Use of IV contrast media in radiotherapy planning CT scans: A UK audit

Aim: This article reports on a UK survey of radiotherapy centres. The primary aim was to define the extent and range of practice for which intravenous (IV) contrast is used within radiotherapy planning (RTP) Computerised Tomography (CT) scans, including how well centres adhere to RCR guidelines (2004, 2010). The secondary aim was to identify whether current guidelines are adequate or should be redefined to reflect new evidence based practice. Materials and method: A UK wide survey was undertaken, questionnaires were sent electronically via survey monkey to all 80 UK cancer centres obtained from the Society and College of Radiographers (SCoR) website. Questionnaires included closed, open and Likert Scale questions to allow complete analysis of protocols and opinions relating to IV contrast use and implementation. Data was collected within a four-week period during October 2014. Results: Eighty three percent of centres responded, 98% of responding centres now routinely deliver IV contrast. However, only 6% of centres deliver IV contrast to all 8 of the RCR 2004 recommended tumour sites. RCR 2010 compliance was also poor with the most common response to method of eGFR calculation stated as unknown. Fifteen percent of centres also did not have extravasation policies. Conclusion: The results suggest that it is perhaps time to reconsider a revision to the existing guidelines based on new evidence regarding good practice. There are many areas such as flow rates, timings, dosimetric corrections and advanced techniques which require further research to enable standardised guidelines to be identified. Keywords: Radiotherapy, IV contrast, Pre-treatment, Planning