A study comparing therapeutic radiographer matching of head and neck electronic portal images using anatomy drawing tools with the oncologists' visual check of the images.
(2013) A study comparing therapeutic radiographer matching of head and neck electronic portal images using anatomy drawing tools with the oncologists' visual check of the images., no. 72.
Aim: The aim was to establish if radiographer matching of head and neck radiotherapy treatment images by drawing anatomy on the reference image and overlaying with the treatment image was comparable to a system where oncologists are emailed and visually check the treatment image against the reference image to approve or recommend action. Materials and methods: One hundred and fifty images from fifty patients (three images per patient from treatment day one, eight and thirteen) which had already been analysed by the oncologist was analysed by the researcher over a period of two months and field displacement results recorded. The method of analysis by the researcher was different as anatomy was drawn on the reference image and overlaid with the treatment image whereas the oncologists' used a visual comparison only. Approval status (less than 3 millimetres which is tolerance level) with this method was compared to the oncologists' method using the McNemar statistical test to establish if the null hypothesis of no difference was accepted or rejected. A literature search was carried out to compare radiographer reporting of images with doctors reporting of images in both therapeutic and diagnostic radiography and also to establish the need for continuing professional development (CPD) in this area. Results: Out of the 50 patients 21 (42%) had all images approved by the radiographer in contrast to 37 (74%) all approved by the oncologists. Out of the 150 images matched the radiographer approved 97 (65%) of these, whereas the oncologist approved 135 (90%). The Chi Square value was calculated to be 29.76, therefore the null hypothesis was rejected. More images were found to be out of tolerance on the anterior/posterior direction than the craniocaudal direction. There was no significant difference found in relation to fraction number and approval status. Conclusion: The null hypothesis was rejected, meaning that there was a significant difference in approval status between radiographer matching of head and neck images using anatomy drawing tools and the oncologists' visual check before approval. Only the approval status of the images could be statistically compared. The results only reflected the study in question as it was a comparison of methods used, not just of professions involved. The study highlighted that although oncologists may be responsible for approval of head and neck images in this particular department, that radiographers take initiative and communicate image problems regularly. This could be improved further with training and image competencies in offline head and neck anatomy matching, and a system of commenting to oncologists when radiographers know through this method that the image is out of tolerance. This method would be similar to that recommended in current literature in diagnostic radiography where the radiographer comments on the image before it is passed to the radiologist.