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When patients come in for radiation treatment the Medical Dosimetrist assists in the patient’s care during multiple steps throughout the workflow process. This is an overview of the patient care process highlighting the Medical Dosimetrist’s impact on the care process.
Consultation
Initially, patients will meet with the Radiation Oncologist for consultation to discuss treatment options. The radiation oncologist decides on the specific treatment modality and radiation dosage, based on the patient’s tumor type, stage, and location of cancer. The Radiation Oncologist may ask the Medical Dosimetrist to fuse prior radiation onto a new treatment scan prior to consultation to better understand feasibility for another treatment course.
Simulation
Afterwards, the Radiation Oncologist will put in an order for the Radiation Therapists to complete a simulation appointment for the patient. The patient simulation appointment is to mockup the position that the patient will be in for treatment. The simulation consists of a CT scan of the specific area where the disease is located. The Medical Dosimetrist may assist during the appointment by assisting the Radiation Therapist in creation of immobilization devices. The Medical Dosimetrist may also be called in to give patient positioning input for a beam arrangement to ensure accurate treatment delivery.
Image Registration/Contour of Anatomy
CT scans, alone or in combination with MRI or PET scans, allow the physician to map out the exact location of the area to be treated, this is called a target. The Medical Dosimetrist assists in this process by creating image fusions by taking the CT acquired at the time of the simulation and overlaying it with different image sets. The other image sets may lead to better visualization of anatomy by inherent properties like MR for soft tissue or using contrast to follow bowel. Medical Dosimetrists also outline or contour normal anatomy or organs near the disease site. The contouring of the anatomy makes it possible to track the dose to the delineated structures.
Plan Design
Under the supervision of the Radiation Oncologist and Medical Physicist, the Medical Dosimetrist uses their knowledge and skills in conjunction with advanced computer technology to design a treatment plan specifically for each patient.
The medical dosimetrist will carefully select the treatment technique, beam angles, and beam shapes to deliver a high dose of radiation to the tumor while sparing as many healthy cells and organs as possible. Once the medical dosimetrist has developed the best treatment plan given the anatomy, tumor location, and dose, the radiation oncologist will review and approve the plan.
Quality Assurance/Safety Cross-Check
Before the treatment plan can be executed, members of the radiation oncology team work together with the Medial Physicist to perform rigorous quality assurance checks to ensure that the treatment plan is safe and effective. A medical dosimetrist will communicate the patient’s treatment plan to the radiation therapists by providing field arrangements, beam modification devices, and any concerns that may arise during treatment planning phase.