Patient Attire
True or False: Patients need to take shoes off for lower vaclok
True
If a CBCT is rejected for patient's treatment, what are the next steps.
Page MD to machine for review the following day.
True or false: The entire block shape and patient positioning must be approved prior to delivering patient's first treatment fraction.
True or False: Pt is having brain SBRT and is on their third fraction. Physics must be present.
False, physics must be in building, MD required for image review only.
True or False: Pelvis patients must change into a gown.
False- pants to knees
Patient is receiving 220cGy to her spinal cord. The shifts are as follows:
Left 1.9cm
Ant 1.5cm
Inf 1.6cm
Roll: 2.5cm
Pitch: 2.9cm
Rotation: 1.7cm
Do we need to reimage?
No, all shifts are under 2cm and 3* rotationally
True or False: If you are running behind and patient is due to port on 5th fraction, you can skip their portal imaging and port on fifth fraction.
True according to current policy.
True or false: "A qualified operator must be present at the operator console whenever a radiation-generating device (e.g. linear accelerator or CT scanner) is active. This includes operating the machines during daily warm-ups before patient care."
True, direct quote from external beam radiation therapy safety policy
True or false: One radiation therapist can be in the room to get patient's name and birthday.
False: two therapists must be present to get patient's name and birthday.
True or False: Pt can wear thin t-shirt for treatment of H&N
False: Men should remove shirt or wear gown.
Women: gown
No, if the imaging looks better at 2.9 degrees of pitch, we should re-CBCT and treat the patient at the most optimal imaging.
True or false: Pt is receiving radiation to the chest. Pt will be a 3 point setup with tattoos in line.
False, pt will have non-coplanar tattoos with AP chest tattoo nearest the level of expected isocenter.
True or false: For spine SBRTs, an extended scan can be taken instead of a KV iso.
True, but MD must put it in the Rx.
What anatomy would be uncovered for Rt breast treatment?
Pt is receiving 400cGy to C-spine. There is a 1.0cm left shift. Is reimaging required?
Yes, anything above 400cGy w/ a 1cm or 1* rotational shift must be reimaged.
Pt's family member requests a tour of the vault. What are the appropriate steps?
Ask rad onc leadership/lead RT for approval; then ensure you escort family member back to lobby before patient-related activities begin (i.e. before patient gets on table).
True or False: Pt is receiving osteoarthritis radiation to their knee. A single AP tattoo is sufficient for patient setup.
False, a minimum of three AP marks to help straighten the limb. Also, add lateral marks to verify correct limb roll when clinically appropriate.
For SBRTs: what do you do after acquiring the image?
START 10 MINUTE TIMER!
Page MD
What are the changing requirements for thorax patients?
Males may take off shirt in room or change into gown.
Women: Change into gown.
Patient dose is 180cGy/day. On CBCT, pt has rotation of 3 degrees. Do you need to reimage?
Yes, 3* of roll, rotation, or pitch must be reimaged at any dose.
False, policy states that "non-patient persons who have been allowed brief access must return to the waiting room area BEFORE any patient-related activities may commence."
False- everything is correct except tattoo on chest.
True or False: For SBRTs: MU, beam energy, gantry angles, collimator angles, table angles must be verified daily prior to treatment delivery.
False, first day only. Only energy, MU, and backside of timeout need to be stated daily.