The impact of an educational tool in cervix image registration across three imaging modalities

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...

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Bibliographic Details
Published in:	British journal of radiology Vol. 95; no. 1137; p. 20211402
Main Authors:	Benson, Rebecca, Rodgers, John, Nelder, Claire, Clough, Abigael, Pitt, Eleanor, Parker, Jacqui, Whiteside, Lee, Davies, Lucy, Bailey, Rachael, McMahon, John, Kolbe, Hope, Cree, Anthea, Dubec, Michael, Van Herk, Marcel, Choudhury, Ananya, Hoskin, Peter, Eccles, Cynthia
Format:	Journal Article
Language:	English
Published:	England 01-09-2022
Subjects:	Cervix Uteri - diagnostic imaging Female Humans Magnetic Resonance Imaging - methods Observer Variation Radiation Oncology Radiotherapy Planning, Computer-Assisted - methods Radiotherapy, Image-Guided - methods Uterine Cervical Neoplasms - diagnostic imaging
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0007-1285 1748-880X
DOI:	10.1259/bjr.20211402