2017_IGRT course book

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