The introduction of MR-Linacs allows for daily adaptive radiotherapy based on MR imaging. This allows the treatment plan to be modified to the patient’s anatomy at each fraction. This process condenses the usual days to weeks long planning workflow into minutes. Therefore, all the usual staff groups represented in the planning workflow have historically been required at the treatment console. This is resource intensive and logistically challenging for services that span multiple locations. This study presents a RO-Lite workflow whereby only radiation therapists are present...

Multidisciplinary team meetings were held to determine appropriate tumour groups for the RO-Lite workflow. A credentialing program was developed for RT training and sign off. The experiences of other Elekta Unity clinical sites shaped the development of our credentialing framework1. Decision trees and tolerances were also determined via workshops and historical data. Elekta Unity has 2 workflow options, fully adaptive adapt to shape (ATS) and virtual isocentre shift adapt to position (ATP). ATS consists of a complete plan adaption with contouring and plan approval by...

Since the implementation of RO Lite, 4 patients were eligible, and 3 patients have had the RO-Lite workflow applied to their fractions. One patient was excluded as RO had strict organ at risk sparing constraints that required the ATS workflow daily. From our initial experiences thus far, this study has indicated that not all fractions are suited for the RO-Lite workflow. Approximately 44% (12/27) of fractions that are eligible for the RO-Lite workflow have been successful in completing a full RT-led ATP workflow. The main...

Given how resource intensive the conventional ATS workflow is for the radiation oncologist, initial indications are that the RO-lite workflow is effective in reducing the workload on the radiation oncologist whilst simultaneously improving on-bed time for the patient when applied successfully. However, it is acknowledged that the data gathered so far is preliminary given that the RO-Lite workflow has only recently been introduced. It will be worth revisiting this study after more patients have had the RO-Lite workflow attempted.

Hales, R.B. Therapeutic Radiographers at the Helm: Moving Towards Radiographer-Led MR-Guided Radiotherapy. Journal of Medical Imaging and Radiation Sciences 2020 [cited 2021 March17]; 51(3). Available from: https://www.jmirs.org/article/S1939-8654(20)30066-7/fulltext