.
The tumour sites and clinical situations where IGRT is not optional — plus the reminder that on modern UK radiotherapy it is the baseline, not the upgrade.
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Prostate SBRT / hypofractionation
Daily CBCT plus implanted gold seed fiducials — the standard for 5-fraction prostate SBRT and dose-escalated conventional courses.
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Lung and liver SBRT
4D-CT planning and 4D-CBCT verification, with breath-hold or gating to lock down a tumour that moves with respiration.
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Left breast — cardiac sparing
Surface-guided deep inspiration breath-hold (AlignRT, Catalyst) pulls the heart away from the chest wall for every fraction.
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Head and neck VMAT
Daily kV/CBCT verification catches weight loss and mask fit changes — the trigger for offline adaptive re-planning mid-course.
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Pancreas and abdominal tumours
MR-linac (Unity, MRIdian) sees soft-tissue targets kV imaging cannot — the case for online adaptive re-planning per fraction.
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Oligometastatic disease
SBRT to a small number of metastases — brain, spine, adrenal, node — needs the sub-millimetre accuracy IGRT delivers.
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Paediatric and re-irradiation cases
Where every millimetre of normal tissue matters, adaptive IGRT — often on MR-linac or proton beam — is the standard.
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Not a red flag — a quality baseline
IGRT is not an add-on. Modern NHS and private UK radiotherapy IS image-guided; a centre that cannot verify daily is not delivering current care.
IGRT modalities
One label, several very different machines.
The imaging technology varies by site and by tumour. Here is what each one is, and where it earns its place.
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kV cone-beam CT (CBCT)
The workhorse. A 3D volumetric scan on the linac before each fraction — most common modality across UK centres.
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kV / MV planar imaging
A pair of 2D X-rays for a quick bony or fiducial match — fast, low-dose, used between volumetric scans.
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MR-linac (Unity, MRIdian)
A linac fused with 1.5T or 0.35T MRI — soft-tissue visualisation and online per-fraction adaptive planning. Christie, Marsden, UCLH, Guy’s.
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Optical surface guidance (AlignRT, Catalyst)
Camera-based 3D surface tracking — DIBH for left breast, tattoo-free set-up, gating, motion interrupt.
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Fiducial markers
Gold seeds in prostate, Lipiodol in liver, Visicoil in pancreas — implanted anchors for daily kV alignment of soft-tissue targets.
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4D-CT / 4D-CBCT (respiratory correlated)
Breathing-resolved imaging for lung and liver SBRT — defines the internal target volume and verifies motion on the day.
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Cyberknife tumour tracking
Robotic linac that tracks a fiducial in real time and steers the beam — used at UK Cyberknife centres for moving targets.
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Ethos AI adaptive delivery
Varian’s AI-driven online adaptive workflow on a conventional linac — emerging UK adoption for prostate, bladder and head and neck.
Our vetted UK network
A small panel of oncology centres, we picked them.
Consultant clinical oncologists across London, Manchester and other UK cities — with access to conventional linacs, MR-linac, Cyberknife and proton beam therapy. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every centre in our network.
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Consultant clinical oncologists, not junior staff or non-medical prescribers alone
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Daily volumetric IGRT (CBCT or MR) as standard, not weekly bone-match only
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Adaptive planning available — offline weekly, and online where MR-linac or Ethos is used
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Motion management (DIBH, gating, fiducials, 4D) matched to tumour site
Safety and eligibility
What to expect during a course — honestly.
IGRT itself is safe — the imaging dose is small. The things worth planning are set-up time, marker or spacer procedures, and whether MR-guided or adaptive workflows fit your case.
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Extra imaging dose is small
A daily CBCT delivers roughly 1–2 mGy — negligible next to the 60–80 Gy therapeutic dose to the target, and offset by the normal-tissue sparing IGRT enables.
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IGRT reduces side effects
Tighter CTV-PTV margins (3–5 mm instead of 10–15 mm) mean less bowel, bladder, rectum, heart and lung in the high-dose region.
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Set-up takes longer than the beam
Expect 10–20 minutes on the couch — most of it imaging and couch shifts. The beam itself is often under 3 minutes.
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Fiducial markers are a minor procedure
Gold seeds for prostate are placed under LA, transrectally, days before planning. Small bruise, brief antibiotics, no downtime.
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DIBH needs practice
Breath-hold for left breast is coached at planning and each fraction. If you cannot hold long enough, gating or free-breathing plans are alternatives.
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MR-linac excludes some metalwork
Pacemakers, cochlear implants, some clips and shrapnel rule MR-guided treatment out — a conventional linac with CBCT is used instead.
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Adaptive re-planning is not automatic
Online adaptive (MR-linac, Ethos) is per fraction; offline adaptive is a mid-course re-plan triggered by weight loss, tumour shrinkage or anatomy change.
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Late effects come from total dose, not IGRT
Fatigue, skin reaction, and organ-specific late effects are from the therapy itself. Better image guidance means fewer of them, not more.
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Red flags during a course
Uncontrolled pain, bleeding, breathlessness or new neurology are not normal — tell the on-treatment review team the same day.
Reading your treatment summary
Your treatment summary in four parts. Read the last one first.
Whichever technique and machine were used, the end-of-treatment letter your oncologist sends keeps to the same shape.
A quiet reminder
Radiotherapy language is precise and can read coldly — we translate it for you.
If you would like us to walk you through the summary before your first follow-up, just ask.
- 01 Header
Diagnosis, intent and prescription
The tumour, stage, treatment intent (radical, adjuvant, palliative), total dose in Gy, and number of fractions.
- 02 Technique
Technique, energy and IGRT protocol
VMAT / IMRT / SBRT / protons, beam energy, and the daily IGRT protocol (CBCT frequency, fiducials, DIBH, MR).
- 03 Findings
On-treatment verification and shifts
Notes on daily image matches, couch shifts, adaptive triggers, and any re-plans during the course.
- 04 Impression
Response, side effects, follow-up
Read this first: acute reaction managed, response at end of treatment, and the late-effect follow-up schedule.
Recognised by major UK insurers
Cover for radiotherapy varies by insurer, by indication, and by machine type (MR-linac and proton beam therapy sometimes need pre-authorisation). We confirm cover before treatment starts.
Frequently asked
Everything we get asked about image-guided radiotherapy.
Quick answers on dose, MR-linac access, fiducial markers, DIBH, and adaptive planning.
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What is image-guided radiation therapy (IGRT)?
IGRT is the use of on-treatment imaging — usually a cone-beam CT (CBCT) — immediately before each radiotherapy fraction to verify tumour and patient position, then adjust the couch so the beam hits the target and spares surrounding tissue. It is the modern standard for radiotherapy delivery in the UK.
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Is IGRT the same as VMAT, IMRT or SBRT?
No. VMAT, IMRT, SBRT and proton beam therapy are delivery techniques — how the dose is shaped and given. IGRT is the verification layer that makes those techniques safe by confirming, every day, that the target is where the plan says it is.
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Does the extra imaging give me more radiation dose?
A little. A daily CBCT is roughly 1–2 mGy — small compared to the 60–80 Gy therapeutic dose to the target, and vastly outweighed by the normal-tissue sparing IGRT allows. NHS and RCR guidance treats daily IGRT as standard for modern radiotherapy.
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What is an MR-linac and where is it in the UK?
An MR-linac combines a linear accelerator with an MRI scanner, so soft-tissue targets can be seen — and re-planned — every day. UK sites include Christie Manchester and University College Hospital London (Elekta Unity 1.5T), plus Royal Marsden, Guy’s & St Thomas’ and Aberdeen; provision is expanding.
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Do I need fiducial markers?
For prostate SBRT and dose-escalated prostate radiotherapy, gold seed fiducials are the UK standard for daily kV alignment. Liver and pancreas cases sometimes use Lipiodol or Visicoil. For head and neck, breast, brain and most other sites, no markers are needed.
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What is deep inspiration breath-hold (DIBH)?
DIBH is a technique — used mostly for left breast radiotherapy — where you take and hold a deep breath during each beam. It lifts the chest wall off the heart and cuts cardiac dose meaningfully. Surface guidance (AlignRT, Catalyst) monitors the breath-hold in real time.
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What is adaptive radiotherapy?
Adaptive radiotherapy re-plans the treatment during the course to account for tumour shrinkage or anatomy change. Offline adaptive is a weekly review with a re-plan if triggered; online adaptive re-plans on the day (per fraction) — currently on MR-linac and, increasingly, Varian Ethos.
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Is IGRT available on the NHS or only privately?
IGRT is the NHS standard for modern radiotherapy. MR-linac and Ethos adaptive workflows are commissioned at specific NHS centres and via clinical trials; private access is available at GenesisCare, HCA and other UK centres. We help you choose the right one.
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A single dose delivered during surgery.
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All tests and procedures
Every test and procedure we arrange.
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Tell us about your diagnosis — a reply within one working day.
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