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Mohyedin MZ, Zin HM, Abubakar A, Rahman ATA. Study of PRESAGE® dosimeter for end-to-end 3D radiotherapy verification using an anthropomorphic phantom with bespoke dosimeter insert. Phys Eng Sci Med 2024:10.1007/s13246-024-01418-9. [PMID: 38634981 DOI: 10.1007/s13246-024-01418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
Modern radiotherapy techniques have advanced and become more sophisticated. End-to-end 3D verification of the complex radiotherapy dose distribution in an anthropomorphic phantom can ensure the accuracy of the treatment delivery. The phantoms commonly used for dosimetry are homogeneous solid water phantom which lacks the capability to measure the 3D dose distribution for heterogeneous tissues necessary for advanced radiotherapy techniques. Therefore, we developed an end-to-end 3D radiotherapy dose verification system based on MAX-HD anthropomorphic phantom (Integrated Medical Technologies Inc., Troy, New York) with bespoke intracranial insert for PRESAGE® dosimeter. In this study, several advanced radiotherapy treatment techniques of various levels of complexity; 3D-CRT, IMRT and VMAT treatment, were planned for a 20 mm diameter of a spherical target in the brain region and delivered to the phantom. The dosimeters were read out using an in-house developed optical computed tomography (OCT) imaging system known as 3DmicroHD-OCT. It was found that the measured dose distribution of the PRESAGE® when compared with the measured dose distribution of EBT film and Monaco TPS has a maximum difference of less than 3% for 3D-CRT, IMRT and VMAT treatment plans. The gamma analysis results of PRESAGE® in comparison to EBT film and Monaco TPS show pass rates of more than 95% for the criteria of 3% dose difference and 3 mm distance-to-agreement. This study proves the capability of PRESAGE® and bespoke MAX-HD phantom in conjunction with the 3DmicroHD-OCT system to measure 3D dose distribution for end-to-end dosimetry verification.
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Affiliation(s)
- Muhammad Zamir Mohyedin
- School of Physics and Material Studies, Faculty of Applied Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
- Centre of Astrophysics and Applied Radiation, Institute of Science, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Hafiz Mohd Zin
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13700, Kepala Batas, Penang, Malaysia.
| | - Auwal Abubakar
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, 13700, Kepala Batas, Penang, Malaysia
- Department of Medical Radiography, Faculty of Allied Health Sciences, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
- Department of Clinical Oncology, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Ahmad Taufek Abdul Rahman
- School of Physics and Material Studies, Faculty of Applied Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia.
- Centre of Astrophysics and Applied Radiation, Institute of Science, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia.
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Mizuno H, Nakaji T, Fukuda S, Kato S. End-to-end dosimetry audit for three-dimensional image-guided brachytherapy for cervical cancer. Phys Med 2024; 119:103321. [PMID: 38394979 DOI: 10.1016/j.ejmp.2024.103321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND End-to-end dosimetry audit for brachytherapy is challenging due to the steep dose gradient. However, it is an efficient method to detect unintended errors in actual clinical practice. PURPOSE We aimed to develop an on-site end-to-end test phantom for three-dimensional image-guided brachytherapy (IGBT) for cervical cancer. METHODS The test phantom we developed consisted of a water tank with an applicator/detector holder. The holder was designed to accommodate the applicator and insert an ionization chamber (PinPoint; PTW, Freiburg, Germany) to measure the dose at point A. Imaging and reconstruction were performed in the same way as performed for a patient. The feasibility of our test phantom was assessed in two different hospitals using tandem and ovoid (made of either metal or carbon) applicators that the hospitals provided. RESULTS The measured and calculated doses at point A were compared for each applicator. We observed that the values obtained using metal applicators were consistently lower, on an average by -2.3%, than the calculated values, while those obtained using carbon applicators were comparable to the calculated values. This difference can be attributed to the attenuation of the dose by the metal applicators, resulting in a lower dose at point A. The majority of treatment planning system, including the one used in this study, do not account for the material of applicator. CONCLUSIONS An end-to-end test phantom for IGBT was developed, tested, and applied in a dosimetry audit in hospitals and showed favorable results for evaluating the point A dose.
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Affiliation(s)
- Hideyuki Mizuno
- Radiation quality control section, QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan.
| | - Taku Nakaji
- Radiation quality control section, QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Shigekazu Fukuda
- Radiation quality control section, QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Shingo Kato
- Saitama Medical University International Medical Centre, Hidaka, Saitama, Japan
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Kakade NR, Kumar R, Sharma SD, Sapra BK. Dosimetry audit in advanced radiotherapy using in-house developed anthropomorphic head & neck phantom. Biomed Phys Eng Express 2024; 10:025022. [PMID: 38269653 DOI: 10.1088/2057-1976/ad222a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/24/2024] [Indexed: 01/26/2024]
Abstract
The treatment of head and neck (H&N) cancer presents formidable challenges due to the involvement of normal tissue and organs at risk (OARs) in the close vicinity. Ensuring the precise administration of the prescribed dose demands prior dose verification. Considering contour irregularity and heterogeneity in the H&N region, an anthropomorphic and heterogeneous H&N phantom was developed and fabricated locally for conducting the dosimetry audit in advanced radiotherapy treatments. This specialized phantom emulates human anatomy and incorporates a removable cylindrical insert housing a C-shaped planning target volume (PTV) alongside key OARs including the spinal cord, oral cavity, and bilateral parotid glands. Acrylonitrile Butadiene Styrene (ABS) was chosen for PTV and parotid fabrication, while Delrin was adopted for spinal cord fabrication. A pivotal feature of this phantom is the incorporation of thermoluminescent dosimeters (TLDs) within the PTV and OARs, enabling the measurement of delivered dose. To execute the dosimetry audit, the phantom, accompanied by dosimeters and comprehensive guidelines, was disseminated to multiple radiotherapy centers. Subsequently, hospital physicists acquired computed tomography (CT) scans to generate treatment plans for phantom irradiation. The treatment planning system (TPS) computed the anticipated dose distribution within the phantom, and post-irradiation TLD readings yielded actual dose measurements. The TPS calculated and TLD measured dose values at most of the locations inside the PTV were found comparable within ± 4%. The outcomes affirm the suitability of the developed anthropomorphic H&N phantom for precise dosimetry audits of advanced radiotherapy treatments.
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Affiliation(s)
- Nitin R Kakade
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
| | - Rajesh Kumar
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
| | - S D Sharma
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
- Homi Bhabha National Institute, Mumbai-400094, India
| | - B K Sapra
- Radiological Physics & Advisory Division, Bhabha Atomic Research Centre, Mumbai-400094, India
- Homi Bhabha National Institute, Mumbai-400094, India
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Jornet N, Strojan P, Howlett DC, Brady AP, Hierath M, Clark J, Wadsak W, Giammarile F, Coffey M. The QuADRANT study: Current status and recommendations for improving uptake and implementation of clinical audit of medical radiological procedures in Europe. The radiotherapy perspective. Radiother Oncol 2023; 186:109772. [PMID: 37385381 DOI: 10.1016/j.radonc.2023.109772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND QuADRANT was a research project funded by the European Commission to evaluate clinical audit uptake and implementation across Europe, with an emphasis on clinical audit as mandated within the BSSD (Basic Safety Standards Directive). AIM Focusing on the QuADRANT objectives - to obtain an overview of European clinical audit activity; identify good practices, resources, barriers and challenges; provide guidance and recommendations going forwards; identify the potential for European Union action on quality and safety focusing on the field of radiotherapy. RESULTS A pan-European survey, expert interviews and a literature review conducted within the framework of the QuADRANT project indicated that developments in national clinical audit infrastructure are required. While in radiotherapy, there is a strong tradition and high level of experience of dosimetry audits and well-established practice through the IAEA's QUATRO audits, few countries have a well-established comprehensive clinical audit programme or international/national initiatives on tumour specific clinical audits. Even if sparse, the experience from countries with established system of quality audits can be used as role-models for national professional societies to promote clinical audit implementation. However, resource allocation and national prioritisation of clinical audit are needed in many countries. National and international societies should take the initiative to promote and facilitate training and resources (guidelines, experts, courses) for clinical audits. Enablers used to enhance clinical audit participation are not widely employed. Development of hospital accreditation programmes can facilitate clinical audit uptake. An active and formalised role for patients in clinical audit practice and policy development is recommended. Because there is a persisting variation in European awareness of BSSD clinical audit requirements, work is needed to improve dissemination of information on the legislative requirements relating to clinical audit in the BSSD and in relation to inspection processes. The aim is to ensure these include clinical audit and that they encompass all clinics and specialties involved in medical applications using ionising radiation. CONCLUSION QuADRANT provided an overarching view of clinical audit practice in Europe, with all its related aspects. Unfortunately, it showed that the awareness of the BSSD requirements for clinical audit are highly variable. Therefore, there is an urgent need to dedicate efforts towards ensuring that regulatory inspections also incorporate an assessment of clinical audit program(s), affecting all aspects of clinical work and specialties involved in patient exposure to ionising radiation.
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Affiliation(s)
- Núria Jornet
- Servei de Radiofísica i Radioprotecció, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; European Society for Radiotherapy and Oncology, Brussels, Belgium.
| | - Primoz Strojan
- Dept. of Radiation Oncology, Institute of Oncology Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia; European Society for Radiotherapy and Oncology, Brussels, Belgium
| | - David C Howlett
- Radiology Department, East Sussex Healthcare NHS Trust, Brighton and Sussex Medical School, UK; European Society of Radiology (ESR), Vienna, Austria
| | - Adrian P Brady
- Radiology Department, Mercy University Hospital, Cork, Ireland; Radiology Department, University College Cork, Ireland; European Society of Radiology (ESR), Vienna, Austria
| | | | | | - Wolfgang Wadsak
- European Association of Nuclear Medicine, Vienna, Austria; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Francesco Giammarile
- European Association of Nuclear Medicine, Vienna, Austria; Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna, Austria
| | - Mary Coffey
- Discipline of Radiation Therapy, School of Medicine, Trinity College Dublin, Ireland; European Society for Radiotherapy and Oncology, Brussels, Belgium
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Ghemiș DM, Marcu LG, Virag V, Virag A. Dosimetric characteristics of 6MV flattening filter free and flattened beams among beam-matched linacs: a three-institutional study. Radiat Oncol 2023; 18:126. [PMID: 37507741 PMCID: PMC10375603 DOI: 10.1186/s13014-023-02313-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Beam matching is a concept in radiotherapy applied to clinics where more than one linac is employed to harmonise beam characteristics across linacs for allowing patients interchange without replanning. In view of this, the current study analyzes and compares dosimetric characteristics of 6MV flattening filter free and flattened beams of three beam-matched linear accelerators (linacs) from three different clinics with the aim to evaluate the matching under tight criteria for gamma analysis. METHODS Three Elekta linacs from three different clinics were included. The linacs have the same collimator assembly, Elekta Agility. Beam data were collected during commissioning process using PTW dosimetry systems. Dose profiles and percentage depth doses (PDD) were analyzed using 1D gamma analysis (1 mm/1%) as well as the following parameters: depth of maximum dose, PDD10, flatness, unflattnes, symmetry, penumbra, output factors. Additionally, five stereotactic treatment plans were optimized in one clinic and calculated by all three planning systems (Monaco) for a dosimetric comparison. RESULTS Gamma analysis of dose profiles and PDDs showed clinically acceptable results of 96.3% passing rate for profiles and 100% passing rate for PDDs. All dosimetric parameters were in good agreement with the reference data. Furthermore, dosimetric comparisons between stereotactic treatment plans showed a maximum standard deviation of 0.48 Gy for the maximum dose to PTV, and a maximum standard deviation of 0.1 Gy for the dose to the organs at risk. CONCLUSIONS All three linacs showed a strong agreement between parameters and passed the gamma analysis using 1% DD/1mm DTA criteria. This study confirmed the matching between linacs, offering the possibility to interchange patients with no replanning.
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Affiliation(s)
- Diana M Ghemiș
- Faculty of Physics, West University of Timisoara, Timisoara, Romania.
- MedEuropa, Oradea, 410191, Romania.
| | - Loredana G Marcu
- Faculty of Physics, West University of Timisoara, Timisoara, Romania
- Faculty of Informatics & Science, University of Oradea, Oradea, 410087, Romania
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, SA, 5001, Australia
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Misson-Yates S, Cunningham R, Gonzalez R, Diez P, Clark CH. Optimised conformal total body irradiation: a heterogeneous practice, so where next? Br J Radiol 2023; 96:20220650. [PMID: 36475820 PMCID: PMC10078861 DOI: 10.1259/bjr.20220650] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The use of volumetric arc therapy and inverse planning has been in routine use in radiotherapy for two decades. However, use in total body irradiation (TBI) has been more recent and few guidelines exist as to how to plan or verify. This has led to heterogeneous approaches. The goal of this review is to provide an overview of current advanced planning and dosimetry verification protocols used in optimised conformal TBI as a basis for investigating the need for greater standardisation in TBI.
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Affiliation(s)
- Sarah Misson-Yates
- Department of Medical Physics, Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Rissa Cunningham
- Department of Medical Physics, Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Regina Gonzalez
- Department of Medical Physics, Guy's Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Patricia Diez
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK
| | - Catharine H Clark
- Radiotherapy Physics, National Radiotherapy Trials Quality Assurance Group (RTTQA), Mount Vernon Cancer Centre, Northwood, UK
- Metrology for Medical Physics Centre, National Physical Laboratory, Teddington, UK
- Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
- Medical Physics and Bioengineering Department, University College London, London, UK
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7
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Pallotta S, Calusi S, Marrazzo L, Talamonti C, Russo S, Esposito M, Fiandra C, Giglioli FR, Pimpinella M, De Coste V, Bruschi A, Barbiero S, Mancosu P, Stasi M, Lisci R. End-to-end test for lung SBRT: An Italian multicentric pilot experience. Phys Med 2022; 104:129-135. [PMID: 36401941 DOI: 10.1016/j.ejmp.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 09/13/2022] [Accepted: 11/05/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Set up a lung SBRT end-to-end (e2e) test and perform a multicentre validation. MATERIAL AND METHODS A group of medical physicists from four hospitals and the Italian Institute of Ionizing Radiation Metrology designed the present e2e test. One sub-group set up the test, while another tested its feasibility and ease of use. A satisfaction questionnaire was used to collect user feedback. Each participating centre (PC) received the ADAM breathing phantom, a microDiamond detector and radiochromic films. Following the e2e protocol, each PC performed its standard internal procedure for simulating, planning, and irradiating the phantom. Each PC uploaded its planning and treatment delivery data in a shared Google Drive. A single centre analyzed all the data. RESULTS The e2e test was successfully performed by all PCs. Participants' comments indicated that ADAM was well suited to the purpose and the protocol well described. All PCs performed the test in static and dynamic modes. The ratio between measured and planned point dose obtained by PC1, PC2, PC3, PC4 was: 0.99, 0.96, 1.01 and 1.01 (static track) and 0.99, 1.02, 1.01 and 0.94 (dynamic track). The gamma passing rates (3 % global, 3 mm) between planned and measured dose maps were 98.5 %, 94.0 %, 99.1 % and 94.0 % (static track) and 99.5 %, 96.5 %, 86.0 % and 94.5 % (dynamic track) for PC1, PC2, PC3 and PC4, respectively. CONCLUSIONS An e2e test for lung SBRT has been proposed and tested in a multicentre framework. The results and user feedback prove the validity of the proposed e2e test.
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Affiliation(s)
- S Pallotta
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy; Medical Physics Unit, AOU Careggi Florence, Italy.
| | - S Calusi
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - L Marrazzo
- Medical Physics Unit, AOU Careggi Florence, Italy
| | - C Talamonti
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy; Medical Physics Unit, AOU Careggi Florence, Italy
| | - S Russo
- Health Physics Unit, Azienda USL Toscana Centro Florence, Italy
| | - M Esposito
- Health Physics Unit, Azienda USL Toscana Centro Florence, Italy
| | - C Fiandra
- Oncology Department, University of Tourin, Tourin, Italy
| | - F R Giglioli
- Health Physics Unit A. O. Città della Salute e della Scienza di Torino P.O. Molinette, Tourin, Italy
| | - M Pimpinella
- National Institute of Ionizing Radiation Metrology, ENEA-INMRI, Rome, Italy
| | - V De Coste
- National Institute of Ionizing Radiation Metrology, ENEA-INMRI, Rome, Italy
| | - A Bruschi
- Medical Physics Unit San Rossore, Pisa, Italy
| | - S Barbiero
- Medical Physics Unit San Rossore, Pisa, Italy
| | - P Mancosu
- IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - M Stasi
- Health Physics - AO Ordine Mauriziano, Tourin, Italy
| | - R Lisci
- Department of Agricultural, Food and Forestry System, University of Florence, Florence, Italy
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Safwan Ahmad Fadzil M, Mohd Noor N, Ngie Min U, Abdullah N, Taufik Dolah M, Pawanchek M, Andrew Bradley D. Dosimetry audit for megavoltage photon beams applied in non-reference conditions. Phys Med 2022; 100:99-104. [PMID: 35779357 DOI: 10.1016/j.ejmp.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE We have conducted for the first time a Malaysian postal dosimetry audit of external beam under non-reference conditions by evaluating the output performance while screening for systematic errors within the dosimetry chain. The potential use from the choice of detector were investigated along with the search for other sources of discrepancies. METHODS Ten radiotherapy centres were audited, encompassing 16 megavoltage photon beam arrangements, adopting the IAEA postal dosimetry protocol for non-reference conditions, with a holder modified to accommodate three TLD types: Ge-doped cylindrical silica fibres (CF), Ge-doped flat silica fibres (FF), and TLD-100 powder. RESULTS Eight of the centres operated within ± 5% of stated dose, one other exceeding tolerance for all measured points, and one did not return any dosimeters for analysis after failing the initial irradiations. Post remedial measures, the mean relative response for CF, FF, and TLD-100 was 1.00, 0.99, and 0.98 respectively, with associated coefficients of variation 6.87%, 6.45%, and 5.06%. CONCLUSION High quality radiotherapy clinical practice postal dosimetry audits that are based on sensitive TLDs are seen to be particularly effective in identifying and resolving dose delivery discrepancies.
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Affiliation(s)
- Muhammad Safwan Ahmad Fadzil
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Diagnostic Imaging and Radiotherapy Program, Centre for Diagnostic, Therapeutic and Investigative Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Noramaliza Mohd Noor
- Department of Radiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Ung Ngie Min
- Clinical Oncology Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Norhayati Abdullah
- Radiation Safety and Health Division, Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor, Malaysia
| | - Mohd Taufik Dolah
- Radiation Safety and Health Division, Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor, Malaysia
| | - Mahzom Pawanchek
- Department of Radiotherapy and Oncology, National Cancer Institute, 62250 W.P. Putrajaya, Malaysia
| | - David Andrew Bradley
- Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, 47500 Petaling Jaya, Selangor, Malaysia; Department of Physics, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom
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Abdullah N, Bradley D, Nisbet A, Kamarul Zaman Z, Deraman S, Mohd Noor N. Dosimetric characteristics of fabricated germanium doped optical fibres for a postal audit of therapy electron beams. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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10
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Lehmann J, Hussein M, Barry M, Siva S, Moore A, Chu M, Díez P, Eaton DJ, Harwood J, Lonski P, Claridge Mackonis E, Meehan C, Patel R, Ray X, Shaw M, Shepherd J, Smyth G, Standen TS, Subramanian B, Greer P, Clark CH. SEAFARER – A new concept for validating radiotherapy patient specific QA for clinical trials and clinical practice. Radiother Oncol 2022; 171:121-128. [DOI: 10.1016/j.radonc.2022.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/22/2022] [Accepted: 04/14/2022] [Indexed: 01/12/2023]
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Mizuno H, Yamashita W, Okuyama H, Takase N, Nakaji T, Fukuda S. Analysis of the uncertainties in the dose audit system using radiophotoluminescent glass dosimeters in Japanese radiotherapy units. RADIAT MEAS 2022. [DOI: 10.1016/j.radmeas.2022.106753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Bolt M, Clark CH, Nisbet A, Chen T. Quantification of the uncertainties within the radiotherapy dosimetry chain and their impact on tumour control. Phys Imaging Radiat Oncol 2021; 19:33-38. [PMID: 34307916 PMCID: PMC8295844 DOI: 10.1016/j.phro.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Dose delivered during radiotherapy has uncertainty arising from a number of sources including machine calibration, treatment planning and delivery and can impact outcomes. Any systematic uncertainties will impact all patients and can continue for extended periods. The impact on tumour control probability (TCP) of the uncertainties within the radiotherapy calibration process has been assessed. MATERIALS AND METHODS The linear-quadratic model was used to simulate the TCP from two prostate cancer and a head and neck (H&N) clinical trial. The uncertainty was separated into four components; 1) initial calibration, 2) systematic shift due to output drift, 3) drift during treatment and 4) daily fluctuations. Simulations were performed for each clinical case to model the variation in TCP present at the end of treatment arising from the different components. RESULTS Overall uncertainty in delivered dose was +/-2.1% (95% confidence interval (CI)), consisting of uncertainty standard deviations of 0.7% in initial calibration, 0.8% due to subsequent calibration shift due to output drift, 0.1% due to drift during treatment, and 0.2% from daily variations. The overall uncertainty of TCP (95% CI) for a population of patients treated on different machines was +/-3%, +/-5%, and +/-3% for simulations based on the two prostate trials and H&N trial respectively. CONCLUSION The greatest variation in delivered target volume dose arose from calibration shift due to output drift. Careful monitoring of beam output following initial calibration remains vital and may have a significant impact on clinical outcomes.
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Affiliation(s)
- Matthew Bolt
- Department of Medical Physics, St Luke’s Cancer Centre, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
- National Physical Laboratory, Teddington, UK
- Department of Chemical and Process Engineering, University of Surrey, Guildford, UK
| | - Catharine H. Clark
- National Physical Laboratory, Teddington, UK
- Radiotherapy Physics, University College London Hospital NHS Foundation Trust, London, UK
| | - Andrew Nisbet
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Tao Chen
- Department of Chemical and Process Engineering, University of Surrey, Guildford, UK
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Mizuno H, Yamashita W, Okuyama H, Takase N, Tohyama N, Shimizu H, Fujita Y, Kito S, Nakaji T, Fukuda S. Dose response of a radiophotoluminescent glass dosimeter for TomoTherapy, CyberKnife, and flattening-filter-free linear accelerator output measurements in dosimetry audit. Phys Med 2021; 88:91-97. [PMID: 34214838 DOI: 10.1016/j.ejmp.2021.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/11/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE We experimentally determined the radiophotoluminescent glass dosimeter (RPLD) dose responses for TomoTherapy, CyberKnife, and flattening-filter-free (FFF) linear accelerator (linac) outputs for dosimetry audits in Japan. METHODS A custom-made solid phantom with a narrow central-axis spacing of three RPLD elements was used for output measurement to minimise the dose-gradient effect of the non-flattening filter beams. For RPLD dose estimation, we used the ISO 22127 formalism. Additional unit-specific correction factors were introduced and determined via the measured data. For TomoTherapy (7 units) and CyberKnife (4 units), the doses were measured under machine-specific reference fields. For FFF linac (5 units), in addition to the reference condition, we obtained the field-size effects for the range from 5×5 cm to 25×25 cm. RESULTS The correction factors were estimated as 1.008 and 0.999 for TomoTherapy and CyberKnife, respectively. For FFF linac, they ranged from 1.011 to 0.988 for 6 MV and from 1.011 to 0.997 for 10 MV as a function of the side length of the square field from 5 to 25 cm. The estimated uncertainties of the absorbed dose to water measured by RPLD for the units were 1.32%, 1.35%, and 1.30% for TomoTherapy, CyberKnife, and FFF linac, respectively. A summary of the dosimetry audits of these treatment units using the obtained correction factors is also presented. The average percentage differences between the measured and hospital-stated doses were <1% under all conditions. CONCLUSION RPLD can be successfully used as a dosimetry audit tool for modern treatment units.
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Affiliation(s)
- Hideyuki Mizuno
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Japan.
| | | | | | | | - Naoki Tohyama
- Tokyo Bay Advanced Imaging & Radiation Oncology Makuhari Clinic, Japan
| | | | | | - Satoshi Kito
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Japan; Graduate School of Medicine, Kyoto University, Japan
| | - Taku Nakaji
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Japan
| | - Shigekazu Fukuda
- QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Japan
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Addressing the burden of cervical cancer through IAEA global brachytherapy initiatives. Brachytherapy 2020; 19:850-856. [PMID: 32928684 PMCID: PMC7895316 DOI: 10.1016/j.brachy.2020.07.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/29/2020] [Accepted: 07/29/2020] [Indexed: 12/02/2022]
Abstract
PURPOSE: Brachytherapy (BT) is an essential component of definitive therapy for locally advanced cervical cancer. Despite the advantages of the dose distribution with BT in cervical cancer, there is paucity of specific skills required for good-quality BT applications. Furthermore, replacing BT with other modern external beam techniques as a boost can lead to suboptimal results in cervix cancer. METHODS AND MATERIALS: Review of available IAEA resources, research and cooperation programs available from the IAEA was completed. These opportunities can be used to address challenges in Brachytherapy. The International Atomic Energy Agency (IAEA) provides support for BT through various means that includes education and training, both long term, short term and continuing medical education of professionals, providing expert visits to support implementation, development of curricula for professionals, e-learning through the human health campus, contouring workshops, 2D to 3D BT training, and virtual tumor boards. In addition, the IAEA provides support for implementing quality assurance in radiotherapy to its member states and provides guidelines for comprehensive audits in radiation therapy (QUATRO), and produces safety standards and training in radiation safety. In addition, mapping BT resources, making the case for investment and support for setting up BT services and radiotherapy centers are also available. The IAEA Dosimetry Laboratory provides calibration services to Secondary Standards Dosimetry Laboratories for well chambers used to confirm the reference air kerma rate of Co60 and Ir192 high-dose-rate BT sources, as well as for Cs137 low-dose-rate sources. Furthermore, the IAEA supports research and development in radiotherapy (and BT) through coordinated research activities that include controlled randomized clinical trials, Patterns of Care studies among others. Partnerships with professional organizations and funding bodies, as well as through the United Nations Joint Global Programme on Cervical Cancer Prevention and Control support radiotherapy activities, including BT in countries worldwide. CONCLUSION: The IAEA supports brachytherapy implementation, training and research and provides resources to professionals in the area.
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Izewska J, Bokulic T, Kazantsev P, Wesolowska P, van der Merwe D. 50 Years of the IAEA/WHO postal dose audit programme for radiotherapy: what can we learn from 13756 results? Acta Oncol 2020; 59:495-502. [PMID: 32036736 DOI: 10.1080/0284186x.2020.1723162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The IAEA/WHO postal dose audit programme has been operating since 1969 with the aim of improving the accuracy and consistency of dosimetry in radiotherapy in low-income and middle-income countries world-wide. This study summarises the 50 years' experience of audits and explores the quality of reference dosimetry in participating radiotherapy centres throughout the years.Material and methods: During the IAEA/WHO postal audits the dose determined from the mailed dosimeter is compared with that stated by the participant. Agreement to within ±5% is regarded acceptable whilst deviations outside ±5% limits trigger follow-up actions. Of particular interest in this study was the dependence of clinical dosimetry quality on factors related to the centre infrastructure and expertise in dosimetry of its staff.Results: The IAEA/WHO dose audit programme noted great increase in the overall percentage of acceptable results from about 50% in its early years to 99% at present, although there is some variability of results amongst participating countries. Whereas results for younger radiotherapy machines show the agreement rate between the measured and the stated doses well above 90%, for those over 20 years old the rate dropped to <80%. Linac dosimetry was always better than 60Co dosimetry and multi-machine centres generally performed better than single machine centres equipped with cobalt alone. Second and subsequent participation in audits showed higher quality dosimetry than the first participation. The implementation of modern dosimetry protocols resulted in more accurate dosimetry than the use of the older protocols.Conclusions: Over the 50 years that the IAEA has accumulated dosimetry audit data, practices in radiotherapy centres have significantly improved. Higher quality dosimetry confirmed in audits is generally associated with better infrastructure and adequate dosimetry expertise of medical physicists in participating centres.
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Affiliation(s)
- Joanna Izewska
- Dosimetry and Medical Radiation Physics Section, International Atomic Energy Agency, Vienna, Austria
| | - Tomislav Bokulic
- Dosimetry and Medical Radiation Physics Section, International Atomic Energy Agency, Vienna, Austria
| | - Pavel Kazantsev
- Dosimetry and Medical Radiation Physics Section, International Atomic Energy Agency, Vienna, Austria
| | - Paulina Wesolowska
- Dosimetry and Medical Radiation Physics Section, International Atomic Energy Agency, Vienna, Austria
| | - Debbie van der Merwe
- Dosimetry and Medical Radiation Physics Section, International Atomic Energy Agency, Vienna, Austria
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Kazantsev P, Lechner W, Gershkevitsh E, Clark CH, Venencia D, Van Dyk J, Wesolowska P, Hernandez V, Jornet N, Tomsej M, Bokulic T, Izewska J. IAEA methodology for on-site end-to-end IMRT/VMAT audits: an international pilot study. Acta Oncol 2020; 59:141-148. [PMID: 31746249 DOI: 10.1080/0284186x.2019.1685128] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: The IAEA has developed and tested an on-site, end-to-end IMRT/VMAT dosimetry audit methodology for head and neck cases using an anthropomorphic phantom. The audit methodology is described, and the results of the international pilot testing are presented.Material and methods: The audit utilizes a specially designed, commercially available anthropomorphic phantom capable of accommodating a small volume ion chamber (IC) in four locations (three in planning target volumes (PTVs) and one in an organ at risk (OAR)) and a Gafchromic film in a coronal plane for the absorbed dose to water and two-dimensional dose distribution measurements, respectively. The audit consists of a pre-visit and on-site phases. The pre-visit phase is carried out remotely and includes a treatment planning task and a set of computational exercises. The on-site phase aims at comparing the treatment planning system (TPS) calculations with measurements in the anthropomorphic phantom following an end-to-end approach. Two main aspects were tested in the pilot study: feasibility of the planning constraints and the accuracy of IC and film results in comparison with TPS calculations. Treatment plan quality was scored from 0 to 100.Results: Forty-two treatment plans were submitted by 14 institutions from 10 countries, with 79% of them having a plan quality score over 90. Seventeen sets of IC measurement results were collected, and the average measured to calculated dose ratio was 0.988 ± 0.016 for PTVs and 1.020 ± 0.029 for OAR. For 13 film measurement results, the average gamma passing rate was 94.1% using criteria of 3%/3 mm, 20% threshold and global gamma.Conclusions: The audit methodology was proved to be feasible and ready to be adopted by national dosimetry audit networks for local implementation.
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Affiliation(s)
| | - Wolfgang Lechner
- Department of Radiation Oncology, Division of Medical Physics, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Vienna, Austria
| | | | - Catharine H. Clark
- Department of Medical Physics, Royal Surrey County Hospital, Guildford, UK
- Metrology for Medical Physics (MEMPHYS), National Physical Laboratory, Teddington, UK
| | | | - Jacob Van Dyk
- Department of Oncology and Medical Biophysics, Western University, London, Canada
| | | | - Victor Hernandez
- Department of Medical Physics, Hospital Sant Joan de Reus, IISPV, Tarragona, Spain
| | - Nuria Jornet
- Servei de Radiofisica i Radioproteccio, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Milan Tomsej
- CHU Charleroi, Hopital Andre Vesale, Montigny-le-Tilleul, Belgium
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Wesolowska P, Georg D, Lechner W, Kazantsev P, Bokulic T, Tedgren AC, Adolfsson E, Campos AM, Alves VGL, Suming L, Hao W, Ekendahl D, Koniarova I, Bulski W, Chelminski K, Samper JLA, Vinatha SP, Rakshit S, Siri S, Tomsejm M, Tenhunen M, Povall J, Kry SF, Followill DS, Thwaites DI, Izewska J. Testing the methodology for a dosimetric end-to-end audit of IMRT/VMAT: results of IAEA multicentre and national studies. Acta Oncol 2019; 58:1731-1739. [PMID: 31423867 DOI: 10.1080/0284186x.2019.1648859] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Within an International Atomic Energy Agency (IAEA) co-ordinated research project (CRP), a remote end-to-end dosimetric quality audit for intensity modulated radiation therapy (IMRT)/ volumetric arc therapy (VMAT) was developed to verify the radiotherapy chain including imaging, treatment planning and dose delivery. The methodology as well as the results obtained in a multicentre pilot study and national trial runs conducted in close cooperation with dosimetry audit networks (DANs) of IAEA Member States are presented.Material and methods: A solid polystyrene phantom containing a dosimetry insert with an irregular solid water planning target volume (PTV) and organ at risk (OAR) was designed for this audit. The insert can be preloaded with radiochromic film and four thermoluminescent dosimeters (TLDs). For the audit, radiotherapy centres were asked to scan the phantom, contour the structures, create an IMRT/VMAT treatment plan and irradiate the phantom. The dose prescription was to deliver 4 Gy to the PTV in two fractions and to limit the OAR dose to a maximum of 2.8 Gy. The TLD measured doses and film measured dose distributions were compared with the TPS calculations.Results: Sixteen hospitals from 13 countries and 64 hospitals from 6 countries participated in the multicenter pilot study and in the national runs, respectively. The TLD results for the PTV were all within ±5% acceptance limit for the multicentre pilot study, whereas for national runs, 17 participants failed to meet this criterion. All measured doses in the OAR were below the treatment planning constraint. The film analysis identified seven plans in national runs below the 90% passing rate gamma criteria.Conclusion: The results proved that the methodology of the IMRT/VMAT dosimetric end-to-end audit was feasible for its intended purpose, i.e., the phantom design and materials were suitable; the phantom was easy to use and it was robust enough for shipment. Most importantly the audit methodology was capable of identifying suboptimal IMRT/VMAT delivery.
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Affiliation(s)
| | - Dietmar Georg
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Vienna, Austria
| | - Wolfgang Lechner
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Vienna, Austria
| | | | | | - Asa Carlsson Tedgren
- Medical Radiation Physics, Department of Medical Physics and Department of Medical and Health Sciences, Linkoping University, Linköping, Sweden
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Emelie Adolfsson
- Medical Radiation Physics, Department of Medical Physics and Department of Medical and Health Sciences, Linkoping University, Linköping, Sweden
| | | | | | - Luo Suming
- Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Wu Hao
- Beijing Cancer Hospital, Beijing, China
| | | | - Irena Koniarova
- National Radiation Protection Institute, Prague, Czech Republic
| | - Wojciech Bulski
- Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Krzysztof Chelminski
- Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | | | - Sumanth Panyam Vinatha
- Radiation Standards Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre Trombay, Mumbai, India
| | - Sougata Rakshit
- Radiation Standards Section, Radiation Safety Systems Division, Bhabha Atomic Research Centre Trombay, Mumbai, India
| | - Srimanoroth Siri
- SSDL, Bureau of Radiation and Medical Devices, Department of Medical Science, Nonthaburi, Thailand
| | - Milan Tomsejm
- CHU Charleroi, Hopital Andre Vesale, Montigny-le-Tilleul, Belgium
| | - Mikko Tenhunen
- Cancer Centre, Helsinki University Hospital, Helsinki, Finland
| | - Julie Povall
- University of Leeds, St James’s University Hospital, Leeds, United Kingdom
| | - Stephen F. Kry
- Imaging and Radiation Oncology Core Houston QA Centre, Anderson Cancer Centre, Houston, TX, USA
| | - David S. Followill
- Imaging and Radiation Oncology Core Houston QA Centre, Anderson Cancer Centre, Houston, TX, USA
| | - David I. Thwaites
- University of Leeds, St James’s University Hospital, Leeds, United Kingdom
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia
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Abstract
PURPOSE The IAEA newly developed "end-to-end" audit methodology for on-site verification of IMRT dose delivery has been carried out in Portugal in 2018. The main goal was to evaluate the physical aspects of the head and neck (H&N) cancer IMRT treatments. This paper presents the national results. METHODS All institutions performing IMRT treatments in Portugal, 20 out of 24, have voluntarily participated in this audit. Following the adopted methodology, a Shoulder, Head and Neck End-to-End phantom (SHANE) - that mimics an H&N region, underwent all steps of an IMRT treatment, according to the local practices. The measurements using an ionization chamber placed inside the SHANE phantom at four reference locations (three in PTVs and one in the spinal cord) and an EBT3 film positioned in a coronal plane were compared with calculated doses. FilmQA Pro software was used for film analysis. RESULTS For ionization chamber measurements, the percent difference was within the specified tolerances of ±5% for PTVs and ±7% for the spinal cord in all participating institutions. Considering film analysis, gamma passing rates were on average 96.9%±2.9% for a criterion of 3%/3 mm, 20% threshold, all above the acceptance limit of 90%. CONCLUSIONS The national results of the H&N IMRT audit showed a compliance between the planned and the delivered doses within the specified tolerances, confirming no major reasons for concern. At the same time the audit identified factors that contributed to increased uncertainties in the IMRT dose delivery in some institutions resulting in recommendations for quality improvement.
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Lehmann J, Alves A, Dunn L, Shaw M, Kenny J, Keehan S, Supple J, Gibbons F, Manktelow S, Oliver C, Kron T, Williams I, Lye J. Dosimetric end-to-end tests in a national audit of 3D conformal radiotherapy. Phys Imaging Radiat Oncol 2018; 6:5-11. [PMID: 33458381 PMCID: PMC7807562 DOI: 10.1016/j.phro.2018.03.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 03/14/2018] [Accepted: 03/14/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Independent dosimetry audits improve quality and safety of radiation therapy. This work reports on design and findings of a comprehensive 3D conformal radiotherapy (3D-CRT) Level III audit. MATERIALS AND METHODS The audit was conducted as onsite audit using an anthropomorphic thorax phantom in an end-to-end test by the Australian Clinical Dosimetry Service (ACDS). Absolute dose point measurements were performed with Farmer-type ionization chambers. The audited treatment plans included open and half blocked fields, wedges and lung inhomogeneities. Audit results were determined as Pass Optimal Level (deviations within 3.3%), Pass Action Level (greater than 3.3% but within 5%) and Out of Tolerance (beyond 5%), as well as Reported Not Scored (RNS). The audit has been performed between July 2012 and January 2018 on 94 occasions, covering approximately 90% of all Australian facilities. RESULTS The audit pass rate was 87% (53% optimal). Fifty recommendations were given, mainly related to planning system commissioning. Dose overestimation behind low density inhomogeneities by the analytical anisotropic algorithm (AAA) was identified across facilities and found to extend to beam setups which resemble a typical breast cancer treatment beam placement. RNS measurements inside lung showed a variation in the opposite direction: AAA under-dosed a target beyond lung and over-dosed the lung upstream and downstream of the target. Results also highlighted shortcomings of some superposition and convolution algorithms in modelling large angle wedges. CONCLUSIONS This audit showed that 3D-CRT dosimetry audits remain relevant and can identify fundamental global and local problems that also affect advanced treatments.
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Affiliation(s)
- Joerg Lehmann
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
- Institute of Medical Physics, School of Physics A28, University of Sydney NSW 2006, Australia
- School of Mathematical and Physical Sciences, The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
- School of Science, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, VIC 3000, Australia
| | - Andrew Alves
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Leon Dunn
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Maddison Shaw
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
- School of Science, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, VIC 3000, Australia
| | - John Kenny
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Stephanie Keehan
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
- School of Science, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, VIC 3000, Australia
| | - Jeremy Supple
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Francis Gibbons
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Sophie Manktelow
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Chris Oliver
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Tomas Kron
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
- School of Science, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, VIC 3000, Australia
- Department of Radiation Oncology, Peter MacCallum Cancer Center, 305 Grattan Street, Melbourne, VIC 3000, Australia
| | - Ivan Williams
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
| | - Jessica Lye
- Australian Clinical Dosimetry Service (ACDS), Australian Radiation Protection and National Safety Agency (ARPANSA), 619 Lower Plenty Road, Yallambie, VIC 3085, Australia
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Affiliation(s)
- Catharine H. Clark
- Medical Physics Department, Royal Surrey County Hospital, Guildford Surrey, UK
- Metrology for Medical Physics, National Physical Laboratory, Teddington, Middx, UK
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Pasler M, Hernandez V, Jornet N, Clark CH. Novel methodologies for dosimetry audits: Adapting to advanced radiotherapy techniques. Phys Imaging Radiat Oncol 2018; 5:76-84. [PMID: 33458373 PMCID: PMC7807589 DOI: 10.1016/j.phro.2018.03.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 11/25/2022] Open
Abstract
With new radiotherapy techniques, treatment delivery is becoming more complex and accordingly, these treatment techniques require dosimetry audits to test advanced aspects of the delivery to ensure best practice and safe patient treatment. This review of novel methodologies for dosimetry audits for advanced radiotherapy techniques includes recent developments and future techniques to be applied in dosimetry audits. Phantom-based methods (i.e. phantom-detector combinations) including independent audit equipment and local measurement equipment as well as phantom-less methods (i.e. portal dosimetry, transmission detectors and log files) are presented and discussed. Methodologies for both conventional linear accelerator (linacs) and new types of delivery units, i.e. Tomotherapy, stereotactic devices and MR-linacs, are reviewed. Novel dosimetry audit techniques such as portal dosimetry or log file evaluation have the potential to allow parallel auditing (i.e. performing an audit at multiple institutions at the same time), automation of data analysis and evaluation of multiple steps of the radiotherapy treatment chain. These methods could also significantly reduce the time needed for audit and increase the information gained. However, to maximise the potential, further development and harmonisation of dosimetry audit techniques are required before these novel methodologies can be applied.
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Affiliation(s)
- Marlies Pasler
- Lake Constance Radiation Oncology Center Singen-Friedrichshafen, Germany
| | - Victor Hernandez
- Department of Medical Physics, Hospital Sant Joan de Reus, IISPV, Tarragona, Spain
| | - Núria Jornet
- Servei de RadiofísicaiRadioprotecció, Hospital de la Santa CreuiSant Pau, Spain
| | - Catharine H. Clark
- Department of Medical Physics, Royal Surrey County Hospital, Guildford, Surrey, UK
- Metrology for Medical Physics (MEMPHYS), National Physical Laboratory, Teddington, Middlesex, UK
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