5.5 Acquire and use patient image data for treatment planning. Estimate uncertainties involved and assess their impact.

1. Gain an understanding of and report on the following:
   • Patient treatment set up and positioning procedures
   • The purpose, importance and dosimetric considerations of patient immobilisation in external beam therapy
   • Accuracy and limitations of immobilization devices
   • Patient data required for treatment planning
   • Methods for acquisition of patient data, including:
     • Manual methods
     • Simulator
     • CT/CT-Simulator
     • MRI
     • PET/CT-PET
   • Magnitude and sources of uncertainties involved in the:
     • Image data
     • Contouring of target volumes and critical tissue structures of interest
   • Treatment margins needed for contouring the target volumes and organs at risk for a variety of treatment sites
   • Application of the ICRU concepts in contouring:
     • Target volumes
     • Normal organs at risk
     • Treatment margins
2. Transfer patient image data to RTPS for a variety of treatment sites using:
   • Radiographs
   • CT images
   • MR images
   • Fused CT, MRI, and PET images
3. Perform image registration and contouring with these images, for the treatment targets and organs of interest.
4. Use:
   • Margins to compensate/accommodate inter-fraction and intrafraction treatment errors.
   • Image reconstruction
   • 2-D and 3-D display of contoured body and tissue structures
   • Generation of digital reconstruction radiograph (DRR)
   • Identification of planning contours reference points for dose assessment and treatment set up
5. Provide supervision, support and advice on:
   • patient immobilization and patient data acquisition procedures
   • Acquisition and application of patient data for treatment planning
   • Image transfer and registration