ORCID Profile
0000-0002-6714-4362
Current Organisations
Queensland University of Technology
,
Sheffield Hallam University
,
University of Zimbabwe
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Publisher: Wiley
Date: 04-05-2021
DOI: 10.1002/JMRS.472
Abstract: Magnetic resonance imaging (MRI) is the preferred imaging modality for Leksell Gamma Knife® (LGK) stereotactic radiosurgery (SRS) treatment planning (TP) due to superior soft tissue definition compared to computed tomography (CT). However, inherent distortions in MRI can affect treatment accuracy. The aim of this study was to develop a model to visualise the effect of MRI distortion on LGK SRS target coverage. A model was developed using MR images of a QUASAR TM GRID 3D QA phantom. One hundred and twenty‐five points were compared against known phantom geometry. Using linear interpolation, the model was applied retrospectively to 10 brain metastases patient data sets treated with LGK. The model estimated the corrected shot position accounting for distortion. A total of 44 metastases were investigated regarding the effects of MRI distortion on target coverage. The model indicated significantly reduced mean error by 0.30 mm and variance by 0.09 mm ( P = 0.008). After model application, 23 (53%) metastases showed reduced coverage. Six of the 23 metastases were deemed to be potentially clinically significant changes. Results indicated MRI distortion had a greater effect on smaller targets (mean 0.06cc) located further away from the image isocentre (mean 64.88 mm). This study developed a model to visualise the effect of MRI distortion on LGK SRS target coverage. Results suggest that MRI distortion can affect target coverage and the developed model may be one method to assess its impact. These results indicate that MRI distortion may have a greater effect on smaller targets located at the image periphery.
Publisher: Wiley
Date: 26-09-2020
DOI: 10.1002/JMRS.434
Publisher: Cambridge University Press (CUP)
Date: 22-04-2014
DOI: 10.1017/S1460396914000132
Abstract: An emerging developmental tool to help radiation therapists achieve better outcomes is ‘peer review’. This review of the current literature summarises the challenges and benefits of peer review in both in idual and departmental practice. There is compelling evidence supporting peer review implementation at both in idual and department level in many professions. Implementing peer review requires that radiation therapists and other radiation oncology professionals embrace a culture that supports safety. Peer review can identify trends and barriers associated with quality radiotherapy and share best practice or recommend changes accordingly. Support for peer review must come from pre-registration educational systems as well as clinical managers. Continuing professional development in the workplace is nurtured by peer review of radiotherapy practice and an aptitude for this should be viewed as important to the profession as technical and clinical skills. It is clear that peer review has the potential to facilitate reflective practice, improve staff motivation and help foster a culture of quality and safety in radiation oncology. To drive the issues of quality and safety a step further radiation therapists need to accept the challenge of adopting peer review methods in day-to-day practice.
Publisher: Cambridge University Press (CUP)
Date: 02-07-2015
DOI: 10.1017/S1460396915000291
Abstract: It is common for head and neck patients to be affected by time trend errors as a result of weight loss during a course of radiation treatment. The objective of this planning study was to investigate the impact of weight loss on volumetric modulated arc therapy (VMAT) as well as intensity modulated radiation therapy (IMRT) for locally advanced head and neck cancer using automatic co-registration of the cone beam computed tomography. A retrospective analysis of previously treated IMRT plans for ten patients with locally advanced head and neck cancer was done. A VMAT plan was also produced for all patients. We calculated the dose–volume histograms (DVH) indices for spinal cord planning at risk volumes (PRVs), the brainstem PRVs (SC+0·5 cm and BS+0·5 cm, respectively) as well as mean dose to the parotid glands. The results show that the mean difference in dose to the SC+0·5 cm was 1·03% and 1·27% for the IMRT and VMAT plans, respectively. As for dose to the BS+0·5, the percentage difference was 0·63% for the IMRT plans and 0·61% for the VMAT plans. The analysis of the parotid gland doses shows that the percentage change in mean dose to left parotid was −8·0% whereas that of the right parotid was −6·4% for the IMRT treatment plans. In the VMAT plans, the percentages change for the left and the right parotid glands were −6·6 and −6·7% respectively. This study shows a clinically significant impact of weight loss on DVH indices analysed in head and neck organs at risk. It highlights the importance of adaptive radiotherapy in head and neck patients if organ at risk sparing is to be maintained.
Publisher: Wiley
Date: 03-2019
DOI: 10.1002/JMRS.2_324
Publisher: Cambridge University Press (CUP)
Date: 23-03-2015
Publisher: Cambridge University Press (CUP)
Date: 29-06-2015
DOI: 10.1017/S1460396915000266
Abstract: This study evaluated the impact of a daily and weekly image-guided radiotherapy protocols in reducing setup errors and setting of appropriate margins in head and neck cancer patients. Interfraction and systematic shifts for the hypothetical day 1–3 plus weekly imaging were extrapolated from daily imaging data from 31 patients (964 cone beam computed tomography (CBCT) scans). In addition, residual setup errors were calculated by taking the average shifts in each direction for each patient based on the first three shifts and were presumed to represent systematic setup error. The clinical target volume (CTV) to planning target volume (PTV) margins were calculated using van Herk formula and analysed for each protocol. The mean interfraction shifts for daily imaging were 0·8, 0·3 and 0·5 mm in the S-I (superior-inferior), L-R (left-right) and A-P (anterior-posterior) direction, respectively. On the other hand the mean shifts for day 1–3 plus weekly imaging were 0·9, 1·8 and 0·5 mm in the S-I, L-R and A-P direction, respectively. The mean day 1–3 residual shifts were 1·5, 2·1 and 0·7 mm in the S-I, L-R and A-P direction, respectively. No significant difference was found in the mean setup error for the daily and hypothetical day 1–3 plus weekly protocol. However, the calculated CTV to PTV margins for the daily interfraction imaging data were 1·6, 3·8 and 1·4 mm in the S-I, L-R and A-P directions, respectively. Hypothetical day 1–3 plus weekly resulted in CTV–PTV margins of 5, 4·2 and 5 mm in the S-I, L-R and A-P direction. The results of this study show that a daily CBCT protocol reduces setup errors and allows setup margin reduction in head and neck radiotherapy compared to a weekly imaging protocol.
Publisher: Cambridge University Press (CUP)
Date: 03-03-2015
DOI: 10.1017/S1460396915000102
Abstract: Peer-review programmes in radiation oncology are used to facilitate the process and evaluation of clinical decision-making. However, web-based peer-review methods are still uncommon. This study analysed an inter-centre, web-based peer-review case conference as a method of facilitating the decision-making process in radiation oncology. A benchmark form was designed based on the American Society for Radiation Oncology targets for radiation oncology peer review. This was used for evaluating the contents of the peer-review case presentations on 40 cases, selected from three participating radiation oncology centres. A scoring system was used for comparison of data, and a survey was conducted to analyse the experiences of radiation oncology professionals who attended the web-based peer-review meetings in order to identify priorities for improvement. The mean scores for the evaluations were 82·7, 84·5, 86·3 and 87·3% for cervical, prostate, breast and head and neck presentations, respectively. The survey showed that radiation oncology professionals were confident about the role of web-based peer-reviews in facilitating sharing of good practice, stimulating professionalism and promoting professional growth. The participants were satisfied with the quality of the audio and visual aspects of the web-based meeting. The results of this study suggest that simple inter-centre web-based peer-review case conferences are a feasible technique for peer review in radiation oncology. Limitations such as data security and confidentiality can be overcome by the use of appropriate structure and technology. To drive the issues of quality and safety a step further, small radiotherapy departments may need to consider web-based peer-review case conference as part of their routine quality assurance practices.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 09-2018
Publisher: Elsevier BV
Date: 09-2018
Publisher: Wiley
Date: 04-2016
DOI: 10.1002/JMRS.1_166
Publisher: Wiley
Date: 13-02-2023
DOI: 10.1002/JMRS.660
Abstract: The Australian healthcare system continues to work towards close the gap to improve and achieve equality in health and life expectancy for Aboriginal and Torres Strait Islander peoples. When culturally safe practice is forefront, it may be the driving force in improving Indigenous Australian healthcare outcomes. For students and practitioners to be equipped with the industry‐required cultural safety skills, we believe Indigenous Australian knowledge and perspectives must be effectively integrated into undergraduate education. A scoping review of the literature was conducted to identify the most effective teaching and learning methods and assessment tools to best integrate Indigenous knowledge and perspectives into undergraduate radiation therapy curriculum at Queensland University of Technology (QUT). Embase, CINAHL, Scopus and PubMed‐Medline were searched to access peer‐reviewed studies published between 2017 and 2022. A total of 591 articles were identified with 39 full‐text articles meeting the inclusion criteria. Methods of teaching and learning and independent assessment tools that promote cultural capability in undergraduate education were identified. Findings included intensive patient‐specific workshops, which were reported to provide students with an immersive learning experience, better preparing them for clinical placements and future practice. Additionally, other allied healthcare professions have utilised tools such as the Cultural Capability Management Tool (CCMT) and Trans‐Cultural Self‐Efficacy Tool (TSET) to quantitatively assess positive shifts and highlight developmental needs. These findings will inform current educational endeavours to promote cultural safety and the cultural capability continuum in the undergraduate radiation therapy curriculum.
Publisher: SAGE Publications
Date: 21-01-2022
DOI: 10.1177/1742271X211072473
Abstract: The integration of artificial intelligence (AI) technology within the health industry is increasing. This educational piece discusses the implementation of AI and its impact on sonography. The authors investigate how AI may influence the profession and provide ex les of how ultrasound imaging may be enhanced and innovated by integrating AI technology. This article highlights challenges related to the application of AI and provides insight into how they could be addressed. The critical distinction between the role of a sonographer and the reporting specialist in the context of AI is highlighted as a key issue for those developing, researching, and evaluating AI systems. A key recommendation is for the sonography community to address ultrasound education, particularly how AI knowledge could be incorporated into university education. This is an important consideration that should be extended to practising professionals as they may be involved in evaluating the efficiency and methodologies used in new research that may incorporate AI technologies.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Elsevier BV
Date: 12-2021
Publisher: Cambridge University Press (CUP)
Date: 17-02-2014
DOI: 10.1017/S1460396914000065
Abstract: This study evaluated the impact of patient set-up errors on the probability of pulmonary and cardiac complications in the irradiation of left-sided breast cancer. Using the CMS XiO Version 4·6 radiotherapy planning system's normal tissue complication probability (NTCP) algorithm and the Lyman–Kutcher–Burman model, we calculated the dose–volume histograms (DVH) indices for the ipsilateral lung and heart and the resultant NTCP for radiation-induced pneumonitis and excess cardiac mortality in 12 left-sided breast cancer patients. Isocentric shifts in the posterior direction had the greatest effect on the lung V 20 , heart V 25 , and mean and maximum doses to the lung and the heart. DVH results show that the ipsilateral lung V 20 tolerance was exceeded in 58% of the patients after 1 cm posterior shifts. Similarly, the heart V 25 tolerance was exceeded after 1 cm antero-posterior and left–right isocentric shifts in 70% of the patients. The baseline NTCPs for radiation-induced pneumonitis ranged from 0·73% to 3·4%, with a mean value of 1·7%. The maximum reported NTCP for radiation-induced pneumonitis was 5·8% (mean 2·6%) after 1 cm posterior isocentric shift. The NTCP for excess cardiac mortality were 0% in 100% of the patients ( n = 12) before and after set-up error simulations. Set-up errors in left-sided breast cancer patients have a statistically significant impact on the Lung NTCPs and DVH indices. However, with a central lung distance of 3 cm or less (CLD 3 cm), and a maximum heart distance of 1·5 cm or less (MHD 1·5 cm), the treatment plans could tolerate set-up errors of up to 1 cm without any change in the NTCP to the heart.
Publisher: Wiley
Date: 06-07-2021
DOI: 10.1002/SONO.12276
Abstract: Sonography researchers are often confronted with questions concerning the relationship between measurements acquired in clinical practice. This educational commentary provides clarity on the definition of the terms correlation and agreement. We discuss the statistical tests used to assess correlation and outline some common pitfalls authors fall into when reporting these. We provide ex les of the inaccurate use of these tests in the sonography literature and recommend better alternatives for assessing agreement. This review will benefit authors embarking on studies comparing measurements and reviewers considering manuscripts to ensure the methodology used is sufficient to justify the claims. The authors also provide plots created in the R statistical software package, and the supplementary data file supplied can be used and adapted for those wishing to perform similar statistical tests.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Wiley
Date: 03-05-2018
DOI: 10.1002/SONO.12146
Publisher: Cambridge University Press (CUP)
Date: 12-12-2016
DOI: 10.1017/S1460396916000522
Abstract: Peer review of treatment plans has been used to improve planning consistency, decrease the need for replanning and improve quality of care through the safe delivery of high-quality radiotherapy plans. This narrative review summarises the clinical benefits and addresses the implementation of peer review of treatment plans in undergraduate medical dosimetry and radiation therapy training. There are encouraging results of peer review for advanced treatment planning techniques such as Stereotactic Body Radiation Therapy techniques in clinical practice. Peer review can be used as a tool to improve students’ knowledge of organ-at-risk contouring, treatment plan critique and quality assurance. These desirable treatment planning skills can be easily transferred to clinical settings. Moreover, there are several potential pedagogical benefits such as improvement in student engagement, better communication skills and provision of synchronous and asynchronous feedback that can positively impact student success and future employment. However, there are several challenges in facilitating its implementation in university settings. Embedding skills in peer review of treatment plans at undergraduate teaching level can be a powerful tool to impart clinical treatment planning knowledge. This narrative review provides a basis on which to develop an exploratory study of structured peer review activities in a training environment.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JMIR.2017.11.002
Abstract: The use of three-dimensional virtual reality technologies in education has been widely reported in the literature. The goal of this article is to review how the virtual environment for radiotherapy training (VERT) can be utilised to support the teaching of intensity-modulated radiotherapy (IMRT), volumetric-modulated arc therapy, and dynamic conformal arc therapy techniques. Utilising Pinnacle v14 (Philips Radiation Oncology Systems, Madison, WI) and Monaco v 5.10 (Elekta CMS, Maryland Heights, MO), we exported IMRT, volumetric-modulated arc therapy, and dynamic conformal arc therapy treatment plans to VERT. Quality assurance (QA) plans were also exported from the Monaco planning software to demonstrate theoretical concepts and virtual plan delivery using the ArcCHECK phantom (Sun Nuclear Corp, Melbourne, FL) and solid water IMRT phantom. Several VERT features were utilised to critically evaluate dose coverage and organ at risk sparing on inverse treatment plans. The display of gantry and multileaf collimator motion and fluence maps could be a useful feature in the education of treatment planning concepts. QA could be delivered on VERT to demonstrate patient-specific QA concepts in a virtual environment. Anecdotal evidence shows that the use of VERT for collaborative plan evaluation sessions is likely to engage the students and improve their ability to evaluate treatment plans. VERT can be utilised to reinforce understanding of treatment plan evaluation skills, QA, and treatment delivery of inverse plans in educational environments.
Publisher: Cambridge University Press (CUP)
Date: 18-01-2017
DOI: 10.1017/S1460396916000546
Abstract: Radiation oncology information systems (OIS) play a crucial role in radiation therapy by ensuring accurate and safe delivery of treatment. A MOSAIQ OIS system is currently used to support undergraduate radiation therapist training at Queensland University of Technology. This review addresses the rationale for implementation and integration in teaching environments and explores the pedagogical benefits supported by educational theory. A review of MOSAIQ functionality shows potential to transform learning through the development of authentic and engaging learning tasks. It provides students with an opportunity to learn two-dimensional image matching through the use of digitally reconstructed radiographs and electronic portal images as well as three-dimensional image matching using computed tomography (CBCT) data in a safe learning environment without clinical time pressures. In addition, this provides the students with knowledge of quality assurance (QA) checks through the verification of treatment parameters and the transfer of information from the planning system to the treatment units. However, there are several potential challenges and practical considerations that need to be overcome. The application of MOSAIQ OIS could potentially transform teaching and learning strategies for student radiation therapists. Increased knowledge and hands-on skills at undergraduate levels in areas such as image matching and QA can be powerful tools to drive the standards of practice a step further.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Wiley
Date: 28-02-2017
DOI: 10.1002/JMRS.1_214
Publisher: Elsevier BV
Date: 06-2020
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Crispen Chamunyonga.