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Comparative Study
. 2015;88(1055):20150586.
doi: 10.1259/bjr.20150586. Epub 2015 Aug 18.

A prospective study comparing radiographer- and clinician-based localization for patients with metastatic spinal cord compression (MSCC) to assess the feasibility of a radiographer-led service

Craig Lacey  1 , Clare Ockwell  1 , Imogen Locke  1 , Karen Thomas  2 , Julie Hendry  3 , Helen McNair  4
Affiliations
Comparative Study

A prospective study comparing radiographer- and clinician-based localization for patients with metastatic spinal cord compression (MSCC) to assess the feasibility of a radiographer-led service

Craig Lacey et al. Br J Radiol. 2015.

Abstract

Objective: To investigate whether there was parity between treatment fields localized by radiographers and clinicians, by comparing geographical variations and hence determining the feasibility of a radiographer-led service.

Methods: 23 patients with metastatic spinal cord compression (MSCC) were prospectively sampled. Four radiographers not involved in the original planning performed localization on each patient. The 92 localizations that they determined were compared with the clinician-approved fields. Agreement was defined as ≤0.5 cm between field length, width and three isocentre co-ordinates. To be feasible, agreement was required in a minimum of 97% of the cases. The potential time saved with a radiographer-led approach was also recorded.

Results: Agreement between clinicians and radiographers was 97.8%. For all field parameters, the average differences were <0.3 cm and were significantly different from the 0.5-cm median (p < 0.0001) that would establish no agreement using Wilcoxon signed-rank test. The average (range) delay awaiting clinician approval was 54 min (4-141 min).

Conclusion: Strong agreement between radiographer and clinician localizations was established. It was also highlighted that time could be saved in the patient's pathway by removing the need to wait for clinician approval. We believe this supports a radiographer-led service.

Advances in knowledge: This article is novel, as it is the first known comparison between clinicians and radiographers in the localization of MSCC radiotherapy. These data show the feasibility of introducing radiographer-led practice and a methodology that could be potentially transferred to investigate the localization parity for other treatment sites.

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Figures

Figure 1.
Figure 1.
The local metastatic spinal cord compression pathway.
Figure 2.
Figure 2.
(a) Sagittal view of field placement. (b) Axial view of field placement.
Figure 3.
Figure 3.
Difference in field width between clinician and radiographer.
Figure 4.
Figure 4.
Difference in field length between clinician and radiographer.
Figure 5.
Figure 5.
Approval time delay.
See this image and copyright information in PMC

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