OK, so I've gone into this lady's images and this is her first fraction so we can have a little look at what we can see on these images.

So initially you get you 3 views and you've got a slider which is just out of the screen that I'm viewing. That allows you to scroll between your planning scan, which is this larger scan and you can see the detail is is better than this smaller scan which is you cone beam CT with slightly less detail and generally you can see some more artifacts in your image.

OK so I'm gonna zoom in a little bit on this.

On the area that we're interested in.

Who spent too much?

OK, that'll do us an.

And.

It helps.

To start off with this.

Lateral view on these patients, so I'm going to use a split screen.

And I'm going to have a little look at. I'm going to take off my outlining at the moment, and I'm going to have a little look at the difference in this.

Image so I can see if I bring my split screen down to here. My bladder is almost identical to the planning scan, so that's pretty good.

Anne.

This big ball of gas, which was outlined as lodging testing, isn't there.

And the Rays.

Us

pattern with this lady with that when that ball of gas isn't there, her uterus falls very slightly further forward, but it's not drastically different and we can see there's less gas and matter in her rectum.

But the Posterial border.

It's pretty similar, really.

So this is just a little base of movements in relation to the body and fundus of her uterus.

But otherwise not unreasonable.

So we put some of our.

Structures on innotec. We also can see in this view.

Got reasonable bohney match and I can see actually in.

Sorry, I'm just fishing around in this view. I would generally have a little look at my pelvic bones right left.

I'd be just making sure that they look reasonable and I would scroll through and I'd be.

Just checking that there's pelvic bones, look a reasonable match and I did. Just if they weren't, that would count be starting point railing that you can do a bit of a Bony match. An annual checking antepost and soup in TH.

On this plane.

So I can see I've got a nice clear sacral promontory there that I can look at the match of. And that's good. I can see the soup in on this vertebra here.

And I can also check out post an. I could also if I want to make sure that I'm central, which usually gives you a better view of your vertebra, I can change my.

Alignment in the frontal view so that this red scrollbar is in the center of my vertebra and that there means that this image here.

This sagittal view is also an central in vertebra and that then it gives me a good place to check whether an I've got nice alignment with my sacrum as well.

So that looks pretty good there. So then I'm going to have a little look. I'm going to scroll through.

Um my.

Transverse slices and I'm going to put some of my volumes on just to check what I'm looking at, so I'm gonna look at. Let's have a little look.

I'm going to put my PCV on. I got PT retail on here. Don't seem to have PTV total here.

So I'm gonna pull.

I have just put my PTV and notes.

Primary and uterus on an OK. So then I can scroll through my slices.

For some reason.

The PTV isn't showing up. Why is that?

OK, so the PCV is available but we'll have a look at the CTVPCTV uterus have brought up bladder and rectum so we could start at.

The top of our volume and Scroll down and see how our match looks.

Say we've got in our and you can see again. This can be MCT. You've got more streaking. It's generally not as crisp. The quality of the image, so you can tell which is which.

So the uterus is just looking a little bit Fuller, more anterior there.

Then as I Scroll down a bit further.

Looking very similar.

Again, just slightly outside that volume, but not unreasonable.

And then we've got our primary.

Outlining that looks like a good match. Their bladder looks very similar.

And the position of the rectum. The rectum is looking smaller. You can see it here, but it's not unreasonable. It's still within the outlining.

Again, bladder looking very very similar. You can see that the quality of the image just isn't quite as good.

But we can see that that's blaza, and if I switch that volume off.

It'll make it easier for us to compare.

And we can see that we've got.

The.

The cervix and we've got.

Anne.

Surrounding structures looking very similar there.

If we bring up the CTV nodes, I think they should be.

Visible as well.

Yeah, so if we.

Have a little look at our noodle areas, even when.

The bladder is filled to a different extent and you get movement of the uterus. You generally will see that the nodal areas remain quite consistent.

Yeah, they look nice and very very similar. You can see the blood vessels inside here.

Are very consistent with the planning scam.

K.

So that was the first fraction where there wasn't really any drastic difference with an.

The original planning scan.

So this is fraction.

In 23, where there is some anatomical difference. So if we bring our.

Excuse me, sagittal view into our bigger window, and we enlarge things there.

So I've taken our outlining off and I've gone to a split screen. So what we're looking at here is our planning scans so we can see uterus and we've got our bladder there, and if I bring the.

Split screen across when you look at the bladder you can see that this bladder is quite a lot bigger.

And the bladder on the planning day. And if I put the bladder outlining on and then I go to our view where we can see our.

Today's comb beam. Then we can see that we've got. It's not an excessively big bladder, but it is bigger than and the planning scan and then we can have a little look at whether that's had an impact on the position of the uterus.

And the the uterus does look.

A little bit superior because it's being pushed up by this bladder here.

If anything, it's it's fallen a little bit more anterior, so it's superior, but a little bit anterior in comparison to the position from the planning scam.

And we could go to our.

This is just running a little bit slowly.

So I will go to our transverse V.

You

have a little look if I bring girls down too.

When are we starting to see the bladder come in?

So we've got a teeny tiny bladder here on the planning scan. Slightly bigger on this cone beam scan.

And we can see that there is. This is the uterus that I would say that's the anterior part of the uterus there. So it's it's just changed very slightly in position, not enormously.

And if we have a look, so we've got a bigger bladder there.

And again, position of the uterus isn't vastly different.

If we have a little look at that, see TV notes. Let's see if we can.

Scroll through to there.

There's a little bit of movement there.

Anne.

We can see that we've got nice and central in this an planning scam, and as we move across.

The blood vessels are more anterior, but still within the outlining, so not unreasonable at all.

So I've had to flick through and I'm pretty sure when I originally looked at these, there was a couple of days where there were more differences, but they're just not jumping out at me, so I'm going to leave that there.