Skin Apposition Breast Scar Setup

Learning Outcomes

• Knowledge

  • Selection of appropriate electron beam energy.

  • Identification of accurate skin apposition angles.

  • Factors influencing electron monitor unit calculation.

• Skills

  • Generating electron plan for post-lumpectomy breast scar.

  • Performing skin apposition setup.

  • Calculating lead cutout and bolus thickness and determining monitor units.

• Attitudes/Behaviours

  • Communication
    Patient-centred care

  • Team working

  • Safe working (checking)

Scenario Environment

Initial Simulation Setup

Initial set up - Eclipse:

• Log into ECLIPSE and load patient (ID …)
• Enter “External Beam Planning” workspace
• “Switch off” tangential fields, dose and previous CTV and PTV.
• “Switch on” volumes “Boost CTV” and “Boost PTV”

Initial set up - VERT:

• Switch on VERT 3.3 and choose Elekta Synergy
• Import patient C:/VERT DATA/VERT Patient Data/PUBLIC DICOM DATA/Dataset1/PUB_VHF_Cover
• Scene – Electron (7 x 10 and baseplate)
• Scene – Electron Setup NUMBER 6
• Full 3D stereoscopy engaged and glasses ready

First actions

Access patient notes and prescription

• Electron beam depth dose tables available

Case Introduction

• This patient is undergoing external beam therapy to the breast. She has now attended for mark up for electron therapy to her lumpectomy scar. The treatment site has been delineated on the patient and the treatment site has been outlined on her CT scans.
• The gantry, collimator and floor angles necessary for skin apposition must be determined using VERT
• This information must then be used to generate an electron beam plan on ECLIPSE
• An appropriate beam energy must be chosen based on the plan and PTV profile
• A monitor unit calculation must be performed

Available Collateral Information

N/A

Instructions for Personnel

Evaluation Strategy

Pre- and post-event completion of the "Readiness for Interprofessional Learning Scale" to measure impact and a Likert-style survey to gather participant feedback.

Bio

• Dr Andrew Williams

  

  Name: Dr Andrew Williams

  Job title: Senior Lecturer (Radiotherapy)

  Department: School of Radiology, AECC University College, Bournemouth

  Simulation experience / simulation research:

  I have been using VERT since 2008 with activities covering pre-clinical preparation, including fundamental principles of radiotherapy and workflows, skin apposition techniques and image review and approval.

  I also have experience of using VERT as a platform for both summative and formative assessment.