Patterns of Practice in Canadian Radiation Treatment Centres: Results of a National Survey

Introducing operator characteristic curves to define appropriate frequency of quality control tests: A case study involving whole breast radiotherapy image guidance

“…4 shows the OC curves calculated for sampling plans reported in Refs. [6][7][8][9][10][11]; the curves are plotted against the residual probability of defective, p r , since detected positional errors are corrected when out of tolerance. Table 2 summarizes the residual probability of defectives and the level of protection offered by each plan, with β = 5%.…”

“…Conversely, most of the image guidance frequencies reported in Refs. [6][7][8][9][10][11], where between 1 and 7 fractions are imaged in a course, are vulnerable, to various degrees, to the possibility 1-3 positional errors out of tolerance to remain undetected. Table 3 shows the estimated changes to the left lung V20, the mean heart dose, and the maximum dose to 10 cm 3 of the heart when one or two positional errors < −5mm are undetected (Fig.…”

“…This is because recent surveys of image guidance across several clinics world-wide report high variation for whole breast radiotherapy image guidance schedules (typically 1-7 times over a course of 16 or 25 fractions) and technology [6][7][8][9][10][11], with a large majority of clinics comparing portal images with a reference digitally-reconstructed radiograph (DRR) [12][13][14][15]. Fortunately, surveyed institutions agree that positional errors within ± 5 mm are tolerated for whole breast radiotherapy, and errors > 5 mm require adjusting of the patient position prior to delivery of the therapy dose [6][7][8][9]. Consequently, practice guidelines still recommend that portal imaging be used for whole breast radiotherapy image guidance, but have not addressed how often should image guidance be performed, despite heart dose being a concern [16].…”

Message de la rédactrice en chef

“…Ces articles traitent des innovations qui ont lieu sur les premi eres lignes de la pratique clinique pour l'adoption transf erable dans l'ensemble de notre milieu professionnel. Les membres de l'ACTRM, particuli erement, ont adopt e ce format avec enthousiasme, en publiant sur des sujets tels que l'int egration des rôles en pratique avanc ee [2], l' etablissement d'une culture de s ecurit e en mati ere d'IRM [3] et le lancement d'un sondage canadien sur les mod eles de pratique [4]. Dans le pr esent num ero, nous pr esentons Consensus Recommendations for Developing Radiation Oncology Care Plans in the Mosaiq Oncology Information System (Recommandations du consensus pour l' elaboration de plans de soins en radiooncologie dans le syst eme d'information en oncologie Mosaiq), par Bann et coll., partageant une ebauche pour la mise en oeuvre de plans de soins dans les centres de canc erologie.…”

Message from the Editor

“…Our new Clinical and Educational Perspective formats are a great example of our focus on practice integration-ready research: these articles report on the innovations taking place at the front lines of clinical practice for transferable uptake across our professional landscape. CAMRT members in particular have been enthusiastically taking up this format, publishing on topics such as the integration of advanced practice roles [2]; building an MRI safety culture [3]; and a Canadian survey of practice patterns [4]. In this issue, we present ''Consensus Recommendations for Developing Radiation Oncology Care Plans in the Mosaiq Oncology Information System'' by Bann et al, sharing a blueprint for implementing care plans in cancer centers.…”