S2925
RTT- RTT operational practice and workflow innovations
ESTRO 2026
variations) or image artefacts from materials such as implants or tracheostomy tubes. The distribution of these reasons for uncertainty is illustrated in Figure 2. No correlation was found between years of professional experience and reported confidence levels. The image matches recorded as "unsure" were reviewed offline, and no plan changes were deemed necessary. In one case, the Radiation Oncologist, through retrospective offline review, disagreed with a match in which the Radiation Therapists had been very sure. In two additional cases, the Radiation Oncologist agreed with the match but requested further imaging due to significant anatomical changes. Conclusion: Radiation Therapists showed high overall confidence in image matching, regardless of clinical experience. Uncertainty was mainly related to patient-specific anatomy or image quality factors rather than operator expertise. These findings suggest that training efforts should focus on managing anatomical variations and image artefacts to strengthen confidence and consistency in clinical image matching practice. As this project was conducted over a two-week period, date collection will be continued to strengthen the representativeness of the study.Figure 1. Radiation Therapists’ confidence levels in matching.
closed facemasks in head and neck radiotherapy: Insights from the OPEN phase III trial. Radiother Oncol. 2025;209:110941. Keywords: Informed Consent, RTT Research, Advanced Practice Digital Poster 2471 Confidence of radiation therapists in image matching: The influence of experience and image quality in a multi-modality workflow. Eleanor Joubert 1 , Tess Dill 2 , Elizabeth Denney 1 , Sophie Perryck 1 , Stephanie Tanadini-Lang 1 , Matthias Guckenberger 1 1 Radiation oncology, Universitatspital Zurich, Zurich, Switzerland. 2 Radiation Oncology, Universitatspital Zurich, Zurich, Switzerland Purpose/Objective: Accurate image matching is a critical component of image-guided radiotherapy, influencing treatment precision and patient safety. Due to the rapid implementation of new imaging modalities in radiotherapy, assessing Radiation Therapists’ confidence during image matching is essential for quality assurance and training purposes. This study investigates Radiation Therapists’ self-perceived matching confidence and analyzes the influence of professional experience together with factors contributing to their uncertainty. Material/Methods: Over a two-week period, data were collected from 150 patients treated by 10 Radiation Therapists with experience ranging from 1 month to 11 years. Image guidance was performed using Cone-Beam CT (CBCT) and kV/kV imaging, with CBCT as the predominant modality. Radiation Therapists rated their confidence on a 5-point scale (1 = very unsure to 5 = very sure). The duration of the match was recorded. Treatments included Stereotactic Body Radiation Therapy, Volumetric Arc Modulated Radiotherapy and Intensity Modulated Radiotherapy, covering multiple anatomical regions such as brain, head and neck, thorax, abdomen, pelvis (prostate, bladder, rectum, gynecology), breast (whole/partial with nodes), bone metastases, axilla, and extremities. Results: Among 150 image matches, confidence levels were distributed as follows: 0% very unsure, 2% unsure, 5% neutral, 33% sure, and 60% very sure (Figure 1). Reduced confidence was primarily associated with anatomical differences between planning and treatment imaging (e.g. bladder or rectal filling
Figure 2. Uncertainty during image matching reasons.
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