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dc.contributor.advisorLouwe, Robert J. W.
dc.contributor.advisorHerst, Patries
dc.contributor.advisorKane, Paul
dc.contributor.authorMoore, Sarah
dc.date.available2015-07-06T20:41:23Z
dc.date.copyright2015
dc.identifier.citationMoore, S. (2015). Review of a multidisciplinary team approach to patient positioning in head-and-neck cancer: a quantitative analysis (Thesis, Bachelor of Radiation Therapy with Honours). University of Otago. Retrieved from http://hdl.handle.net/10523/5772en
dc.identifier.urihttp://hdl.handle.net/10523/5772
dc.description.abstractAccurate patient positioning is extremely important in radiation therapy for head-and-neck cancer. With the introduction of three-dimensional cone beam computed tomography (CBCT) at the Wellington Blood and Cancer Centre (WBCC), it was agreed that positioning accuracy required improvement. This led to the establishment of a multidisciplinary team (MDT) focused on patient positioning. Following a number of process changes made by the MDT, improvements in setup accuracy were observed but not formally quantified. The aim of this thesis was to retrospectively quantify setup accuracy at WBCC, using CBCT images of 96 patients treated for head-and-neck cancer. On average 7 CBCT scans per patient were sequentially registered using each of the following match structures: C1-C3, C3-C5, C5-C7, C7-caudal, mandible occipital bone and the larynx. This enabled quantification of patient deformation as the measure of setup accuracy, by calculating the position of each structure relative to C1-C3. Statistical Process Control (SPC) was then used to assess trends in setup accuracy over time, allowing identification of specific time points where improvements occurred and correlation with process changes to be made. The multiple rigid registration protocol and deformation values calculated for this patient cohort clearly demonstrated the relative movement of anatomical sub regions in the head-and-neck. SPC charts showed that a significant and consistent reduction in deformation was achieved since the instigation of the MDT. A reduction in the magnitude and variation of the patient systematic 3D-deformation vector was observed, from 2.8 mm ± 0.1 mm (1 S.D.) in 2011 to 0.9 ± 0.0 mm (1 S.D.) in late 2013/early 2014. Statistical correlation analysis revealed that the introduction of new head supports (p = 0.003), as well as retraining of staff in making immobilisation equipment (p = 0.003) had a significant impact on patient systematic deformation. Both of these changes were actions initiated by the multidisciplinary team, which shows that a multidisciplinary approach to patient positioning had a positive impact on setup accuracy in our department.
dc.format.mimetypeapplication/pdf
dc.language.isoen
dc.publisherUniversity of Otago
dc.rightsAll items in OUR Archive are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
dc.subjectradiation therapy
dc.subjectradiotherapy
dc.subjectquality management
dc.subjectstatistical process control
dc.subjecthead and neck
dc.subjectpatient positioning
dc.titleReview of a multidisciplinary team approach to patient positioning in head-and-neck cancer: a quantitative analysis
dc.typeThesis
dc.date.updated2015-07-06T04:32:38Z
dc.language.rfc3066en
thesis.degree.disciplineRadiation Therapy
thesis.degree.nameBachelor of Radiation Therapy with Honours
thesis.degree.grantorUniversity of Otago
thesis.degree.levelHonours
otago.openaccessOpen
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