A prospective study comparing radiographer and clinician based localisation for patients with metastatic spinal cord compression (MSCC) to assess the feasibility of a radiographer led service.

OBJECTIVES: To investigate if there was parity between treatment fields localised by radiographers and clinicians, by comparing geographical variations and hence determining the feasibility of a radiographer led service. METHODS: 23 patients with metastatic spinal cord compression (MSCC) were prospectively sampled. 4 radiographers not involved in the original planning performed a localisation on each patient. The 92 localisations were compared to the clinicians approved field. Agreement was defined as Ôëñ0.5cm between field length, width and 3 isocentre coordinates. To be feasible agreement was required in a minimum of 97% of the cases. The potential time saved with a radiographer led approach was also recorded. RESULTS: Agreement between clinicians and radiographers was 97.8%. For all field parameters, the average differences were <0.3cm and was significantly different from the 0.5cm median (p<0.0001) that would establish no agreement using wilcoxon signed rank test. The average (range) delay waiting for clinician approval was 54 minutes (4 minutes to 141 minutes). CONCLUSIONS: Strong agreement between radiographers and clinicians localisation was established. It was also highlighted that time could be saved in the patient's pathway by removing the need to wait for clinician approval. We believe this supports a radiographer led service. Advances in Knowledge: This article is novel as it is the first known comparison between clinicians and radiographers in the localisation of MSCC radiotherapy. This data shows the feasibility of introducing radiographer led practice and a methodology that could be potentially transferred to investigate the localisation parity for other treatment sites.