ESTRO 2024 - Abstract Book

S5790

RTT - Education, training, advanced practice and role developments

ESTRO 2024

UCLH, PBT, London, United Kingdom

Purpose/Objective:

Online volumetric image-guided radiotherapy (IGRT) has become a standard practice for Therapeutic Radiographers/Radiation Therapists (RTT’s) in photon beam radiotherapy [1]. There is literature addressing training and confidence levels in RTT for photon IGRT [2-4]. It demonstrates their expertise in leading or contributing to departmental protocols, including evidence review, protocol development, site-specific training, and competency programs. However, there is a scarcity of evidence regarding the involvement of RTT’s in IGRT in proton beam radiotherapy (PBT). This is of importance due to the distinct physical properties of the proton beam compared to the photon beam. Given the greater sensitivity of proton beams to small density changes along the beam path, it becomes crucial for RTTs to comprehend the specific considerations and differences in the analysis of cone beam CTs (CBCTs) in PBT. This study investigates the development and effectiveness of an IGRT workbook and CBCT case studies in enhancing the confidence of RTTs in analysing and making decisions on PBT CBCTs. The study emphasizes the importance of this training for a rotational workforce between photon radiotherapy and PBT departments. Resources available for evaluating RTT competence in reviewing PBT IGRT cases were limited so an IGRT workbook was developed specifically for the PBT department. Information within this workbook included an introduction to the differences in the physical properties and treatment plans between photon radiotherapy and PBT. It was then divided into anatomical sections covering 2D and 3D imaging considerations along with potential dosimetric impact of any anatomical changes. In conjunction with the development of the PBT IGRT training workbook and case studies, two department-approved questionnaires were created: one to be completed before receiving PBT IGRT training, and another to be completed after receiving the training. These questionnaires were developed following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidance to ensure their effectiveness and were validated by senior RTTs. RTTs accessed the questionnaires online using Google Forms. The data collected through the questionnaire was then transferred to an Excel spreadsheet and stored in a secure location. Basic statistical methods were employed to analyze the data, providing a foundational framework for understanding key patterns and trends. Material/Methods:

Results:

An 11-participant questionnaire-based study was conducted to assess pre- and post-training confidence levels in PBT IGRT following completion of a training workbook. The results show that prior to additional training, RTTs exhibited higher confidence in photon CBCT decision making over proton CBCT due to lack of experience in PBT and knowing that there are specific considerations to think about. This highlights the need for PBT-specific IGRT training when RTTs rotate into the PBT department, irrespective of prior experience. Following the completion of the IGRT workbook and case studies, all staff experienced increased confidence in analysing PBT CBCTs (Figure 1). However, the workbook was particularly beneficial for junior RTTs, while more experienced staff desired clearer guidance and real-life