The radiation therapist (RTT) is a practitioner who must learn to take responsibility as an autonomous professional within a collaborative multi-professional team. A case study of international students on fellowship studies to a South African Higher Education Institution was used as the lens to explore the development of professional expertise in RTTs. Documents and semi-structured interviews generated textual data that was semantically analysed. The findings are presented as a discussion of the themes that emerged from the text data; (1) autonomy in a team, (2) collaboration facilitates learning, (3) the need for professional competence, (4) reflective practice and (5) participatory learning. The paper offers the interpretation of professional competence as a practitioner who has applicable knowledge, clinical and generic competence as well as appropriate behaviour and attitudes. It is proposed that a collaborative, integrated curriculum meets the need for the education of RTTs on the African continent. In such an environment optimised learning is facilitated by access to good clinical role models, the development of skills toward reflective practice and student participation in the learning environment.

Continuous professional development (CPD) is regarded as an essential component of working life for radiation therapists and is increasingly being used by professional associations to ’prove’ the competence of their members. In the past, CPD activities have primarily been viewed as an individual responsibility, and have focused on maintaining a professional knowledge base and, subsequently, hands-on competency through didactic learning. However, there are drawbacks associated with this model; and concentrating on only one facet of learning ignores other theoretical areas of knowledge acquisition. This article explores several areas of social and organisational theories of learning including social networks, communities of practice, learning organisations, knowledge management, knowledge translation and research utilisation. It is concluded that maintenance of competence after graduation is multilayered and should be viewed in a holistic manner to incorporate some of the relevant elements of the concepts discussed. This article also offers some suggestions for the individual wanting to maximise their educational opportunities beyond traditional models of CPD.

The goals of this study were (1) to compare, in a single institute, the clinical results of patients with newly diagnosed glioblastoma multiforme (GBM) treated with stereotactic radiosurgery (SRS), which has been incorporated into the initial management approach, with those in-patients treated with intra-operative radiotherapy (IORT) and (2) to assess whether these local irradiation boost therapies are prognostic factors on survival analysis. One hundred and twenty adult patients with supratentorial GBM had undergone tumour resection or biopsy and had received external beam radiotherapy (EBRT). Of them, 31 underwent IORT, 29 underwent SRS, and the remaining 60 had no local high-dose irradiation boost. The local irradiation boost led to clearly better results on survival of GBM patients. Furthermore, SRS is less invasive and allows for meticulous target planning of the irradiation boost, and was superior to IORT in terms of survival prolongation as well as suppression of local tumour recurrence/progression at the primary site in this series. In addition, SRS was a significant, positive prognostic factor for survival as well as gross-total resection of the tumour, and could be an alternative therapeutic modality to IORT for GBM.

This paper reports on the commissioning tests performed on a new GE Lightspeed RT wide-bore computed tomography (CT) scanner with GE Advantage Sim software. This paper focuses on the laser marking system, CT hardware and the interfaces between each component of the system, and generalises the findings to most CT simulation systems currently available. A discussion on the commissioning of the virtual simulator software will follow in a separate paper. Three phantoms were used (two constructed in-house) to assist with a range of tests covering aspects such as the laser patient marking system, CT hardware, and connections between the CT scanner, virtual simulator system and the treatment planning system (TPS) and VARiS. Tests performed showed the CT simulation system to be working within acceptable tolerances suggested in the literature, and baseline data have been obtained against which future comparisons of system performance have been made. Where no tolerances were available, we have suggested suitable values. While considering tolerances on Hounsfield number variation that may lead to a dose error in excess of 2%, we found that in the case of low-kV CT scanning the range of Hounsfield numbers for dense bone was outside the acceptable limits for potential dose errors and so users were advised not to perform radiotherapy planning CT scans with kV below 100 kV.

This paper continues the discussion on the commissioning tests performed on a new GE Lightspeed RT wide-bore computed tomography (CT) scanner, focusing on the GE Advantage Sim software (version 6.0).

The tests performed and phantoms used to assess the virtual simulator functionality, including the 3D image display, contouring, treatment unit beam parameters, digitally reconstructed radiograph generation and image quality, isocentre generation and multi-modality image registration, are described.

The series of tests performed showed the virtual simulation software to be working within acceptance tolerances suggested in the literature and baseline data have been obtained against which future comparisons of system performance have been made. Where no tolerances were available, we have suggested suitable values.

As more and more patients are planned in 3D, the need to verify their position and treatment in 3D also becomes apparent. Megavoltage (MV) and kilovoltage (KV) cone beam computed tomography (CBCT) provide 3D verification of patient position. However, the soft tissue contrast and thus the accuracy of delineation is superior with KV CT imaging. CBCT in conjunction with energy fluence maps from electronic portal imaging devices (EPIDs) could theoretically be used to verify the dose delivered. In this instance, a cross calibration between the KV CBCT and the EPID would be required which would not be necessary with MV CBCT. Adaptive planning with CBCT poses similar challenges for both KV and MV CBCT. Although KV CBCT can produce images with Hounsfield units (HUs) comparable with conventional CT in homogenous phantoms there are large discrepancies in inhomogeneous mediums. If the cupping artefact is corrected for in MV CBCT, the HU values can compare well with KV CBCT for homogenous media. However, advances need to be made to achieve a lower patient dose with MV CBCT. At present, the lower dose required for KV CBCT allows for more frequent imaging and better image quality.