An evaluation for the need for ultrasound scanning to assess bladder filling prior to radiotherapy to the prostate based on clinical data and radiographers' perception

Abstract

Purpose: To investigate the need for introducing ultrasound bladder scanning to assess bladder volume (BV) in patients undergoing radiotherapy to the prostate. Objectives: To quantify the frequency of repeated CBCTs and to explore any correlation between patient variables and repeated imaging (phase 1). Moreover, to investigate the radiographers’ perceptions on repeated CBCT imaging and ultrasound bladder scanning, whilst also evaluating their perceived confidence and opinions on additional training in using the bladder ultrasound scanner (BUS) (phase 2). Methodology: The study was conducted in 2 phases involving a quantitative, cross-sectional, nonexperimental, prospective study design. In the initial phase of the study, the CBCT scans of 27 patients who had undergone prostate radiotherapy were evaluated to obtain data about the frequency and causes for repeated imaging. The Spearman correlation coefficient was calculated to identify the presence of any correlations between repeated imaging and patient variables. In the second phase of the study, a self-constructed questionnaire was distributed amongst all radiographers working in a designated radiotherapy department. The gathered responses were summarised and described using simple descriptive statics. Results: Repeated CBCT scans accounted for 15.3% (n=98) of the total CBCT scans (n=639) performed. Variations in BV accounted for 51% (n=50) of the repeated scans while 24.5% (n=24) and 23.5% (n=23) of repeated scans were respectively attributed to rectum volume and set-up discrepancies. A statistically significant (p= 0.011) moderate negative correlation (Rs=-0.482) between the AP patient separation and the total number of repeated scans was identified. However, there was no statistically significant correlation between repeated imaging to the patients’ age, lateral patient separation, and BV contoured on planning CT. Radiographers’ perceptions on repeated imaging and bladder scanning varied and self-rated confidence in performing ultrasound bladder scans was also varied. This supported the need for additional training in this area. Conclusions: Research findings indicated the need for a local study to determine whether the introduction of a BUS could potentially reduce repeated imaging. Moreover, radiographers’ perceptions highlighted the need to develop suitable workflows and additional space for bladder scanning. The need for additional training was also outlined.