Testing the methodology for a dosimetric end-to-end audit of IMRT/VMAT : results of IAEA multicentre and national studies

Autor: Anna Maria Campos, Stephen F Kry, K. Chelminski, Daniela Ekendahl, Victor Gabriel Leandro Alves, Wu Hao, Emelie Adolfsson, Joanna Izewska, Srimanoroth Siri, David Thwaites, Dietmar Georg, José Luis Alonso Samper, Mikko Tenhunen, Paulina Wesolowska, Wolfgang Lechner, Sumanth Panyam Vinatha, Luo Suming, Åsa Carlsson Tedgren, Tomislav Bokulić, David S Followill, Julie Povall, Milan Tomsejm, Sougata Rakshit, Wojciech Bulski, Irena Koniarova, Pavel Kazantsev
Přispěvatelé: HUS Comprehensive Cancer Center, Department of Oncology
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Organs at Risk
medicine.medical_specialty
Quality Assurance
Health Care
3122 Cancers
Pilot Projects
Audit
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
X ray computed
medicine
Humans
Radiology
Nuclear Medicine and imaging
Medical physics
IMRT
Radiometry
Medical Audit
Phantoms
Imaging
business.industry
Radiotherapy Planning
Computer-Assisted
International Agencies
Radiotherapy Dosage
Hematology
General Medicine
Intensity-modulated radiation therapy
Nuclear Energy
IMRT
VMAT
dosimetry
end-to-end audit
3. Good health
Quality audit
Oncology
Multicenter study
030220 oncology & carcinogenesis
Feasibility Studies
RADIATION
Radiotherapy
Intensity-Modulated
Radiologi och bildbehandling
Tomography
X-Ray Computed
business
Quality assurance
SYSTEM
Radiology
Nuclear Medicine and Medical Imaging
RADIOTHERAPY
Popis: 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.
Databáze: OpenAIRE
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