Module - Radiotherapy Physics (SPE103)

STP

Aim of this module

Trainees will gain an understanding of dosimetry, codes of practice, treatment machines and treatment planning, together with relevant radiation protection legislation.

Work-based learning outcomes


  1. Assist with the safe handling and operation of small sealed sources.
  2. Undertake a risk assessment and perform a radiation protection room survey.
  3. Operate treatment equipment safely (under supervision), selecting and using relevant measurement devices, undertaking basic measurements on the treatment machines. 
  4. Assist with routine quality control on external beam radiotherapy equipment and evaluate the appropriateness of action/tolerance levels. 
  5. Assist with the treatment-planning process from immobilisation to the start of treatment and produce and critically appraise routine MV photon treatment plans. 
  6. Perform quality assurance checks on treatment-planning systems. 

Work-based Competencies


Learning outcome Title Knowledge
1 1

Assist with the safe handling and operation of small sealed sources in the department, including the performance of strontium-90 consistency checks on dosimetry equipment.

  • Relevant national legislation and associated guidance.
  • Local rules, their linkage to the legislation and their relevance in the local department.
  • Safe handling and operation of small sealed sources in the department.
  • High Activity Sealed Source (HASS) sources and security issues.
  • Basic awareness of the quality system and an understanding of its relationship to legislation.
  • Concept of justification for medical radiation exposures.
  • Duty holders under IR(ME)R and defined roles under IRR99, within the department.
  • Programme of personnel and environmental monitoring.
2 2

Perform a radiation protection room survey and discuss the results with your training officer.

  • The sources of radiation and construction of radiotherapy equipment.
  • Performance characteristics and suitability of area survey monitoring equipment.
  • Principles of radiation protection and their application in context.
  • The As Low As Reasonably Practicable (ALARP) principle.
3 2

Perform a radiation risk assessment and discuss the results with your training officer.

  • Structure and requirements of a risk assessment.
  • Importance of engineering controls for risk management.
4 3

Operate treatment equipment safely and evaluate the operation of the interlocks

  • Basic principles of linear accelerators and their operation.
  • The function of relevant components of the linear accelerator.
  • Relevant dosimetry chains and codes of practice.
  • Range and type of instruments for measurement and how to select to meet the identified need.
  • Capabilities and limitations of such devices.
  • At least one code of practice and its application/relevance.
  • The dosimetric chain relating the output to the primary standards.
  • Beam characteristics.
  • The function of relevant components of the linear accelerator.
5 3

Select an appropriate dosemeter and measure standard output, including assessment of the constancy and leakage of the measurement system and its significance.

  • Basic principles of linear accelerators and their operation.
  • The function of relevant components of the linear accelerator.
  • Relevant dosimetry chains and codes of practice.
  • Range and type of instruments for measurement and how to select to meet the identified need.
  • Capabilities and limitations of such devices.
  • At least one code of practice and its application/relevance
  • The dosimetric chain relating the output to the primary standards.
  • Beam characteristics.
  • The function of relevant components of the linear accelerator.
6 3

Relate standard output measurement to the relevant code of practice (MV/kV electron).

  • Basic principles of linear accelerators and their operation.
  • The function of relevant components of the linear accelerator.
  • Relevant dosimetry chains and codes of practice.
  • Range and type of instruments for measurement and how to select to meet the identified need.
  • Capabilities and limitations of such devices.
  • At least one code of practice and its application/relevance.
  • The dosimetric chain relating the output to the primary standards.
  • Beam characteristics.
  • The function of relevant components of the linear accelerator.
7 3

Measure a beam profile at the depth of maximum dose and reference depth, and calculate the field size, penumbra, flatness and symmetry Explain the differences and relate to the beam specification

  • Basic principles of linear accelerators and their operation.
  • The function of relevant components of the linear accelerator.
  • Relevant dosimetry chains and codes of practice.
  • Range and type of instruments for measurement and how to select to meet the identified need.
  • Capabilities and limitations of such devices.
  • At least one code of practice and its application/relevance.
  • The dosimetric chain relating the output to the primary standards.
  • Beam characteristics.
  • The function of relevant components of the linear accelerator.
8 3

Critically evaluate the function of the ionisation chamber in the linear accelerator and its importance for correct treatment delivery

  • Basic principles of linear accelerators and their operation.
  • The function of relevant components of the linear accelerator.
  • Relevant dosimetry chains and codes of practice.
  • Range and type of instruments for measurement and how to select to meet the identified need.
  • Capabilities and limitations of such devices.
  • At least one code of practice and its application/relevance.
  • The dosimetric chain relating the output to the primary standards.
  • Beam characteristics.
  • The function of relevant components of the linear accelerator.
9 4

Assist with routine quality control on external beam radiotherapy equipment (including items such as light to radiation, quality index) and evaluate the appropriateness of action/tolerance levels

  • Quality control of treatment machines.
  • How action levels are used to ensure equipment remains in tolerance and relate to the patient dose.
  • Relevant Institute of Physics and Engineering in Medicine (IPEM) reports.
10 5

Assess available immobilisation techniques and identify treatment sites that would most benefit

  • International, national and local guidelines in treatment planning.
  • How the legislation and guidance particular to treatment planning, eg data protection, patient confidentiality, and Ionising Radiation (Medical Exposures) Regulations 2000 fit in with local practice.
  • How to identify and comply with relevant international and national recommendations, IR(ME)R, Caldecott principles, ICRU guidelines.
  • Use of imaging data for the treatment-planning process.
  • Relevant departmental protocols and policies and their application with respect to dose prescription.
  • Local protocols for data entry, utilisation and transfer.
  • Basic understanding of sectional anatomy.
  • Relative merits of treating with photons or electrons in clinical situations.
  • How to prepare the relevant patient data and patient treatment- related data in a form appropriate for calculation.
  • Relative dosimetry and the calculation of monitor units for photons and electrons.
  • The underlying principles of creating a treatment plan and the manipulation of treatment parameters to achieve an acceptable relative dose distribution.
  • How to record all calculations, calculation results and treatment instructions according to departmental protocols to provide sufficient detail for the method and results to be verified to satisfy an independent check and for the results to be used for treatment.
  • The radiobiology behind choice of fractionation regimens.
  • Criteria for acceptable dose to the planning target volume and maximum allowed dose to organs at risk, dependent on disease site.
  • Capabilities and limitations of treatment machines and associated equipment.
11 5

Import images for treatment- planning purposes Evaluate the interactions between data systems and be able to critically assess the essential information, eg image quality assurance, slice requirements, etc

  • International, national and local guidelines in treatment planning.
  • How the legislation and guidance particular to treatment planning, eg data protection, patient confidentiality, and Ionising Radiation (Medical Exposures) Regulations 2000 fit in with local practice.
  • How to identify and comply with relevant international and national recommendations, IR(ME)R, Caldecott principles, ICRU guidelines.
  • Use of imaging data for the treatment-planning process.
  • Relevant departmental protocols and policies and their application with respect to dose prescription.
  • Local protocols for data entry, utilisation and transfer.
  • Basic understanding of sectional anatomy.
  • Relative merits of treating with photons or electrons in clinical situations.
  • How to prepare the relevant patient data and patient treatment- related data in a form appropriate for calculation.
  • Relative dosimetry and the calculation of monitor units for photons and electrons.
  • The underlying principles of creating a treatment plan and the manipulation of treatment parameters to achieve an acceptable relative dose distribution.
  • How to record all calculations, calculation results and treatment instructions according to departmental protocols to provide sufficient detail for the method and results to be verified to satisfy an independent check and for the results to be used for treatment.
  • The radiobiology behind choice of fractionation regimens.
  • Criteria for acceptable dose to the planning target volume and maximum allowed dose to organs at risk, dependent on disease site.
  • Capabilities and limitations of treatment machines and associated equipment.
12 5

Generate outlines for anatomical structures and geometrical volumes to aid planning based on Computed Tomography (CT) data sets

  • International, national and local guidelines in treatment planning.
  • How the legislation and guidance particular to treatment planning, eg data protection, patient confidentiality, and Ionising Radiation (Medical Exposures) Regulations 2000 fit in with local practice.
  • How to identify and comply with relevant international and national recommendations, IR(ME)R, Caldecott principles, ICRU guidelines.
  • Use of imaging data for the treatment-planning process.
  • Relevant departmental protocols and policies and their application with respect to dose prescription.
  • Local protocols for data entry, utilisation and transfer.
  • Basic understanding of sectional anatomy.
  • Relative merits of treating with photons or electrons in clinical situations.
  • How to prepare the relevant patient data and patient treatment- related data in a form appropriate for calculation.
  • Relative dosimetry and the calculation of monitor units for photons and electrons.
  • The underlying principles of creating a treatment plan and the manipulation of treatment parameters to achieve an acceptable relative dose distribution.
  • How to record all calculations, calculation results and treatment instructions according to departmental protocols to provide sufficient detail for the method and results to be verified to satisfy an independent check and for the results to be used for treatment.
  • The radiobiology behind choice of fractionation regimens.
  • Criteria for acceptable dose to the planning target volume and maximum allowed dose to organs at risk, dependent on disease site.
  • Capabilities and limitations of treatment machines and associated equipment.
13 5

Design treatment plans for two to four field treatments for a range of sites in accordance with International Commission on Radiation Units and Measurements (ICRU) Guidance and local clinical protocols (explain choice of modality/energy, beam arrangement,  and compensation)

  • International, national and local guidelines in treatment planning.
  • How the legislation and guidance particular to treatment planning, eg data protection, patient confidentiality, and Ionising Radiation (Medical Exposures) Regulations 2000 fit in with local practice.
  • How to identify and comply with relevant international and national recommendations, IR(ME)R, Caldecott principles, ICRU guidelines.
  • Use of imaging data for the treatment-planning process.
  • Relevant departmental protocols and policies and their application with respect to dose prescription.
  • Local protocols for data entry, utilisation and transfer.
  • Basic understanding of sectional anatomy.
  • Relative merits of treating with photons or electrons in clinical situations.
  • How to prepare the relevant patient data and patient treatment- related data in a form appropriate for calculation.
  • Relative dosimetry and the calculation of monitor units for photons and electrons.
  • The underlying principles of creating a treatment plan and the manipulation of treatment parameters to achieve an acceptable relative dose distribution.
  • How to record all calculations, calculation results and treatment instructions according to departmental protocols to provide sufficient detail for the method and results to be verified to satisfy an independent check and for the results to be used for treatment.
  • The radiobiology behind choice of fractionation regimens.
  • Criteria for acceptable dose to the planning target volume and maximum allowed dose to organs at risk, dependent on disease site.
  • Capabilities and limitations of treatment machines and associated equipment.
14 5

Appraise treatment plans, making use of dose volume information and dose constraints for organs at risk and the target volume

  • International, national and local guidelines in treatment planning
  • How the legisl.ation and guidance particular to treatment planning, eg data protection, patient confidentiality, and Ionising Radiation (Medical Exposures) Regulations 2000 fit in with local practice.
  • How to identify and comply with relevant international and national recommendations, IR(ME)R, Caldecott principles, ICRU guidelines.
  • Use of imaging data for the treatment-planning process.
  • Relevant departmental protocols and policies and their application with respect to dose prescription.
  • Local protocols for data entry, utilisation and transfer.
  • Basic understanding of sectional anatomy.
  • Relative merits of treating with photons or electrons in clinical situations.
  • How to prepare the relevant patient data and patient treatment- related data in a form appropriate for calculation.
  • Relative dosimetry and the calculation of monitor units for photons and electrons.
  • The underlying principles of creating a treatment plan and the manipulation of treatment parameters to achieve an acceptable relative dose distribution.
  • How to record all calculations, calculation results and treatment instructions according to departmental protocols to provide sufficient detail for the method and results to be verified to satisfy an independent check and for the results to be used for treatment.
  • The radiobiology behind choice of fractionation regimens.
  • Criteria for acceptable dose to the planning target volume and maximum allowed dose to organs at risk, dependent on disease site.
  • Capabilities and limitations of treatment machines and associated equipment.
15 5

Produce a range of routine MV photon treatment plans

  • International, national and local guidelines in treatment planning.
  • How the legislation and guidance particular to treatment planning, eg data protection, patient confidentiality, and Ionising Radiation (Medical Exposures) Regulations 2000 fit in with local practice.
  • How to identify and comply with relevant international and national recommendations, IR(ME)R, Caldecott principles, ICRU guidelines.
  • Use of imaging data for the treatment-planning process.
  • Relevant departmental protocols and policies and their application with respect to dose prescription.
  • Local protocols for data entry, utilisation and transfer.
  • Basic understanding of sectional anatomy.
  • Relative merits of treating with photons or electrons in clinical situations.
  • How to prepare the relevant patient data and patient treatment- related data in a form appropriate for calculation.
  • Relative dosimetry and the calculation of monitor units for photons and electrons.
  • The underlying principles of creating a treatment plan and the manipulation of treatment parameters to achieve an acceptable relative dose distribution.
  • How to record all calculations, calculation results and treatment instructions according to departmental protocols to provide sufficient detail for the method and results to be verified to satisfy an independent check and for the results to be used for treatment.
  • The radiobiology behind choice of fractionation regimens.
  • Criteria for acceptable dose to the planning target volume and maximum allowed dose to organs at risk, dependent on disease site.
  • Capabilities and limitations of treatment machines and associated equipment.
16 5

Perform manual calculations for basic treatment techniques, taking into account field size, wedge factor, change of FSD, off-axis, etc

  • Use of calculation data and charts.
17 6

Perform and discuss routine quality assurance checks on the treatment planning/VSim system and the radiotherapy network

  • Range and extent of independent checks required.
  • National or international guidelines according to local practice, eg IPEM81.

Work-based assessment


Complete 1 Case-Based Discussion(s)
Complete 1 of the following DOPS and/or OCEs
Type Title
DOPS Perform a radiation survey of a treatment room
DOPS Produce and evaluate a simple treatment plan
DOPS Measure the radiation output of a treatment machine