Session Item

Surface guided Radiotherapy (SGRT) is more and more used in radiation therapy. With SGRT a marker less patient’s workflow can be implemented in a radiotherapy center and will give patients more comfort during their treatments, skin marks should no longer be placed. The implementation of SGRT in a Radiotherapy Network Centre with 4 radiotherapy sites and 9 linear accelerators can be quite challenging. This work demonstrates the steps adopted in our Network for the implementation of a SGRT system and the progressive transition to a marker less Radiotherapy with the use of a “Superusers” Team.

In October 2020 we have started the implementation of C-Rad Surface Guided Radiotherapy system in our Radiotherapy Network Center. We began with a “Superusers” Team - a selected group of 5 RTTS and 3 physicists with previous extended experience on SGRT/ tattoo less. The implementation of SGRT was progressive and included: I) Superusertraining by cRAD II) Training of the “Superusers” team at one linear accelerator in order to evaluate current used methods, identify bottlenecks and troubleshooting and create a new uniformized workflow III) Introduction of table parameters, since the Surface scanning system can only give accurate measurements with object within 5 cm of targeted position IV) Going Marker less meaning new patients had no tattoos workflow V) Create support materials, such as the positioning and procedure manuals. VI) Train the RTT’s. A SWOT analyze (see fig 1) was done by the superuserteam, our management and cRAD.

From SWOT analyze, we see that the use of a Superuser team concept has helped with the fast implementation of marker less SGRT based positioning workflow and especially in a period of Covid-19. In one year, we have implemented SGRT in 3 radiotherapy sites totaling 7 linear accelerators and 25 trained RTTs. The more RTTs were trained and used to the new workflow, time of implementing in a new machine became shorter. At the time of writing, more than 75% of the treated population is in a tattoo less workflow. (See fig 2)

The use of the Superusers principe has allowed the implementation of marker less SGRT based positioning workflow in a one-year period at 3 radiotherapy sites totaling 7 linear accelerators and 25 trained RTTs.