Background: Several studies have investigated cardiac dose reduction when utilizing the deep inspiration breath hold (DIBH) technique in patients undergoing radiotherapy for left-sided breast cancer. This paper aims to recommend potential selection criteria based on a retrospective single institute study of free breathing (FB) and DIBH computed tomography (CT) simulation planning scans. Methods: Dosimetric comparisons were performed retrospectively for 20 patients correlating the dose reduction and patient anatomical factors (anatomical variation of chest shape, chest wall separation, total lung volume (TLV) and others). Results: Paired t-tests demonstrated significant cardiac dose reduction for most patients but not all. Minimal cardiac dose reduction was observed for three patients using their DIBH plan, with one patient receiving a higher dose. Linear regression analysis identified a positive correlation between the patient’s TLV (on the FB CT simulation scan) and the magnitude of dosimetric benefit received (0.4045 R2). Conclusion: The TLV measured on a FB plan could potentially be utilised to predict cardiac exposure and assist with patient selection for DIBH. This is important in resource allocation, as DIBH may be unnecessarily recommended for some patients with little dosimetric benefit.
IntroductionThis article presents the results of a single‐day census of radiation therapy (RT) treatment and technology use in Australia. The primary aim of the study was to ascertain patterns of RT practice and technology in use across Australia. These data were primarily collated to inform curriculum development of academic programs, thereby ensuring that training is matched to workforce patterns of practice.MethodsThe study design was a census method with all 59 RT centres in Australia being invited to provide quantitative summary data relating to patient case mix and technology use on a randomly selected but common date. Anonymous and demographic‐free data were analysed using descriptive statistics.ResultsOverall data were provided across all six Australian States by 29 centres of a possible 59, yielding a response rate of 49% and representing a total of 2743 patients. Findings from this study indicate the increasing use of emerging intensity‐modulated radiotherapy (IMRT), image fusion and image‐guided radiation therapy (IGRT) technology in Australian RT planning and delivery phases. IMRT in particular was used for 37% of patients, indicating a high uptake of the technology in Australia when compared to other published data. The results also highlight the resource‐intensive nature of benign tumour radiotherapy.ConclusionsIn the absence of routine national data collection, the single‐day census method offers a relatively convenient means of measuring and tracking RT resource utilisation. Wider use of this tool has the potential to not only track trends in technology implementation but also inform evidence‐based guidelines for referral and resource planning.
The global COVID-19 pandemic has impacted all facets of life. In medical radiation science (MRS) education, the effects on continuity of learning were felt by educators, students and clinical supervisors both nationally and internationally. The focus of this commentary is on the common elements that impacted MRS students, specifically related to cancelled clinical placements and the interruption to their academic progress at university. An outline is provided of some innovative strategies implemented by universities and clinical departments to support students' academic progress, continuity of clinical experiences, their transition from students to practitioners and overall strategies to support student wellbeing. The recent published literature illustrates novel responses to shared challenges faced, and an opportunity to learn from collective experiences.
Purpose: To investigate whether simulated learning programs can be expanded to include aspects of clinical education in medical radiation science (MRS) curricula. Methods: Information about the use and perceptions of simulation in MRS education was collected from academic, clinical and accrediting stakeholders using semi-structured telephone interviews, an online survey, invited comment and face to face consultative meetings. Participants represented the MRS sub-disciplines: Diagnostic Radiography, Radiation Th erapy, Nuclear Medicine and Medical Sonography. Th e following themes were explored with regard to simulation programs: existing, potential expansion of, eff ectiveness of and implementation. Results: Currently, simulation is widely implemented across Australia to deliver MRS curricula. Areas for potential expansion include: authentic replication of the clinical environment with facilities for video recording, fl exible multipurpose space, video demonstrations, online computer assisted tutorials, interactive programs, authentic scenarios using role play or live actors, virtual reality environments and comprehensive digital imaging libraries. Th e literature revealed no fi rm evidence that simulation training was more eff ective than clinical training. Participants in our project viewed simulation as complementary to clinical placement, but not as a replacement for the complexity of situations that clinical placement presents.Stakeholders cautioned for careful curriculum planning and evaluation when implementing simulation in MRS education. Conclusion: Th is consultative process provided a comprehensive summary of the current use of simulation in MRS and the potential for expansion with examples from the sub-disciplines. Th ere is a need for further research to investigate the eff ectiveness of simulation in clinical skills development.
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