Journal of Medical Imaging and Radiation Sciences最新文献

{"title":"Do years of experience influence RTTs’ intention to execute best practices?","authors":"Jennifer Dang, Tara Rosewall","doi":"10.1016/j.jmir.2026.102363","DOIUrl":"10.1016/j.jmir.2026.102363","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>The Theory of Planned Behaviour (TPB) states that behaviour is influenced by attitudes, norms, and perceived behaviour control. When combined these create intention, which has shown to be predictive of behaviour. Radiation Therapists’ (RTTs’) practice is often guided by best practice principles, however, adoption of what is perceived as best practice may not always be feasible. Herein we determine whether there are differences in five main constructs (intention, social influence, beliefs about capabilities, moral norms, and beliefs about consequences) that stem from TPB as it relates to prostate prep (bladder/bowel filling) in relation to years of work experience.</div></div><div><h3>Methods/Process</h3><div>A four-part survey hosted on Redcap was shared via email amongst RTTs and Radiation Therapy students across Canada via CAMRT membership notification blasts from March to June 2025. Part 1 included general demographics, Part 2 included aspects of the practice environment, Part 3 included perceived ‘best practice’ for prostate prep, and Part 4 included the CPD-RQ. The CPD-RQ is a validated questionnaire, based on TPB, where questions are grouped to obtain a mean score reflective of the five main constructs. A high score (max 7) represents a positive assessment of the construct. Descriptive statistics, Pearson’s correlation coefficient, and one-way ANOVA along with a post-hoc Turkey test were used to identify any relationship between RTT intention to adopt ‘best practice’ and other constructs as well as any significant differences based on experience.</div></div><div><h3>Results or Benefits/Challenges</h3><div>A total of 228 survey responses were received. 122 RTTs completed the CPD-RQ section. The majority of respondents (97.6%) had an intention score of 5 or higher. The intention score (mean, SD) based on years of experience were: 0-10 years (6.45, 0.73), 10-20 years (6.51, 0.64), and 20+ years (6.65, 0.53) with no significant differences between the groups. The strongest correlation between intention and other constructs based on the years of experience were beliefs about capabilities (r0-10y=0.49) and moral norms (r10-20y=0.78, r20+y=0.52). The only construct that showed statistically significant difference was beliefs about capabilities which was lower for those in their second decade of experience compared to their third decade.</div></div><div><h3>Conclusions/Impact</h3><div>Responses to this questionnaire suggest that most RTTs intended to execute what they perceived to be best practice for prostate prep. The strongest factors that influenced intention to adopt best practices were beliefs about capabilities and moral norms depending on years of experience. Interestingly, beliefs about capabilities were significantly lower in the second decade of work. Thus, it is important to recognize that confidence in one’s ability may fluctuate over time, and there may be a need for additional supports to help foster RTT","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102363"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Is There a Difference’: Can Bowel Gas be Ignored in Pelvic Radiation Therapy Planning?","authors":"Esther Lo,&nbsp;Orest Ostapiak","doi":"10.1016/j.jmir.2026.102349","DOIUrl":"10.1016/j.jmir.2026.102349","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>The presence of large gas bubbles in the bowels during pelvic treatment can lead to an unreliable prediction of dose to target volumes and organs-at-risk (OARs). Current practice at our centre involves overriding the gas volume with a water-equivalent unit density; and the efficacy of using this strategy is typically evaluated against not using it as per most literature. However, whether density override (DO) is an acceptable method to use in the first place is not explored in detail. This study investigated whether the use of DO in a planning CT (pCT) is adequate for predicting the total dose when bowel gas status changes on a weekly basis in pelvic cancer patients.</div></div><div><h3>Methods/Process</h3><div>The retrospective study included 10 pelvic cancer patients who had large gas bubbles near targets in successive fractions. Gas volumes on a pCT were overridden with ‘water’ (DO of 1.0g/cc). To estimate the effect of gas during treatment, density overrides were applied to the pCT to match the gas status in each of the 5 CBCTs acquired weekly throughout the patient's treatment. The plans representing each week of treatment were summed, and data for dose received by the PTV including D98%[cGy], D2cc[cGy], and Dmean[cGy], and by the OARs, being D2cc[cGy] for the rectum, bowel, and bladder (BLAD D2cc[cGy]), were compared with the original pCT. Statistical analysis was performed using a Wilcoxon signed-rank test.</div></div><div><h3>Results or Benefits/Challenges</h3><div>A positive percentage difference indicates that the delivered dose was greater than the planned dose. This was the case for the PTVs and OARs, but only PTV D2cc[cGy] (p=0.02), PTV Dmean[cGy] (p=0.02), and BLAD D2cc[cGy] (p=0.01) had statistically but not clinically significant dose differences. The increased dose received by the PTV and OARs is attributed to the reduced photon attenuation in gas. The higher dose received by the OARs on treatment could also be further dependent on the location of gas bubbles relative to the OARs, or the organs’ anatomical locations.</div></div><div><h3>Conclusions/Impact</h3><div>This study indicates that overriding the gas on the pCT does not introduce clinically significant errors in dose metrics compared to an approach where the gas is correctly represented over 5 fractions.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102349"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of the Radiation Assistant Role During a Health Human Resource Crisis","authors":"Claire-Marie Peck,&nbsp;Catherine Vanderwater","doi":"10.1016/j.jmir.2026.102456","DOIUrl":"10.1016/j.jmir.2026.102456","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The Hudson Regional Cancer Program (HRCP) in the Simcoe Muskoka Region provides comprehensive Cancer Care to residents of Simcoe County, the District of Muskoka and surrounding areas. In 2023, the Program experienced significant staffing challenges for Radiation Therapists (MRTT) with 10 vacant positions. HRCP treats 100-115 patients per day across 4 Linear accelerators. It had become challenging to treat the sustained volume of patients, given the health human resource (HHR) challenges. Temporary solutions were operationalized to alleviate staffing pressures, such as pausing non-essential project/ site team/ research activities, completing final treatments for non-urgent patients over the weekend with on-call MRTs, and delaying patients 1-2 days beyond their Ready-to-Treat deadline. These strategies provided a temporary relief valve to address some of these challenges. Despite these temporary measures, the HHR were not adequate to address the existing volume demands. As a result, the RT (Radiation Therapy) Assistant role was introduced. This role was modeled similarly to the existing MRI (Magnetic Resonance Imaging) Assistant Role and was offered to university students in health-related programs. The RT Assistants aided Radiation Therapists by conducting new patient orientation, confirming required treatment prep with patients, relaying questions and concerns to the MRT staff, moving patient equipment and accessories, unit restocking, navigating scheduling concerns with patients, and assisting with patient transfers. The role evolved to support all areas of Radiation Treatment including, treatment unit staff, CT sim, dosimetry, physics, nursing, and scheduling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the perceptions and satisfaction of the RT Assistant role at the Hudson Regional Cancer Program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methodology&lt;/h3&gt;&lt;div&gt;Forty-one Radiation Therapists were invited to participate in an anonymous satisfaction survey. Participants were asked to answer 10 questions ranging from the implementation of the role, key role responsibilities, and overall perceptions of the role. MRTT’s ranked their satisfaction using a Likert scale where 5 indicated “Strongly Agree” and 1 indicated “Strongly Disagree.” MRTT’s were given a week to complete the survey. 16 responses were collected and tabulated. A higher survey score was indicative of a greater overall satisfaction with the RT Assistant role. Conversely, a lower survey score indicated poorer satisfaction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Sixteen (39%) MRTT completed the survey. The mean overall score was 39.36 (86% Satisfaction) out of a possible 46. The maximum overall score was 45 (98% Satisfaction), and the minimum score was 35 (76% Satisfaction). Key findings from the survey: When asked how the Radiation Therapists felt about the RT assistant role at its initiation, there was a divide between a positive implementation (44%) and neither a positive ","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102456"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Pilot to Practice: Radiation Therapist–Driven Integration of AI Auto-Contouring into Treatment Planning from an eHealth Perspective","authors":"Jeeun An,&nbsp;Orest Ostapiak","doi":"10.1016/j.jmir.2026.102350","DOIUrl":"10.1016/j.jmir.2026.102350","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Artificial intelligence (AI) auto-contouring tools are increasingly available in radiation therapy planning; however, translating these technologies into safe, sustainable clinical practice remains challenging. This practice innovation initiative aimed to move beyond pilot evaluation and integrate AI auto-contouring into routine treatment planning through a clinician-led, evidence-informed workflow, with emphasis on performance variability, user resistance, and adaptive quality assurance (QA).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;A departmental QA pilot evaluated AI-generated contours across pelvic disease sites. Evaluation included comparison of contouring time between manual and AI-assisted workflows, qualitative rating of contoured structures, clinician willingness to adopt AI-assisted contouring, documentation of clinical experience, and structured user feedback. Rather than emphasizing formal accuracy validation, the pilot focused on identifying systematic error patterns, workflow disruption points, and usability considerations. Findings informed iterative workflow refinements, including earlier AI integration at CT simulation, development of site-specific structure templates, and scripting tools to reduce editing burden for nodal target volumes. Conservative QA strategies were initially introduced; however, ongoing evaluation demonstrated that some steps increased workflow burden and reduced compliance. QA processes were therefore adapted to align with existing professional review responsibilities, supported by targeted training and continuous feedback. Systemic AI contouring errors identified during implementation were communicated to users and escalated for vendor feedback.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Benefits included improved planning efficiency in selected contexts, particularly for structures with higher image contrast and less complex anatomy, as well as increased standardization of contour quality through reduced inter-user variability. Adoption and perceived benefit were greater among less experienced clinicians, suggesting a role of AI tools in supporting workforce variability and training. Team awareness of AI behaviour and limitations also improved. Challenges included increased contouring time for complex target volumes, particularly nodal chains requiring extensive slice-by-slice editing, and user resistance to added workflow steps such as additional image transfers and explicit QA labelling of AI-generated structures. QA workload was redistributed rather than eliminated, reinforcing the need to mitigate automation bias through clinician education, awareness of AI limitations, and ongoing professional review. Leadership support required sustained real-world evidence and iterative refinement prior to broader expansion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;This initiative demonstrated that successful AI implementation depends on clinician-led govern","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102350"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Numbers: MRT Voices and Management Data Reveal Workforce Realities","authors":"Charlene S. Song,&nbsp;Mark Given,&nbsp;Mikki Campell","doi":"10.1016/j.jmir.2026.102410","DOIUrl":"10.1016/j.jmir.2026.102410","url":null,"abstract":"<div><h3>Purpose</h3><div>Integrates findings from the 2024 MRT Workforce Survey and the 2025 HHR Survey to highlight workforce pressures and inform policy for sustainability.</div></div><div><h3>Methods</h3><div>Dual-survey design: management vacancy/attrition metrics (4216.78 FTEs across Canada) and MRT mixed-methods survey with thematic analysis.</div></div><div><h3>Results</h3><div>Management-reported vacancy rates 8.4%–16.6%; attrition 5.98%–20.45%. MRT themes: lack of support, increased workload, chronic short staffing, physical/mental strain, and adaptation to facility/technology change.</div></div><div><h3>Conclusion</h3><div>Findings indicate systemic, multifactorial workforce strain; coordinated planning and targeted supports are needed, alongside stronger longitudinal data collection.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102410"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enabling Interoperability and Safety in Radiation Therapy: Transitioning from IEC 60601 to IEC 61217","authors":"Edwin Chan,&nbsp;Stephanie Sae,&nbsp;Daria Comsa,&nbsp;Erin Barnett","doi":"10.1016/j.jmir.2026.102389","DOIUrl":"10.1016/j.jmir.2026.102389","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Standardized spatial definitions are essential for safety, reproducibility, and interoperability in external beam radiation therapy. Beam geometry, patient positioning, imaging orientation, and treatment couch motion are defined using either the legacy IEC 60601 or the modern IEC 61217 coordinate systems. As clinical workflows increasingly rely on integrated, multi-vendor software, automation, and data exchange, IEC 60601 has become incompatible with some modern systems and upgrades. Mixed coordinate systems use or reliance on conversion logic can introduce data inconsistencies, workflow inefficiencies, plan incompatibilities and patient safety risks. In 2025, a major linac vendor issued a safety communication highlighting hazards associated with mixed coordinate systems. This work describes a structured, multi-phase institutional transition to IEC 61217, emphasizing clinical workflow continuity, data integrity, interoperability, and risk mitigation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;At project initiation, four linac operated with MOSAIQ 3.1.3 (IEC 61217 display) and Pinnacle (IEC 60601). A 16-month phased transition was designed to maintain clinical capacity and mitigate risks from mixed coordinate systems. Phase 1 coincided with the go-live of RayStation (IEC 61217) and fifth linac, which was commissioned under the new system. One existing linac was converted with only 6 MV beams. Legacy plans were reassigned to compatible linacs to avoid mid-course replanning, while new genitourinary (GU), lower gastrointestinal (GI), and palliative VMAT cases were created using RayStation. Staff training ensured familiarity of the new coordinate conventions. Phase 2 involved conversion of a second linac and commissioning 15MV beams, enabling transition of breast, lung, and upper GI treatments. The final phase, scheduled for April 2026, will convert the remaining two linacs with HexaPOD couches, commissioning 18 MV and 6 FFF beams, and transitioning all SBRT sites. Treatment schedules are coordinated to ensure patients complete therapy prior to conversion or initiate afterward, with limited mid-course replanning. Acceptance testing and comprehensive end-to-end validation are performed at each phase to confirm geometric accuracy, data integrity, and safe clinical operation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Implementation of an aligned linac-TPS framework (i.e. converted linac with RayStation plan using IEC 61217) reduced geometric ambiguity and minimized the risk of setup and delivery errors. From MOSAIQ upgrade to IEC 61217 display, it led to therapist process change of Isocentre shifts using “couch shift direction” from TPS as opposed to Isocentre shifts that were performed based on patient anatomy. Transitioning our couch coordinate systems from IEC 60601 to IEC 61217 to align with MOSAIQ display avoid confusion regarding couch motion. The phased approach maintained clinical throughput, with","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102389"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Identification and Support for Anxiety for Patients using Thermoplastic Immobilization","authors":"Riya Patel,&nbsp;Merrylee McGruffin,&nbsp;Darby Erler,&nbsp;Madette Galapin","doi":"10.1016/j.jmir.2026.102366","DOIUrl":"10.1016/j.jmir.2026.102366","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Patients undergoing radiation treatments for head and neck cancers often require thermoplastic masks to ensure treatment accuracy. While essential for precise delivery, mask immobilization can cause anxiety among many patients, with approximately one in four patients reporting clinically significant distress. Mask-related anxiety can also result in prolonged setup time and missed treatments. Traditional management strategies have largely relied on pharmacological interventions; however, this may not always be an option due to contraindications, personal preferences or logistical concerns. The aim of this project was to explore non-pharmacological anxiety management interventions and enhance the radiation therapist’s (RTT) confidence in providing these strategies to patients with mask-related anxiety.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;A needs assessment survey was conducted to identify the proportion of patients experiencing mask-related anxiety, as well as understanding patient needs for coping strategies. RTT confidence in providing management strategies to patients with mask-related anxiety was measured through pre- and post-intervention surveys. Three key interventions were introduced: a standardized anxiety screening tool embedded into the new patient teaching workflow to enable early identification of patients experiencing mask-related anxiety; RTT education sessions emphasizing mindfulness-based techniques (MBT) and practical communication strategies to support anxious patients; and lastly, a patient facing resource providing accessible, evidence-based mindfulness exercises and coping strategies tailored for patients with a thermoplastic mask. Feedback for all three interventions were taken through post-intervention RTT surveys and patient feedback forms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;The implementation of early anxiety screening and non-pharmacological interventions offered a variety of benefits, including improved identification of at-risk patients and increased RTT knowledge of MBT to address mask-related anxiety. Challenges of this project included variability in baseline RTT staff confidence levels, time constraints within busy clinical workflows, and ensuring consistency in the application of MBT amongst the planning and treatment teams. Integrating the new tools into established practice standards relied on sustained collaboration and leadership support.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;RTT engagement during the education sessions demonstrated a strong appetite for learning alternative management strategies for mask-related anxiety. Following implementation, staff confidence in providing management strategies to patients with mask-related anxiety increased from 37.9% to 87.8% post-education. The anxiety screening tool has since been embedded into routine clinical workflow, the educational materials are available for RTT onboarding and continuing edu","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102366"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Scripting-Based Approach to Standardizing and Streamlining Palliative Treatment Planning","authors":"Tyler Pestill","doi":"10.1016/j.jmir.2026.102353","DOIUrl":"10.1016/j.jmir.2026.102353","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>Following a transition to a new treatment planning system in December 2024, planners at our institution encountered limitations within the native protocol framework, particularly its rigidity with respect to varying dose fractionation schemes. Manual adjustment of clinical goals and optimization objectives was occasionally required, introducing workflow inefficiencies and potential sources of error. This project aimed to develop a flexible, scripting-based automation tool to standardize and streamline palliative treatment planning while improving efficiency, accuracy, and consistency.</div></div><div><h3>Methods/Process</h3><div>A graphical user interface (GUI) was developed using the treatment planning system’s Python application programming interface. The GUI allows planners to manually enter the plan name, target ROI, total dose, fractionation, and beam isocenter, supporting POP and VMAT beamsets. For POP plans, the GUI collects the ICRU point, target ROI, and multileaf collimator margin. For VMAT plans, it collects the number of arcs, gantry rotation direction, and start/stop angles. Upon submission, the script automatically generates the treatment plan and beamset, applies standardized TG-263–compliant nomenclature, and populates clinical goals based on a palliative template. Required inputs such as CTV/PTV and isocenter points are validated, and clinical goals are assigned only to existing ROIs; OARs are incorporated if present. The system supports adding multiple treatment sites or techniques as beamsets within a single plan for composite review.</div></div><div><h3>Results or Benefits/Challenges</h3><div>This tool reduces manual data entry and eliminates the need for multiple fractionation-specific protocols, decreasing the risk of errors while preserving planner oversight. Automated scaling of clinical goals ensures consistency across plans, even when prescriptions differ from standard dose schedules. The GUI interface enables planners without scripting expertise to efficiently generate plans while retaining flexibility for additional optimization or segment editing. Challenges included ensuring robustness across variable structure sets, which was addressed through conditional logic and user override options.</div></div><div><h3>Conclusions/Impact</h3><div>Currently used for palliative planning, where time-sensitive sim-and-treat workflows are common, the system can generate clinically appropriate, TG-263–compliant plans in under 15 minutes from receipt of target contours. The tool standardizes nomenclature and goal scaling, improves efficiency and confidence, and supports multiple treatment sites within a single plan. Physics validation is in progress in order to confirm safe application for wide-scale planner use, and the approach provides a scalable framework for broader adoption in similar clinical settings.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102353"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying Non-Clinical Activities of CSRTs/APRTs: A Data-Driven Approach within a Canadian Community of Practice in Canada","authors":"Saher Ali,&nbsp;Carrie Lavergne,&nbsp;Natalie Rozanec,&nbsp;Grace Lee,&nbsp;Henna Parmar","doi":"10.1016/j.jmir.2026.102359","DOIUrl":"10.1016/j.jmir.2026.102359","url":null,"abstract":"<div><h3>Purpose/Aim</h3><div>Clinical Specialist Radiation Therapists (CSRTs) and Advanced Practice Radiation Therapists (APRTs) contribute significantly to system improvements for cancer care by providing direct clinical care to patients while also contributing extensively to research, education, and quality improvement projects (QI). Although code capture systems have been developed to quantify clinical and technical impact, there are no standardized methods to track non-clinical workload contributions. To address this gap, the CSRT Community of Practice (CoP) launched an initiative to develop a systematic approach for capturing these activities, to support workforce advocacy, enhance collaboration, and inform CSRT/APRT role development.</div></div><div><h3>Methods/Process</h3><div>In late 2024, a survey of CoP members revealed that 100% of respondents (n=20) participated in non-clinical activities, including research, education, QI, and protocol revisions/development. Using the CAMRT APRT(T) competency profile, four domains were defined: leadership, education, research, and process improvement/best practice. Ten unique roles that further capture and describe the scope of non-clinical contributions were identified based on the CRediT taxonomy, and a template was developed. This framework and tracking template were shared with members for quarterly reporting.</div></div><div><h3>Results or Benefits/Challenges</h3><div>Initial submissions in early 2025 were limited due to the time-consuming nature of retrospective tracking and the unfamiliarity with the templates. Revisions were made to reduce barriers to submission, including a more user-friendly template and a how-to guide with examples. Along with transitioning to prospective tracking, these modifications improved engagement and increased reporting of diverse projects and roles. Using a Plan-Do-Study-Act (PDSA) methodology, the framework and definitions are refined quarterly to capture the breadth of activities.</div></div><div><h3>Conclusions/Impact</h3><div>By the end of 2025, participation peaked at 15 of 27 members, and the CoP continues to encourage further involvement. Systematic collection of non-clinical workload data offers a clearer understanding of the breadth and depth of CSRT/APRT roles beyond direct patient care. Future collection, analysis, and reporting of these findings will better inform workforce planning and may strengthen advocacy for funding. This standardized approach also fosters collaboration between CoP members, supports individuals developing their portfolios for advanced practice qualifications, and demonstrates the broader value of non-clinical contributions to healthcare systems.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102359"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Radiation Therapist Experience with CBCT-Guided Adaptive Radiation Therapy","authors":"Michael Velec,&nbsp;Vickie Kong,&nbsp;Samuel Appiah,&nbsp;Devin Hindle,&nbsp;Paul Kwan,&nbsp;Michelle Lara,&nbsp;Natassia Naccarato,&nbsp;Sidney Phung,&nbsp;Michael Sung,&nbsp;Lian Velasco,&nbsp;Alan Wong,&nbsp;Grace Wu,&nbsp;Simon Xie,&nbsp;Teuta Zoto Mustafayev,&nbsp;Dana Keilty,&nbsp;Monica Serban","doi":"10.1016/j.jmir.2026.102351","DOIUrl":"10.1016/j.jmir.2026.102351","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose/Aim&lt;/h3&gt;&lt;div&gt;Adaptive radiation therapy (ART) enables precise management of complex organ motion and tumour response, potentially improving patient outcomes. Online ART is resource-intensive and requires radiation therapists (RTs) to develop technical competencies across treatment planning, delivery, and in some workflows, target segmentation. This work outlines our experience implementing ART and developing RT skills for safe, efficient clinical application.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods/Process&lt;/h3&gt;&lt;div&gt;Our institution implemented ART using a dedicated planning platform with a ring-based linear accelerator (Ethos, Varian Medical Systems). The system supports cone beam CT (CBCT)-guided online and offline ART with AI-assisted contouring and automated planning. Initial implementation and training were multidisciplinary, including 6 RTs. Daily online ART delivery followed a collaborative team model with RTs, a physicist, a radiation oncologist, and a dedicated radiation oncology fellow. The same RTs delivering ART also generated the initial reference plans. Training included system operation, anatomy and segmentation, reference planning, and online ART workflows. To support and evaluate training, we developed an ART-specific competency framework by adapting 27 competencies from the national RT entry-to-practice profile, which does not explicitly address ART. Competency validation was based on RT self-assessment after training and two months of clinical experience. RT training evaluation and skill development were conducted as an approved quality improvement initiative (QI #25-1064). Initial ART cases included genitourinary and sarcoma sites, with additional sites added as experience grew.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results or Benefits/Challenges&lt;/h3&gt;&lt;div&gt;Over 12 months, 13 RTs were trained in ART delivery and reference planning. To date, 126 patients have been planned and treated in the system: 41 sarcoma, 41 genitourinary, 16 upper gastrointestinal, 8 gynecologic, 7 head-and-neck, 5 other, and 8 palliative cases using a CTsim-free technique. Of these, 92 received daily online ART, while 20 underwent offline replanning, mostly using CBCT directly rather than a new CTsim. RTs reported increased competency across all domains after two months. Skills in reference planning increased to an intermediate level, requiring occasional support and skill development, especially among RTs without prior dosimetry experience. This did not significantly affect online ART delivery due to the team-based model. Challenges included the steep learning curve for complex cases, managing different techniques for multiple disease sites, adapting to a new planning system with distinct workflows, and initially low case volumes limiting hands-on experience.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions/Impact&lt;/h3&gt;&lt;div&gt;CBCT-guided ART has been successfully implemented across multiple disease sites through an online, multidisciplinary model involving RTs, physicists, and oncologists.","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"57 4","pages":"Article 102351"},"PeriodicalIF":2.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148566004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}