CT Scan Planning for Radiation Therapy Clinical Outcomes
The success of cancer treatment using radiotherapy (RT) is dependent on the accuracy and quality of the design and delivery of the radiation beam. All cancer radiation treatments depend upon patient characteristics and need to be individualised for each patient. To improve upon the targeting of the cancer and limitation of unnecessary irradiation of normal tissues, the initial design or planning of the RT is vital.
Improvements in digital technology have allowed medicine to utilise the images taken from diagnostic imaging (CT, MRI, PET scans) and incorporate them into the radiation therapy equipment. This allows accurate planning of RT and individualisation of therapy for each patient1.
Although some radiation treatments only require more simple design (2D planning), the majority of treatments will benefit by sophisticated CT guided 3D planning. In a busy radiation therapy department 3D CT scan planning is more resource-intensive, but it does improve the quality of radiation therapy delivery.
3D CT scan Planning Rate as Radiation Oncology Clinical Quality Indicator
The Australian Council of Healthcare Standards (ACHS)2 has emphasised the importance of quality delivery of radiation therapy by implementing the rate of 3D CT scan Planning as a national clinical quality indicator. ACHS recognizes that poor access to CT planning facilities will lead to delays and inferior treatment and this rate is audited across Australia. The indicator is a reflection of quality technique in radiation therapy and demonstrates that patients are managed with excellent standards.
At NCIS, it is recognised that 3D CT scan planning should be undertaken for the majority of cancer sites especially in the curative treatment of breast, lung, gastro-intestinal and CNS tumours. Although some patients with cancers involving the arm/leg or skin cancer will not require CT scan planning, a general target of over 70% of patients is sought.
Definition (ACHS 2002)
CT planning refers to any Computed Tomography simulator (CTSim or SimCT) capable of scanning in the treatment position and interfacing with a Radiotherapy Treatment planning system. The rate is defined as the percentage of treatment courses where CT planning was utilised compared to the total number of external beam treatment courses undertaken.
Figure 1 : CT Simulator; CT scan simulation of patient for radiation therapy; and 3D
radiation plan produced by CT Planning
3D CT scan Planning Rate at NCIS Radiation Oncology
Figure 2 : Percentage rate of 3D CT Planning compared with Aust ACHS data2.
Conclusion
In NCIS, the rate of 3D CT cancer planning is 77%, which is equivalent to the Australian Council of Healthcare Standards (ACHS) outcomes from Australian units. This confirms the quality design of radiation therapy at NCIS.
Footnotes
1. Aird E and Conway J. CT simulation for radiotherapy treatment planning British Journal of Radiology, 75 (2002), 937–949
2. ACHS Clinical Indicator Results for Australia and New Zealand 1998 – 2004: Determining the Potential to Improve Quality of Care 6th Edition. ACHS Ultimo NSW November 2005
This material does not cover all information and is not intended as a substitute for professional care. Please consult your physician on any matters regarding your health.
