Medical physics external beam plan review: What contributes to the variability?

Autor: Salomons G; Cancer Center of Southeastern Ontario, 25 King Street West, Kingston, Ontario K7L 5P9, Canada. Electronic address: Gregory.Salomons@kingstonhsc.ca., Nakonechny K; Simcoe Muskoka Regional Cancer Centre, Royal Victoria Regional Health Centre, 201 Georgian Drive, Barrie, Ontario L4M 6M2, Canada., Neath C; R.S. McLaughlin Durham Regional Cancer Centre, Lakeridge Health Oshawa, 1 Hospital Court, Oshawa, Ontario, L1G 2B9, Canada., Chin L; Odette Cancer Centre, Sunnybrook Health Sciences Centre, T-wing 2075 Bayview Avenue TG 260, Toronto, Ontario M4N 3M5, Canada., Keller H; Princess Margaret Cancer Centre, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario M5G 2C1, Canada., Chan GH; Juravinski Cancer Centre - Hamilton Health Sciences, 699 Concession Street, Hamilton, Ontario L8V 5C2, Canada.
Jazyk: angličtina
Zdroj: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) [Phys Med] 2021 Sep; Vol. 89, pp. 293-302. Date of Electronic Publication: 2021 Sep 04.
DOI: 10.1016/j.ejmp.2021.08.004
Abstrakt: Purpose: In this article we report on the results of a survey of physics plan review practices conducted by the Cancer Care Ontario Communities of Practice and the variations in practice between and within centers.
Methods: The medical physicists at each center worked together to complete the survey and submit a single response for that center. A 4-point Likert scale, used to report the variation in practice at each center, was quantified into two parameters: "Intra-center variation", the distribution of responses within the center, and "Variation between centers", the difference between the center's response and the provincial mean. These metrics were correlated with center characteristics to identify factors that impacted on variations in practice.
Results: Bolus and heterogeneity correction were the only two items checked by all physicists in all centers. In more than half of the centers, image registration and DVH binning are not likely checked by physics. A significant difference in the variation between centers is observed for centers that used a single vendor's products. Centers that used an official checklist indicated higher levels and a wider range of Intra-center variation. Higher workload did not affect the variation in checking patterns between physicists in the same center.
Conclusions: The effect of a center's resources on their checking practice suggest that local environment and workflow be accounted for when implementing TG275 guidelines. The observation that standardized checklists did not reduce checking variability point to the importance of following the checklist development guidelines in MPPG4 to avoid ineffective checklists.
(Crown Copyright © 2021. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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