Training activity information
Details
Import patient CT scans into a treatment planning system and assess the relevant parameters for RT treatment planning
Type
Entrustable training activity (ETA)
Evidence requirements
Evidence the activity has been undertaken by the trainee repeatedly, consistently, and effectively over time, in a range of situations. This may include occasions where the trainee has not successfully achieved the outcome of the activity themselves. For example, because it was not appropriate to undertake the task in the circumstances or the trainees recognised their own limitations and sought help or advice to ensure the activity reached an appropriate conclusion.
Reflection at multiple timepoints on the trainee learning journey for this activity.
Considerations
- Data transfer and networks
- DICOM
- Relevance of slice thickness
- HU to electron density conversion
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What does success look like for importing CT scans and assessing parameters for RT planning? What are the key steps and checks required to ensure accurate import and proper assessment of parameters within the treatment planning system (TPS)? How will you verify that the CT scans are correctly registered and that all relevant parameters are accurately assessed for clinical use?
- What is your prior experience with treatment planning systems and patient data handling? What do you already understand about CT scan formats, TPS functionalities, and the parameters critical for radiotherapy planning? What potential challenges might arise during import or parameter assessment (e.g., data corruption, incorrect patient orientation), and how would you handle them? When should you consult with a more experienced team member regarding data integrity or complex parameter assessment? How do you feel about working with patient data and the TPS for this critical step?
- What specific skills do you aim to develop in navigating the TPS, verifying data integrity, or critically assessing imaging parameters for planning? What insights do you hope to gain regarding the interplay between imaging, data import, and the initial stages of treatment planning?
- Are there any previous issues or best practices from similar activities that you need to consider? What important information, such as imaging protocols, patient identification details, or TPS specific guidelines, should you review?
In action
- Make a note of anything that felt surprising or different from what you anticipated, such as:
- Corrupted or incomplete DICOM data for the CT scans.
- Difficulty in importing the correct scan series or patient information.
- Unexpected artifacts in the CT images that could affect contouring or dose calculation.
- Discrepancies in image resolution, slice thickness, or field of view compared to expectations.
- Consider how this specific experience compared with previous experiences of similar activities. Was this a common issue with data transfer or a unique patient case?
- How did you react to the unexpected development? Identify how this impacted upon your actions, for example:
- Did you respond appropriately e.g., did you verify the source data, check network connections, or try alternative import methods?
- Did you adapt or change your approach to importing or assessing the parameters e.g., focusing on specific scan series, or adjusting import settings?
- Did it affect your ability to undertake the activity independently e.g., did you recognise the need to consult IT support or a senior planner?
- Consider how you felt in that moment, for example:
- Did you find it difficult to adapt? Did you feel confident in troubleshooting data import issues?
- Did it affect your confidence in assessing the suitability of the scans for treatment planning?
- Did you feel positive you could reach a successful conclusion, ensuring data integrity?
- Identify how you worked within your scope of practice to address the unexpected development. Did you ensure that any potential issues with the imported data were flagged for the planning team?
- Identify what you learnt in the moment as a result of the unexpected development e.g., a specific TPS setting, a data management protocol, or a common CT artifact and its implications.
On action
- Begin by summarising the key points of your experience importing patient CT scans into a treatment planning system and assessing relevant parameters for RT treatment planning. Consider specific events, actions, or interactions which felt important during the scan import and assessment process, including your own feelings at the time. Include any ‘reflect-in-action’ moments where you adapted to the situation as it unfolded during the import and assessment process.
- Identify what learning you can take from this experience of handling CT scans for planning e.g., what strengths did you demonstrate? What skills and/or knowledge gaps were evident? Compare this experience against previous engagement with similar scan import and assessment activities – were any previously identified actions for development achieved? Has your practice improved in handling CT scans for planning? Identify any challenges you experienced during the import and assessment process and how you reacted to these e.g., did this affect your ability to deal with the situation? Were you able to overcome the challenges? Identify anything significant about this activity of importing and assessing CT scans e.g., did you need to seek advice or clarification regarding scan parameters or the TPS? Or did you need to escalate to ensure that you were working within your scope of practice? Acknowledge any changes in your own feelings now that you are looking back on the experience of importing and assessing CT scans.
- Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learnt from this activity, including from any feedback you have received e.g., what will you do differently next time you import patient CT scans or assess parameters? Has anything changed in terms of what you would do if you were faced with a similar scan import or parameter assessment situation again? Do you need to practise any aspect of scan import or parameter assessment further?
Beyond action
- Have you reviewed the actions you identified for improvement from your prior reflections on this activity? For example, did you identify areas for improving your speed, accuracy in checking scan parameters, or understanding of data integrity? Have you completed these actions, and are you ready to consistently apply this new learning? Has discussing these experiences with others offered new insights into common pitfalls or best practices for data handling?
- Consider how this collective learning supports you in preparing for observed ‘in-person’ assessments related to treatment planning data. Reflect on how your practice in handling and assessing CT data for planning has evolved. Do you now more easily identify potential issues with scan quality or patient setup, and do you recognise when an anomaly requires input from another specialist?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 5 |
Outcome
Explain and critically analyse the use of pre-treatment and on-treatment imaging within radiotherapy. |
| # 6 |
Outcome
Develop and appraise external beam radiotherapy treatment plans for clinical use. |