This document discusses how a large university radiotherapy department in Belgium deals with the increasing workload from stereotactic guided radiation therapy (SGRT). It implemented a SGRT team consisting of in-field radiotherapy technologists (RTTs) and physicists to take over importing SGRT plans and defining regions of interest, as well as monitoring for problems and providing feedback. This reduces workload for physicists while improving RTT understanding and experience with the system through continuous coaching. The SGRT team acts as a bridge between physics and RTTs and lowers support needs as experience grows. Automating imports and regions of interest could further improve efficiency.

1. Dealing with SGRT Workload in a Large-Scale University
Radiotherapy Department
Dennis Konings Radiotherapy Technologist, University Hospitals Leuven, Belgium
Dennis.konings@uzleuven.be

2. How to deal with workload?
Just let someone else do it for you!

3. 2Truebeam, 1Truebeam STx, 2 Halcyon, 2 CT’s,1 IBA ProteusOne with in-room CT
2700 unique courses - 40 000 RT sessions / year
Our department

4. Implementation of SGRT
April 2018
Breast DIBH
October 2019
SBRT Lung
SRS
Extremities
Gynaeco
Breast FB
Pelvic
2020
Halcyon in-bore
DIBH
+
Monitoring
Proton
Future
More indications
Tattooless
Simulation
Patient identification
Accessory tracking

5. Workload!
0
20
40
60
80
100
120
140
160
180
200
jul
aug
sep
okt
nov
dec
jan
feb
mrt
apr
mei
jun
jul
aug
sep
okt
nov
dec
jan
feb
mrt
apr
mei
jun
jul
aug
sep
okt
2019 2020 2021
#
patients
Total SGRT imports/month
10 %
10 imports/week
48.6 %
25 imports/week
75 %
40 imports/week
0
10
20
30
40
50
60
70
80
90
100
2017 2018 2019 2020 2021 2022 2023
%
patients
Growth SGRT imports compared to % patients
2019 +305% 2020 +48% 2021

6. Let someone else do it?
SGRT team
• In-field RTT’s
• + Physicists
• Daily:
• Import of SGRT plans + defining ROI’s
• monitoring and solving of problems
• Coaching and training of RTT’s
• Provide feedback to physicist

7. Vision RT Physicist SGRT team RTT’s
Vision RT Physicist
SGRT
team
RTT’s
Support and feedback
1 1 8 40

8. • Train the trainer: in-field professionals (SGRT-team)
• Steep learning curve: need for training and insight at start SGRT
• Educate RTT’s with every new indication
• Monitor and solve problems, provide structured feedback
• Efficient workflow
• Use of digital workflow manager to optimize workflow (ex.Varian Care Path)
• Create time for import between plan approval and start RT (!urgent/late plans)
Let someone else do it! If...

9. Workflow management
(VARIAN - Care Path)

10. • Reduced workload for physicists
• Better understanding of the system by RTT’s
• In-field professionals
• Low threshold for education – support – horizontal feedback
• Continuous coaching and training
• Efficient and structured vertical feedback
• Need for support lowers when experience grows
Benefits SGRT team

11. “A SGRT-team consisting of RTT’s can be an ideal solution for
an efficient and effective continuous implementation of the
technique.
Operating as a bridge of knowledge and expertise between
the physics department and RTT department has a positive
impact when troubleshooting at time of treatment.”
Dylan Callens – Clinical Support Manager

12. Automated import
Automated ROI

13. • Questions?
• Thoughts?
Special thanks to Saskia Petillion,
Laurence Delombaerde and Robin Deroover (physicists)