# COMAR Title 10 — Maryland Department of Health

## Subtitle 32 — Board of Physicians

### Chapter 10 — Licensure of Radiation Therapists, Radiographers, Nuclear Medicine Technologists, and Radiologist Assistants

#### Regulation .08 Scope of Practice — Radiation Therapy.

*COMAR 10.32.10.08*

The practice of radiation therapy includes the following:

A. Scope of practice for simulation procedures and for operation of external beam treatment devices, CT simulator, and fluoroscopic simulator for patient therapy which includes:

  (1) Preparation of machine for patient procedure;

  (2) Positioning patient for treatment or localization, or both;

  (3) Adjustment of machine components and systems;

  (4) Application of machine adjustments while patient is on the table;

  (5) Attachment or removal of any machine device or machine accessory for patient service, or both;

  (6) Manipulation of machine controls for patient exposure for localization or treatment, or both;

  (7) Production of radiation for tumor or field localization on, or treatment of, a patient, or both;

  (8) Documentation of technical set up used on a patient;

  (9) Monitoring of patient and equipment during the simulation or treatment procedures for application of corrective actions;

  (10) Oversight and application of image development standards and appropriate labeling of images regarding patient identification, date, and documentation of technical parameters;

  (11) Performance of patient or image measurements, or both;

  (12) Application of technical procedures in accordance with accepted radiation safety standards and regulations;

  (13) Performance of dosimetric and geometric calculations related to patient treatment; and

  (14) Manipulation, data entry, or other use of computer-accelerator interfaced hardware or software for patient treatment;

B. Scope of practice for preparation of patient treatment devices which includes:

  (1) Oversight of in-facility manufacture of devices or device accessories for use in patient treatment; and

  (2) Approval of devices for use in patient simulation and treatment;

C. Scope of practice for brachytherapy and radiopharmaceutical procedures which includes:

  (1) Removal, return, or handling of radiation sources or medical applicators, or both, containing radioactive material;

  (2) Transportation of radioactive materials;

  (3) Documentation for the accountability and use of the radiation sources;

  (4) Insertion and removal of sources from medical applicators;

  (5) Preparation of sealed radiopharmaceuticals for therapeutic administration to patients under physician supervision;

  (6) Assisting the licensed physician in the preparation and administration of sealed therapeutic radiopharmaceuticals for brachytherapy;

  (7) Documentation of the therapeutic application of radiopharmaceuticals;

  (8) Oversight of radiation safety practices related to the handling and administration of radiopharmaceuticals for therapy of patients;

  (9) Management of transportation and handling of therapeutic radiopharmaceuticals, immediate management and appropriate notifications for any spills or other accidents involving radiopharmaceuticals;

  (10) Calibration of therapeutic radiopharmaceuticals for dose accuracy; and

  (11) Preparation of unsealed radiopharmaceuticals for therapeutic administration to patients under direct supervision by a licensed physician if the radiation therapist has received on-site training from an authorized user; and

D. Performance of any other duties that the Board determines may be performed by a radiation therapist.