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First published online September 1, 2008
British Journal of Radiology (2008) 81, 963-969
© 2008 British Institute of Radiology
doi: 10.1259/bjr/24432468
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British Journal of Radiology 81 (2008),963-969 ©2008 The British Institute of Radiology

Full paper

Suboptimal use of intravenous contrast during radiotherapy planning in the UK

S KIM, MRCP W RUSSELL, MSc P PRICE, MD, FRCP, FRCR and A SALEEM, PhD, FRCR

Department of Clinical Oncology, Christie Hospital, Manchester, 2Academic Clinical Oncology and Radiobiology Research Network (ACORRN), c/o University of Manchester and 3Academic Department of Radiation Oncology, Christie Hospital, Manchester, UK

Correspondence: A Saleem, Academic Department of Radiation Oncology, Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK. E-mail: azeem.saleem{at}manchester.ac.uk

We aimed to evaluate the use of intravenous (IV) contrast during acquisition of radiotherapy planning (RTP) scans and to compare current usage with the Royal College of Radiologists' (RCR) recommendations. Questionnaires were circulated via the Academic Clinical Oncology and Radiobiology Research Network (ACORRN) website, email and post to 60 UK radiotherapy centre managers. Questions were asked regarding the (i) tumour sites where IV contrast was used, (ii) person administering the contrast, (iii) availability of dynamic pump, (iv) tumour sites that centres wished to use contrast, (v) reasons for not using contrast and (vi) awareness of RCR recommendations. 50 (83%) centres responded to the questionnaire, of which 27 responded via the ACCORN website and 18 by e-mail. Despite 38 out of 50 responding centres using IV contrast, and accessibility to dynamic pumps existing in 39 centres, IV contrast usage was suboptimal, with more than half of the centres (27/50; 54%) wishing to use it at more tumour sites. IV contrast was most often used during RTP of the brain, with suboptimal usage in lung tumours. None of the 50 centres administered IV contrast during RTP scan acquisition in all of the 8 RCR recommended tumour sites. Radiographers were mainly responsible for contrast administration, and a lack of staff was cited as the main reason for suboptimal contrast usage. Disappointingly, only 35 of the 50 radiotherapy managers (70%) were aware of the RCR recommendations. Redress of the underlying reasons for suboptimal IV contrast administration during RTP, including acquisition of the necessary skill mix by staff and implementation of RCR recommendations, would help standardize UK practice.




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