ESTRO course on Image Guided Radiotherapy in Clinical Practice 2018

Significant shape change

Bladder too big

No plan provides appropriate coverage

Shape change due to bladder overfilled

Shape change due to rectal filling (flatus/faeces)

Remove patient from couch, void bladder, repeat drinking protocol but review i) volume of fluid drank and or ii) reducing time to image acquisition (<30mins), iii) ensure appropriate clinical assessment is made and that patient is not developing toxicity necessitating intervention and preventing from appropriate voiding