Consolidating learning and collaborative working in setting up a clinical MR-Linac service

Abstract

Introduction: To audit the dynamic interrelationship between rectal distension at diagnosis magnetic resonance (MRI) scan with the computed tomography (CT) radiotherapy planning scan; to determine the effect of rectal movement on the position of the prostatic gland. This review will examine the efficacy of rectal preparation. At present rectal distension at RT CT planning scan is assessed on control slices using GSTT protocol prior to having a full CT scan. If this is outside tolerance a repeat CT scan appointment whereby the patient is given an enema. If rectal size can be predicted prior to the CT planning scan, bowl preparation can be preempted to ensure efficiencies in the patient pathway. Method: A retrospective audit looking at the MRI diagnostic scans and radiotherapy CT planning scans of 141 patients with adenocarcinoma of the prostate between May to August 2019. To find out if rectal size at MRI serves as an indicator of rectal size at planning RT CT. Dependent on the outcome of the retrospective study, a prospective study will then be undertaken to assess if an intervention prior to RT CT scan such as a prescription of Docusate Sodium enema help resolve the issue of rectal size at planning. Results: Results pending. Conclusions & Discussion: The outcome should inform clinical practice, benefit patients and clinicians and provision of service. The audit may result in reduction of rebooking patients for repeat CT scan and cease the delay of treatment processes.

Therapeutic Radiographers at the Helm: Moving Towards Radiographer-Led MR-Guided Radiotherapy

“…A multifaceted approach to education was used to compensate for different learning preferences [10] and included self-directed reading, formal courses, practical sessions, and the transfer of knowledge through the training of other professionals. Positive feedback was obtained after the RTT-clinician training sessions, the details of which will be presented elsewhere [11]. The literature reinforces the necessity of an interdisciplinary and collaborative approach to health care professional education, and the need for fluidity in roles within this team setting for effective operation [16].…”

“…This included the ongoing development of skills required for radiographer-led treatments, treatment planning, and plan evaluation, in addition to the planning and coordination of a two day interdisciplinary 'boot-camp'. These sessions were aimed at clinicians and incorporated education and teaching as a method of learning by the radiographers, and enabled practical runthroughs as well as discussions on patient pathways and potential online treatment scenarios [11]. Alongside these sessions, regular formal and informal meetings were scheduled to allow opportunity for the interdisciplinary team to meet and address learning objectives collaboratively, and reflect on progress ( Table 2).…”