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Are therapeutic radiographers able to achieve clinically acceptable verification for stereotactic lung radiotherapy treatment (SBRT)?

  • J. Hudson (a1), C. Doolan (a2), F. McDonald (a1), I. Locke (a1), M. Ahmed (a1), G. Gunapala (a1) and H. McNair (a1)...



The aim of this study was to assess the feasibility of radiographer led verification of cone-beam computed tomography (CBCT) images for patients with solitary lung tumours treated with stereotactic body radiotherapy treatment (SBRT).

Material and methods

CBCT setup images of 20 patients from the first fraction of each patient were retrospectively registered by therapeutic radiographers. The displacements recorded were compared with the clinical oncologist’s original online match. The time taken by radiographers to verify the CBCT images was also recorded.


Overall agreement for all radiographers when compared with the clinical oncologist match was 91%. Interobserver variations between radiographers were X plane 0·87 (0·76–0·94); Y plane 0·74 (0·51–0·88); and Z plane 0·88 (0·78–0·95) intraclass correlation coefficient and 95% confidence interval. The average time taken for verification was 128 seconds.


Therapeutic radiographers are able to verify CBCT images for thorax SBRT with results comparable to the ‘gold standard’ clinical oncologists’ match, however additional training will be provided for online verification. The time taken was within acceptable limits.


Corresponding author

Correspondence to: Jacqui Hudson, Department of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, SM2 5PT, UK. Tel: +44 (0) 20 8915 6020. Fax: +44 (0) 20 8915 6793. E-mail:


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