In this article several issues will be discussed. Firstly, the efficacy of using helical CT data to image the thorax, and delineate volumes (clinical target volumes (CTV) and planning target volumes (PTV). Secondly, the practicalities of using CT data sets for dose inhomogeneity corrections and planning in the thorax. And thirdly, the associated problems of organ motion and immobilisation in this region.

This review article aims to address the paucity of information regarding professional portfolio development for therapeutic radiographers. It will review briefly the current literature regarding continuous professional development (CPD) for therapeutic radiographers and add to the on going debate regarding the monitoring and enforcement of a mandatory CPD scheme. It will recapitulate the applications of professional development portfolios and equip therapeutic radiographers with the basic knowledge and skills to undertake the process of portfolio development, ultimately leading to a product that provides evidence of CPD.

Background: Non-Hodgkin's Lymphomas (NHL) are considered to be a highly radiosensitive group of diseases with radiotherapy playing a major role in their treatment. It is recognised that the different grades and stages of NHL require different treatment approaches with current recommendations including combined chemotherapy and radiotherapy, chemotherapy alone or radiotherapy alone. Despite these recommendations there still remains a variation in the radiotherapy dose and fractionation regimens prescribed for NHL and this could be attributed to a lack of written treatment protocols for these patients. This paper gives an overview of the literature and reports on a small local study.

Method: A retrospective study recorded the treatment details of 35 patients treated with radiotherapy for NHL between April and September 1996 in a major radiotherapy centre. An analysis of the various radiotherapy dose and fractionation regimens identified was carried out and an attempt to identify the rationale behind the variations was made by correlating them to the grade of disease, the age of the patients, the prescribing consultants and whether chemotherapy was part of the treatment regimen.

Results: Thirteen consultants were identified as prescribing treatment for NHL. Forty-nine percent of patients presented as low, 11% intermediate and 31% high grade NHL. Of the 60% of patients who underwent chemotherapy the majority (62%) were prescribed Cyclophosphamide, Hydroxydaunorubicin, Oncovin (Vincristine) and Prednisolone (the CHOP regimen). Nineteen different radiotherapy dose and fractionation regimens were identified, 20 Gy in 5 fractions being the most common. No correlation was found between the age of the patients and the radiotherapy dose delivered. A strong positive relationship (r = 0.95) was identified between the radiotherapy dose and the number of fractions. There was no effect on the radiotherapy dose delivered between the different grades of disease or whether chemotherapy was administered.

Conclusions: It is considered that the implementation of a NHL treatment protocol is important and in an attempt to initiate this, specific NHL teams should be formed.

A clear rationale exists for routine in vivo dosimetry as part of an overall quality assurance (QA) programme within a radiotherapy department. A survey was undertaken in order to identify the extent of diode dosimetry practice within the UK.

Questionnaires were distributed to 57 radiotherapy physics departments in the UK in order to determine the extent of central axis diode dosimetry and the protocols implemented, the range of other in vivo measurements performed using diodes and the type of equipment used. Fifty-four responses were received. Eighteen departments undertook some form of central axis entrance dosimetry. Fifteen departments could be considered to be doing this routinely. Seven departments indicated planned future use. Six centres routinely undertook exit dosimetry with a further 3 indicating planned future use. Varied protocols for use were reported by those centres undertaking central axis dosimetry. Thirty-two respondents used a diode system for other forms of in vivo measurements with critical organ and TBI dosimetry being the most common. The vast majority used Scanditronix equipment.

Despite the distinct benefits of central axis diode dosimetry, this continues to be infrequently adopted as part of a departmental QA programme. However, an indication of a number of departments planning to implement such an approach is reassuring.

Radiotherapy departments are increasingly reliant on networked computers to co-ordinate all aspects of radiotherapy treatment such as treatment planning, verification or simulation. This paper suggests three relatively inexpensive strategies that can be applied to file servers within such networks. If they are implemented, the additional resilience of the network will increase the number of clinically available hours as most common hardware problems can be scheduled for repair outside routine clinical use.

Therapy radiographers require the ability to perceive three-dimensional relationships, in order to position patients correctly for treatment. A test predicting this would therefore be useful during undergraduate selection. This study examines whether therapy radiographers have a greater spatial ability than the general population, and secondly the relationship between spatial and clinical ability.

A correlation design utilised 54 therapy radiographers. Each subject undertook 3 tests: 2 spatial ability tests; WAIS block test (WBT) and Lego block test (LBT), and a clinical set-up (CS). Results indicate that therapy radiographers have a significant higher level of spatial ability, p <0.001, than the general population in the 25–34 year age group. Pearsons correlation of WBT with LBT (r = 0.56, p < 0.0005) demonstrated concurrent validity of the new LBT.

The results suggest therapy radiographers have a higher degree of spatial ability than the general population. A test of spatial ability would therefore be of use to determine potential clinical competency during undergraduate selection. Whilst a potential useful instrument has been identified further research needs to be undertaken in this area as spatial ability is just one factor needed for clinical competence.

The issue of patients' rights has become an important part of modern health care practice due to patients being much more aware of what they can expect from health care professionals when they enter the health care environment. This paper commences by explaining what rights are, followed by a discussion of two fundamental rights issues considered important in the relationship between patients and health care professionals in order to ensure good health care practice.