ESTRO 2024 - Abstract Book

S5851

RTT - Education, training, advanced practice and role developments

ESTRO 2024

Once the training period was completed and approved by supervisors, both RTTs and a physician were required to blindly assess contours generated by the AC tool for each treatment session choosing if accepting or modifying them. The Dice Similarity Coefficient (DSC), and the 95%-Hausdorff Distance (HD) were used to assess the differences between RTTs and physician contours. Similarly, each participant was asked to independently evaluate the plans provided by Ethos and determine their preference or whether the plans could be deemed equivalent. Cohen's coefficient (k-Cohen) was calculated to evaluate the level of agreement among physician and RTTs.

Results:

The DSC and HD values are summarized in table 1. The highest DSC agreement was observed for bladder and femoral heads, while slightly lower agreement was noted for CTV and rectum. In terms of HD analysis, excellent agreement has been found among physician and RTTs for Organs at Risk (OAR). Nevertheless, only the CTV displayed values higher than 10 mm (12.1 [6.3 - 20.2] mm).

The comparison conducted for the evaluation and decision-making process highlighted a k-Cohen value of 0.79 (154/200), indicating a quite good agreement.

Conclusion:

This study suggests that RTTs can be trained to independently manage prostate carcinoma oART workflow in both phases of contouring and plan evaluation. In this context, RTTs can develop appropriate skills to adjust automatically delineated structures before Physician review optimizing treatment timelines. This procedure, successfully implemented in other countries, has not yet been introduced in Italy, making this study particularly pertinent. Adequate training empowers RTTs to achieve a significant level of agreement with Radiation Oncologists, highlighting the feasibility of RTT-only CBCT-guided daily oART workflow for prostate cancer. Further studies will be performed expanding the cohort of patients treated with this methodology and involving additional RTTs with a longer training period in the research context.

Keywords: prostate cancer, oART, Ethos