Department of Radiotherapy, The Christie Hospital NHS Trust, Manchester, UK.
Department of Clinical Oncology, The Clatterbridge Cancer Centre, Liverpool, UK.
Br J Radiol. 2022 Sep 1;95(1137):20211402. doi: 10.1259/bjr.20211402. Epub 2022 Jun 9.
Accurate image registration is vital in cervical cancer where changes in both planning target volume (PTV) and organs at risk (OARs) can make decisions regarding image registration complicated. This work aims to determine the impact of a dedicated educational tool compared with experience gained in MR-guided radiotherapy (MRgRT).
10 therapeutic radiographers acted as observers and were split into two groups based on previous experience with MRgRT and Monaco treatment planning system. Three CBCT-CT, three MR-CT and two MR-MR registrations were completed per patient by each observer. Observers recorded translations, time to complete image registration and confidence. Data were collected in two phases; prior to and following the introduction of a cervix registration guide.
No statistically significant differences were noted between imaging modalities. Each group was assessed independently pre- and post-education, no statistically significant differences were noted in either CBCT-CT or MR-CT imaging. Group 1 MR-MR imaging showed a statistically significant reduction in interobserver variability (=0.04), in Group 2, the result was not statistically significant (=0.06). Statistically significant increases in confidence were seen in all three modalities (≤0.05).
At The Christie NHS Foundation Trust, radiographers consistently registered images across three different imaging modalities regardless of their previous experience. The implementation of an image registration guide had limited impact on inter- and intraobserver variability. Radiographers' confidence showed statistically significant improvements following the use of the registration manual.
This work helps evaluate training methods for novel roles that are developing in MRgRT.
在宫颈癌中，准确的图像配准至关重要，因为计划靶区（PTV）和危及器官（OAR）的变化可能使图像配准的决策变得复杂。本研究旨在确定专用教育工具与在磁共振引导放射治疗（MRgRT）中获得的经验相比的影响。
10 名治疗放射技师作为观察者，根据他们以前的 MRgRT 和 Monaco 治疗计划系统的经验分为两组。每位观察者对每位患者完成了三次 CBCT-CT、三次 MR-CT 和两次 MR-MR 配准。观察者记录了平移、完成图像配准所需的时间和信心。数据在引入子宫颈配准指南前后分两个阶段收集。
在成像方式之间未观察到统计学上的显著差异。在教育之前和之后，分别对每组进行评估，在 CBCT-CT 或 MR-CT 成像中均未观察到统计学上的显著差异。组 1 的 MR-MR 成像显示观察者间变异性有统计学显著降低（=0.04），而组 2 的结果无统计学意义（=0.06）。在所有三种模态中，信心均有统计学显著提高（≤0.05）。
在 The Christie NHS Foundation Trust，放射技师始终能够在三种不同的成像方式下注册图像，无论他们以前的经验如何。图像配准指南的实施对观察者间和观察者内变异性的影响有限。在使用配准手册后，放射技师的信心显示出统计学上的显著提高。
这项工作有助于评估在 MRgRT 中发展的新角色的培训方法。
