Radiation treatment considerations for patients with implanted medical devices

Aim Advances in medical technology are driving the integration of medical devices that support management of chronic health conditions, including but not limited cardiac implantable electronic devices (CIED), glucose monitors, cochlear implants, and deep brain stimulators. This has led to several considerations with respect to radiation exposure to the implant device over a course of treatment. Although programs may have local implanted device policies variation in guidance and the devices considered exist. This initiative sought to take a provincial approach to establish recommendations when developing implanted device policies. Process Pursuant to an incident that resulted in the malfunction of an implanted cardiac device implanted devices policies were collected from all regional cancer programs within the province. A thematic analysis was performed specifically focusing on pre, during and post treatment considerations as well as stakeholders engaged when and were along the care pathway. A summary of identified themes was used to develop the recommendation document. Benefits/Challenges Ten realms were identified that should be considered in the development of institution-specific policies and procedures for implanted devices. including requirements; responsibility for identification; documentation responsibility and locations; engagement of relevant stakeholders (e.g. cardiology), imaging/planning considerations; beam energy and dose constraints, on treatment monitoring and additional considerations (e.g. MR simulation etc.) Impact/Outcomes The purpose of this document is to heighten awareness within the clinical community of existing and emerging implanted devices, provide considerations for minimizing possible negative effects on patient care and avoid potential corruption of implanted medical devices after exposure to radiation.