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. 2021 Aug 2;22(9):4–19. doi: 10.1002/acm2.13366

TABLE 1.

Example simulation orders from radiation oncologists

Sections Recommended Optional
Patient information Patient name, MRN, and DOB
Informed consent completed
IED (implantable electronic device)/pregnancy/prior RT treatment (Y/N, then choose from a list)
Treatment intent (urgent, palliative, definitive, etc.)
Patient weight over couch weight limit per local policy (Y/N)
Treatment site Anatomic location
Bolus needed at simulation
Patient positioning Supine, prone, lateral decub, frog leg, etc.
Immobilization device (choose from a list)
Adaptive planning (eg, resim, use an old isocenter, change immobilization device, etc.)
Wire markers at simulation
Special shielding required (Y/N)
Contrast (oral, IV, urethra, etc.)
Organ preparation during simulation (full bladder, empty rectum, etc.)
Imaging technique CT scan extension (super‐infer borders) MRI and other image modality needed
Breath‐hold, 4DCT Image fusion needed
Treatment techniques photon, electron
3D (SSD, AP/PA, tangent, etc.), IMRT, SBRT Treatment delivery system (choose from a list)
IGRT IGRT method (choose from a list)
IGRT alignment method (bone, specific organ, or markers)