title: Incorporating a radiologist in a radiation oncology department: a new model of care?
abstract: OBJECTIVE
  Increasingly complex imaging techniques, such as computed tomography, magnetic resonance imaging and positron emission tomography/computed tomography scans are being used by radiation oncologists to improve the accuracy of their radiotherapy planning contours, despite limited formal training in diagnostic imaging. This study aimed to assess whether the availability of an 'in-house' radiologist would be beneficial in enhancing the interpretation of oncological imaging and accuracy of contouring.
  
  
  METHODS
  A radiology/oncology fellow was based in the oncology department, providing radiological advice on diagnostic and planning images, for two sessions per week over a 9 month period. Oncology staff were able to book a time slot with the radiologist on a MOSAIQ cancer database and record the reason for the consultation and its outcome. The radiologist also reviewed the accuracy of the patient's contours for the weekly quality assurance audit meetings.
  
  
  RESULTS
  The radiologist reviewed 56 scans during the 49 consultation sessions. Advice over diagnostic images and target volume delineation were the main reasons for the consultations, which resulted in a change of practice in 45% of cases, ranging from changing target volumes (25%) to carrying out further imaging (20%). For the quality assurance audit meetings, the radiologist's review of 99 patients' planning contours resulted in a significant change in management in 6% of cases.
  
  
  CONCLUSIONS
  This is the first study to attempt to formally quantify the clinical benefit of having a dedicated 'in-house' radiologist within a radiation oncology department, clearly showing the valuable impact of such a role.
authors.affiliation: Department of Radiology, Liverpool Hospital, NSW, Australia; University of Western Sydney, NSW, Australia. Electronic address: mariond.livrad@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Dimigen
authors.affiliation: University of Western Sydney, NSW, Australia; Cancer Therapy Centre, Liverpool Hospital, NSW, Australia; University of New South Wales, NSW, Australia.
authors.forename: S K
authors.initials: SK
authors.lastname: Vinod
authors.affiliation: University of Western Sydney, NSW, Australia; Cancer Therapy Centre, Liverpool Hospital, NSW, Australia; University of New South Wales, NSW, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Lim
mesh_terms: D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D010347:Patient Care Planning / Q000592:standards*; D010819:Physician's Role; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D018787:Radiation Oncology / Q000592:standards*; D011871:Radiology / Q000592:standards*; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards*
keywords: Contour; in-house radiation oncologist; radiologist; radiotherapy planning