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Objective: The purpose of this UK study was to evaluate interfraction reproducibility and body image score when using ultraviolet (UV) tattoos (not visible in ambient lighting) for external references during breast/chest wall radiotherapy and compare with conventional dark ink., Methods: In this non-blinded, single-centre, parallel group, randomized control trial, patients were allocated to receive either conventional dark ink or UV ink tattoos using computer-generated random blocks. Participant assignment was not masked. Systematic (∑) and random (σ) setup errors were determined using electronic portal images. Body image questionnaires were completed at pre-treatment, 1 month and 6 months to determine the impact of tattoo type on body image. The primary end point was to determine that UV tattoo random error (σ setup ) was no less accurate than with conventional dark ink tattoos, i.e. <2.8 mm., Results: 46 patients were randomized to receive conventional dark or UV ink tattoos. 45 patients completed treatment (UV: n = 23, dark: n = 22). σ setup for the UV tattoo group was <2.8 mm in the u and v directions (p = 0.001 and p = 0.009, respectively). A larger proportion of patients reported improvement in body image score in the UV tattoo group compared with the dark ink group at 1 month [56% (13/23) vs 14% (3/22), respectively] and 6 months [52% (11/21) vs 38% (8/21), respectively]., Conclusion: UV tattoos were associated with interfraction setup reproducibility comparable with conventional dark ink. Patients reported a more favourable change in body image score up to 6 months following treatment. Advances in knowledge: This study is the first to evaluate UV tattoo external references in a randomized control trial.

Objective: To investigate whether there was parity between treatment fields localized by radiographers and clinicians, by comparing geographical variations and hence determining the feasibility of a radiographer-led service., Methods: 23 patients with metastatic spinal cord compression (MSCC) were prospectively sampled. Four radiographers not involved in the original planning performed localization on each patient. The 92 localizations that they determined were compared with the clinician-approved fields. Agreement was defined as ≤0.5 cm between field length, width and three isocentre co-ordinates. To be feasible, agreement was required in a minimum of 97% of the cases. The potential time saved with a radiographer-led approach was also recorded., Results: Agreement between clinicians and radiographers was 97.8%. For all field parameters, the average differences were <0.3 cm and were significantly different from the 0.5-cm median (p < 0.0001) that would establish no agreement using Wilcoxon signed-rank test. The average (range) delay awaiting clinician approval was 54 min (4-141 min)., Conclusion: Strong agreement between radiographer and clinician localizations was established. It was also highlighted that time could be saved in the patient's pathway by removing the need to wait for clinician approval. We believe this supports a radiographer-led service., Advances in Knowledge: This article is novel, as it is the first known comparison between clinicians and radiographers in the localization of MSCC radiotherapy. These data show the feasibility of introducing radiographer-led practice and a methodology that could be potentially transferred to investigate the localization parity for other treatment sites.

In this study, we aimed to create a comprehensive register of UK research radiographers (RRs), identify perceived training needs and make recommendations for the forward planning of the RR community in 2007 and 2008. Radiotherapy departments in England were sent an Academic Clinical Oncology and Radiobiology Research Network (ACORRN) questionnaire on RR establishment, demographics, role descriptions, research responsibilities, funding, time allocations, research skills and barriers to research. ACORRN received 85 replies from 51 departments of which just 5 RRs had a 100% research role. 70 radiographers participated in research at some level. 13 departments did not have any RRs. The RR role was defined as both developmental and specialist in nature by 43% of respondents; the remainder had a more diverse role. The National Health Service Trusts were responsible for funding 40% of RRs; the rest were fully or part-funded by national or local cancer networks, charity appeals and industry. 61% of RRs did not have dedicated academic time despite 93% being required to teach or support others. Critical barriers reported in conducting research were time, funding and supporting others In conclusion, the ACORRN RR Working Party makes the following recommendations for the future development of the community: the role of research should be viewed as an integral feature, at least one RR should be employed per radiotherapy department, the RR community must work together, dedicated research time is required, along with stable funding, RRs require more training, RRs need more support to accomplish the diversity of roles.