My Project Gallery Revolution (Part 3)

This is the third posting in a series describing my experiment on creating a project gallery at the Canadian Organization of Medical Physics 2015 Winter School. See Part 1 and Part 2 for entries.

Now to get down to business. The fundamental things I would like to have in the presentation include:

• Data
• Graphs of retrospective audits of patient shift data from our older experience with MV imaging, contrasted with similar graphs of audits from the new kv orthogonal imaging. This is pretty easy to do: just a few scatter plots of lateral/longitudinal/vertical plots. I will probably collapse the data into 3 bar plots with x/y error bars showing shift data pre- and post- daily image guidance. OR use the graphs I already generated that are non-directional.
• Dosimetric data that shows the consequences of changes in SSD during the course of treatment (table below shows the reduction in dose to the ICRU reference point if there is a change observed at some point during the treatment. For example, if there is a uniform 1 cm expansion of the the breast tissue for only 1 (of 16 delivered) fractions, the impact it has on the total dose the ICRU point is a 0.4% reduction.

Breast tissue	week 1					week 2					week 3
Change	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16
1 cm+	99.6%	99.3%	98.9%	98.5%	98.1%	97.8%	97.4%	97.0%	96.6%	96.3%	95.9%	95.5%	95.1%	94.8%	94.4%	94.0%
2 cm+	99.3%	98.6%	97.8%	97.1%	96.4%	95.7%	95.0%	94.3%	93.5%	92.8%	92.1%	91.4%	90.7%	89.9%	89.2%	88.5%
1cm+LAT	99.8%	99.5%	99.3%	99.1%	98.8%	98.6%	98.4%	98.2%	97.9%	97.7%	97.5%	97.2%	97.0%	96.8%	96.5%	96.3%
1cm+MED	99.8%	99.7%	99.5%	99.3%	99.2%	99.0%	98.8%	98.7%	98.5%	98.3%	98.1%	98.0%	97.8%	97.6%	97.5%	97.3%
2cm+LAT	99.6%	99.1%	98.7%	98.3%	97.8%	97.4%	96.9%	96.5%	96.1%	95.6%	95.2%	94.8%	94.3%	93.9%	93.4%	93.0%
2cm+MED	99.7%	99.4%	99.1%	98.8%	98.4%	98.1%	97.8%	97.5%	97.2%	96.9%	96.6%	96.3%	95.9%	95.6%	95.3%	95.0%

• I like the above table, but I think it's a bit challenging to interpret ... I may need to pepper it up with some explanatory text or rejig it.
• Figures 
• Some visual explanation of how we determined what was deemed a shift that is 'in control' and 'not in control'. We merged the idea of using process control systems method and the regular standard deviation / 95% confidence idea, but I need to be able to translate this as succinctly as possible
• A visual of the workflow we currently adopt for image guidance
• A visual representing why we dropped measuring SSDs
• Explanatory Text
• There will be text associated with each of the figures and data / graphs, so that is easy. But I need to provide some context to all this stuff, which centres on my subtitle "Some guidance on image guidance, please". I need to be able to present a story of how we struggled with adopting daily image guidance in breast cancer and the challenges we faced. Some of the key things I'd like to touch on:
• Dogmas and traditions that may not be necessary in todays world and new technology
• The process was more important than the technology
• Needed and had a multi-disciplinary approach
• Focus on treatment slot times as the rate limiting factor
• The need for training, education, and documentation
• Feedback
• There were a variety of questions I wanted to ask the participants, such as
• Do you perform daily image guidance and how?
• Do you measure SSDs daily? If so how is this information used?
• Do you use CBCTs for breast imaging? If so, why and how?
• What is the most difficult image guidance site at your centre? (for us, it is breast!)
• What is the single most important lesson you've learned during your adoption of kV and CBCT technology at your centre?
• I need to find a way of capturing these ideas permanently and share them.

So, that is what I'd like to share. Now the tricky part is HOW am I going to do it? 

Unfortunately time is not on my side, so not only do we have a lot of information, I only have a  few days to cobble something together. Some random thoughts I had in organizing and presented included the following:

• Provide a hardcopy of our IGRT manual. Its tangible/physical, and something someone can flip through at their own pace
• Use printed media for presenting some of the data, figures and explanatory text. I still don't have ideas on how I'm going to do this. Alternately, I could provide access to my laptop to display raw data and some graphs directly OR just throw the figures/graphs into a powerpoint. (although this does sound a tad boring).
• Use an 'old school easle/board' with a bunch of questions and allow people to write down responses to the questions themselves. OR, generate a QR code to link to a survey monkey on precisely these questions that people could access on their smart phones at their leisure.

Last time I went a bit high-tech with my presentation. This year I'm considering toning it down a bit and using some 'old-school' methods. 

Any thoughts or suggestions are appreciated! Comment away.