2017_IGRT course book

Offline decision making for CBCT verification Prostate and nodes

NB All operators must have completed competency assessment (S-WB-019) to carry out prostate soft tissue matching. It may be necessary for clinical lead or urology clinician to review imaging offline.

Review rectum and bladder status

Discuss with patient and check correct used of rectal preparation (as per J-CH-059). Record rectal status on S-RT- 083-02.

Is rectum ≥50% different from planning scan?

YES

NO

Record ‘Rectal status ‘good ’ on log S-RT-083-02

Under-filled: Encourage hydration.

Over-filled: Discuss bladder preparation (J-CH-053-02) with patient. If consistently over-filled discuss with clinical team. Record ‘under or over-filled bladder’ on XVI log S-RT- 083-02.

YES

Is bladder over or under-filled?

NO

Figure 1 : Planning scan (top) showing large gas filled rectum. CBCT (bottom) showing smaller, stool filled rectum on treatment (~50% smaller).

Record ‘Bladder status good ’ on XVI log S- RT-083-02

S-CH-364

Courtesy of Steven Landeg, RMH