Background and Aims
WNSWLHD covers a vast 247,000 square kilometres. However, radiation oncology is only available in two relatively south eastern sites: Western Cancer Centre Dubbo, and Central West Cancer Care Centre in Orange. These distances mean that a significant number of patients need to travel not only for the actual radiation treatment, but also for a separate preceding CT planning appointment. Particularly for patients with palliative intent, significant issues such as travel and transport and associated emissions, pain management and accommodation are barriers for receiving this essential treatment. A Medical Imaging Simulated Radiation Therapy (MISRT) pathway was implemented to alleviate this issue and expedite the process through the use of diagnostic images which the patient has already undergone. This quality assurance (QA) study will help give confidence in the accuracy of the different datasets from the many CT machines throughout the district.
Methods
A list of private and public medical imaging departments in the district was developed. Each department was contacted, and a remote or on-site visit was organised. An education session on the new pathway requirements was delivered and a QA phantom (GAMMEX Tissue Characterisation Phantom) was scanned. Radiotherapy dose distributions were calculated for these different scans, as well as different treatment situations.
Results
The engagement and education was well received by the different medical imaging centres. Slight differences in CT to ED data were noted due to the nature of differing CT brands and series. However these differences were within clinically acceptable ranges.
Implications or Conclusion
With existing data and protocols we feel confident any small variances are clinically insignificant and are far outweighed by the benefits this innovative pathway brings to both our rural patients and health system.