The responsibilities of a radiation therapist supporting MRI-guided High Dose Rate Brachytherapy for Prostate Cancer Jessy Abed 1, Amanda Bolderston 1, 2, Caroline Davey 1, Tara Rosewall 1, 2, Dr. Cynthia Menard 1, 2 1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Canada 2. Department of Radiation Oncology, University of Toronto, Toronto, Canada INTRODUCTION 1) Brachytherapy: –achieves better therapeutic ratio for prostate cancer –demands higher precision 1 2) MRI guidance provides the best visualization of the prostate 2 3) Interventional MRI (iMRI) improves treatment quality for HDR prostate brachytherapy (HDRpb) –also requires supporting processes –may provide an opportunity for RTT role expansion This poster presentation: –Outlines MRI-guided HDRpb process –RTT role responsibilities –RTT educational requirements METHODS Retrospective case study Research environment: –Large Canadian teaching hospital –Operational permanent prostate implant program –MRI scanner dedicated to RT –No prior institutional experience with either HDRpb or iMRI Researcher: –BSc-prepared RT –2-years experience –Clinical placement in brachytherapy –Dedicated research role in this project

The responsibilities of a radiation therapist supporting MRI-guided High Dose Rate Brachytherapy for Prostate Cancer Jessy Abed1, Amanda Bolderston1, 2, Caroline Davey1, Tara Rosewall1, 2, Dr. Cynthia Menard1, 2 1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Canada 2. Department of Radiation Oncology, University of Toronto, Toronto, Canada The responsibilities of a radiation therapist supporting MRI-guided High Dose Rate Brachytherapy for Prostate Cancer Jessy Abed 1, Amanda Bolderston 1, 2, Caroline Davey 1, Tara Rosewall 1, 2, Dr. Cynthia Menard 1, 2 1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Canada 2. Department of Radiation Oncology, University of Toronto, Toronto, Canada MRI SUITE Prep Equipment Patient Set up Scout Scan Catheter target identification Catheter insertion Final scan Transfer patient to HDR suite Fluoro imagingDRO contouring Catheter ConnectionPlan optimization Plan QA Treatment Pt transferred to recovery RESULTS iMRI-HDRpb procedure (see figure) –Same-day catheter insertion, planning and treatment –Inter-professional team necessary Anesthesiology, engineers, MRI technologists, nursing, brachytherapists, physicists and oncologists RTT role can not be simply be defined –Tasks often beyond normal scope of practice: Project management skills Data collection MRI safety RTT educational requirements: –Brachytherapy theory and practice –MRI theory and safety –Research methodology course

The responsibilities of a radiation therapist supporting MRI-guided High Dose Rate Brachytherapy for Prostate Cancer Jessy Abed1, Amanda Bolderston1, 2, Caroline Davey1, Tara Rosewall1, 2, Dr. Cynthia Menard1, 2 1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Canada 2. Department of Radiation Oncology, University of Toronto, Toronto, Canada The responsibilities of a radiation therapist supporting MRI-guided High Dose Rate Brachytherapy for Prostate Cancer Jessy Abed 1, Amanda Bolderston 1, 2, Caroline Davey 1, Tara Rosewall 1, 2, Dr. Cynthia Menard 1, 2 1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, Canada 2. Department of Radiation Oncology, University of Toronto, Toronto, Canada CONCLUSIONS iMRI-HDRpb procedure is still experimental, yet early results are promising The procedure: –is novel and complex –has created an interesting opportunity for RT role expansion This opportunity provides a new avenue for RTT career diversity Must be supported by significant professional development efforts REFERENCES Menard, C., R. C. Susil, et al. (2004). "MRI-guided HDR prostate brachytherapy in standard 1.5T scanner." Int J Radiat Oncol Biol Phys 59(5): Yu K, Hricak H. (2000). “Imaging prostate cancer.” Radiol Clin North Am 38: 59-85