Investigating User Perspective on Training and Clinical Implementation of Volumetric Imaging

Radiation therapist perspectives on cone-beam computed tomography practices and response to information

“…16,21 The potential impact on the entire radiation therapy department of equipping therapists 'with the knowledge and skills necessary to manage the wealth of new information now presented to them at the time of treatment delivery' was acknowledged by White and Kane, 10 but they stopped short of identifying what the content of that education and training needs to be. 12,22 While the level of comfort in contacting the RO in response to such information was consistently high in this investigation, variations were reported between respondents, disease sites and centres. 9,20 Burow et al 21 suggest that soft tissue image interpretation, such as is required for CBCT image interpretation, is not addressed in entrylevel radiation therapy certification programmes in Australia.…”

Competencies of therapeutic radiographers working in the linear accelerator across Europe: A systematic search of the literature and thematic analysis

“…White literature 33,38,39,43,44,46,49,53 mostly discussed the less well-established competencies (e.g. participating in audits).…”

“…"perform risk and hazard analysis in the workplace", "analyse errors and near-misses and ensure prevention of future events", among others). This phenomenon of decomposing competencies into its sub-dimensions was discussed by Adams et al and Gillan et al 33,34 23,27,44 Verify prescription e Interpret treatment prescriptions e Verify treatment prescription and report discrepancies e Compare the plan with the prescription 23,24,28 Data transfer e Carry out necessary data transfer checks 24 Positioning and immobilisation Critically assess immobilisation e Confirm appropriate immobilisation considering aim of treatment and patient condition 24 Reproduce immobilisation e Position the patient according to planning and simulation 24 Accuracy e Ensure accuracy in positioning 24,49 Patient comfort e Promote patient comfort, as much as possible 24 Delivery of treatment Choice of devices e Choose the appropriate therapeutic, imaging and ancillary devices 19,27 Parameters check e Check if appropriate treatment parameters were selected 23 Treatment administration e Administer treatment accurately and safely e Apply best practice at all times e Interrupt treatment, if required, in an emergency 24,27,28 Patient observation e Constantly observe the patient during treatment 42 Avoid treatment gaps e Avoid radiotherapy treatment gaps 44…”

“…Image acquisition e Select the appropriate image modality e Acquire planar (2D) images e Acquire volumetric (3D) images 19,24,27 Image interpretation e Analyse verification images: Analyse planar (2D) verification images a Analyse volumetric (3D) verification images a e Make decisions regarding the action to take following image analysis, within the protocols e Follow patient setup verification protocols e Develop patient setup verification protocols e Analyse images to evaluate the result of radiotherapy treatments 19,24,27,28,34,44,47,49,53 Equipment quality assurance Perform QA e Perform daily QA of the linear accelerator e Perform QA of imaging systems e Carry out in vivo dosimetry 19,23,24,39,41 Evaluate and report results of QA e Evaluate results of QA procedures e Take corrective actions in view of QA results e Report inconsistencies in QA procedures 23,24,39 a The sub-theme "Image interpretation" was further divided to include two sub-themes: Analysis of 2D and 3D images. The literature does not provide information regarding which competencies are developed in the individual European countries.…”

“…Furthermore, the literature does not discuss which modalities or techniques the linac-TRs should be competent on. Although some literature 39,44,49,53 directly relates the need for further development of competencies with the rising of new technologies, these focus on the development of competencies that ensure that the treatments are administered adequately, rather than specifying which modalities should the professionals be trained on.…”