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Michalec B, De Angelis C, Foltyńska G, Horwacik T, Reniers B, Wochnik A, Kopeć R, Swakoń J. Alanine/EPR dosimetry for mailed intercomparison at ocular proton therapy facilities-preliminary results for three centres for irradaitions at CCB IFJ PAN eyeline. RADIATION PROTECTION DOSIMETRY 2023; 199:1616-1619. [PMID: 37721070 PMCID: PMC10505937 DOI: 10.1093/rpd/ncad127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 02/17/2023] [Accepted: 03/10/2023] [Indexed: 09/19/2023]
Abstract
Quality control of therapeutic photon beams in the form of postal dose audits based on passive dosemeters is widely used in photon radiotherapy. On the other hand, no standardised dosimetry audit programme for proton centres has been established in Europe so far. We evaluated alanine/EPR dosimetry systems developed at the Istituto Superiore di Sanità (Italy), the Hasselt Universiteit (Belgium) and the Henryk Niewodniczanski Institute of Nuclear Physics Polish Academy of Sciences (Poland) for their applicability as a potential tool for routine mailed dose audits of passively scattered therapeutic proton beams. The evaluation was carried out in the form of an intercomparison. Dosemeters were irradiated in the 70 MeV proton beam at ocular proton therapy facility in the Cyclotron Centre Bronowice at the Henryk Niewodniczanski Institute of Nuclear Physics Polish Academy of Sciences in Krakow. A very good agreement was found between the dose measured by three laboratories and the delivered dose determined with an ionisation chamber. This, together with the inherent properties of alanine, such as non-destructive readout, tissue equivalence, weak energy dependence, dose rate independence and insignificant fading, makes alanine a good candidate for a dosemeter used in postal auditing in proton ocular radiotherapy.
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Affiliation(s)
- Barbara Michalec
- Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland
| | - Cinzia De Angelis
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Gabriela Foltyńska
- Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland
| | - Tomasz Horwacik
- Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland
| | - Brigitte Reniers
- Research Group NuTeC, Hasselt University, Agoralaan Gebouw H, B-3590 Diepenbeek, Belgium
| | - Agnieszka Wochnik
- Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland
| | - Renata Kopeć
- Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland
| | - Jan Swakoń
- Institute of Nuclear Physics Polish Academy of Sciences, Radzikowskiego 152, 31-342 Krakow, Poland
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Ketabi A, Karbasi S, Faghihi R, Mosleh-Shirazi MA. A phantom-based experimental and Monte Carlo study of the suitability of in-vivo diodes and TLD for entrance in-vivo dosimetry in small-to-medium sized 6 MV photon fields. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.110411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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De Saint-Hubert M, De Angelis C, Knežević Ž, Michalec B, Reniers B, Pyszka E, Stolarczyk L, Swakon J, Foltynska G, Wochnik A, Parisi A, Majer M, Harrison RM, Kopec R, Vanhavere F, Olko P. Characterization of passive dosimeters in proton pencil beam scanning - A EURADOS intercomparison for mailed dosimetry audits in proton therapy centres. Phys Med 2021; 82:134-143. [PMID: 33611050 DOI: 10.1016/j.ejmp.2021.01.073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/18/2020] [Accepted: 01/15/2021] [Indexed: 11/27/2022] Open
Abstract
The lack of mailed dosimetry audits of proton therapy centres in Europe has encouraged researchers of EURADOS Working Group 9 (WG9) to compare response of several existing passive detector systems in therapeutic pencil beam scanning. Alanine Electron Paramagnetic Resonance dosimetry systems from 3 different institutes (ISS, Italy; UH, Belgium and IFJ PAN, Poland), natLiF:Mg, Ti (MTS-N) and natLiF:Mg, Cu, P (MCP-N) thermoluminescent dosimeters (TLDs), GD-352M radiophotoluminescent glass dosimeters (RPLGDs) and Al2O3:C optically stimulated dosimeters (OSLDs) were evaluate. Dosimeter repeatability, batch reproducibility and response in therapeutic Pencil Beam Scanning were verified for implementation as mail auditing system. Alanine detectors demonstrated the lowest linear energy transfer (LET) dependence with an agreement between measured and treatment planning system (TPS) dose below 1%. The OSLDs measured on average a 6.3% lower dose compared to TPS calculation, with no significant difference between varying modulations and ranges. Both GD-352M and MCP-N measured a lower dose than the TPS and luminescent response was dependent on the LET of the therapeutic proton beam. Thermoluminescent response of MTS-N was also found to be dependent on the LET and a higher dose than TPS was measured with the most pronounced increase of 11%. As alanine detectors are characterized by the lowest energy dependence for different parameters of therapeutic pencil beam scanning they are suitable candidates for mail auditing in proton therapy. The response of luminescence detector systems have shown promises even though more careful calibration and corrections are needed for its implementation as part of a mailed dosimetry audit system.
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Affiliation(s)
- M De Saint-Hubert
- Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, BE-2400 Mol, Belgium.
| | - C De Angelis
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, 00161 Rome, Italy
| | - Ž Knežević
- Ruđer Bošković Institute (RBI), Bijenička 54, Zagreb, Croatia
| | - B Michalec
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - B Reniers
- Research Group NuTeC, University Hasselt (UH), Agoralaan Gebouw H, B-3590 Diepenbeek, Belgium
| | - E Pyszka
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - L Stolarczyk
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - J Swakon
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - G Foltynska
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - A Wochnik
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - A Parisi
- Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, BE-2400 Mol, Belgium
| | - M Majer
- Ruđer Bošković Institute (RBI), Bijenička 54, Zagreb, Croatia
| | - R M Harrison
- University of Newcastle, Newcastle Upon Tyne NE2 4HH, UK
| | - R Kopec
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
| | - F Vanhavere
- Belgian Nuclear Research Centre (SCK CEN), Boeretang 200, BE-2400 Mol, Belgium
| | - P Olko
- Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Radzikowskiego 152, 31-342 Krakow, Poland
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Shiau AC, Hsu SM, Huang PY, Chen CP, Huang YT, Lien KY, Chen CP, Fan SH, Jeng SC, Chen HH, Liang JA. Dosimetry audits in Taiwan radiotherapy departments. BJR Open 2021; 3:20210002. [PMID: 35707755 PMCID: PMC9185846 DOI: 10.1259/bjro.20210002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives: This study examines the practice of the regulation of Standards for Medical Exposure Quality Assurance (SMEQA) in Taiwan based on on-site quality audit for radiation therapy systems from 2016 to 2019. Methods: 81 radiation therapy departments, 141 linacs, 9 γ knife systems, 34 high dose rate brachytherapy systems, 20 Tomotherapys, and 6 Cyberknives were audited yearly. Data collection and analysis for each institute’s documents including QA procedure, ion chamber and electrometer calibration reports, and a questionnaire relating to machine type and staffing, were requested first and reviewed by auditors. On-site SMEQA core item measurements, including beam output, beam profile and energy constancy for external beam therapy systems, and the source strength, positioning, and timer accuracy for brachytherapy systems were audited second. More than 300 photon beams and more than 400 electron beams were measured each year. Results: There were approximately 8.9 radiotherapy units per million population, and 1.2 medical physicists per unit in Taiwan. For the output measurements, more than 78 and 75% of the photon beams and electron beams, respectively, from linacs were with deviations within ±1.0%. Photon beams have lower beam quality measurement deviations than electron beams. Including in-plane and cross-plane measurements, more than 90 and 85% photon and electron beams, respectively, were with flatness consistency within 1.0%. All audit measurements were within the SMEQA acceptance criteria. Conclusions: According to SMEQA regulations on-site QA audits were successfully carried out from 2016 to 2019 for all Taiwan radiotherapy units. The measurement results showed high quality machine performance in Taiwan. Advances in knowledge: Dosimetry audits with directly acquired measurement readings have lower uncertainties; allow immediate feedback, discussion, and adjustment in a timely manner. In addition to regulation system establishment and education and training implementation, the machine quality is closely related to machine maintenance implementation.
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Affiliation(s)
- An-Cheng Shiau
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan
| | - Shih-Ming Hsu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Yun Huang
- Department of Radiation Oncology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | - Chiu-Ping Chen
- Department of Radiation Oncology, Taipei Medical University-associated Wan-Fang Hospital, Taipei, Taiwan
| | - Yi-Ting Huang
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Ke-Yu Lien
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Chin-Ping Chen
- Department of Radiation Protection, Atomic Energy Council, Taipei, Taiwan
| | - Shung-Hwei Fan
- Department of Radiation Protection, Atomic Energy Council, Taipei, Taiwan
| | - Shiu-Chen Jeng
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ho-Hsing Chen
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ji-An Liang
- Department of Radiation Oncology, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, China Medical University, Taichung, Taiwan
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Mizuno H, Fukumura A, Kanematsu N, Yonai S, Shirai T, Yusa K, Yanou T, Suga M, Mizota M, Minohara S, Kanai T, Kamada T. External dosimetry audit for quality assurance of carbon-ion radiation therapy clinical trials. J Appl Clin Med Phys 2019; 20:31-36. [PMID: 30387294 PMCID: PMC6333139 DOI: 10.1002/acm2.12465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The QA team of the Japan carbon-ion radiation oncology study group (J-CROS) was organized in 2015 to enhance confidence in the accuracy of clinical dosimetry and ensure that the facility QA procedures are adequate. The team conducted onsite dosimetry audits in all the carbon-ion radiation therapy centers in Japan. MATERIALS AND METHODS A special phantom was fabricated for the onsite dosimetry audit. Target volumes such as the GTV, CTV, and PTV were contoured to the obtained CT images, and two plans with different isocenter depths were created. The dose at the isocenter was measured by an ionization chamber, in the onsite audit and compared with the calculated dose. RESULTS For all the centers, the average of the percentage ratio between the measured and calculated doses (measured/calculated) was 0.5% (-2.7% to +2.6%) and the standard deviation, 1.7%. In all the centers, the beams were within the set tolerance level of 3%. CONCLUSIONS The audit demonstrated that the dose at a single point in the water phantom was within tolerance, but it is a big step to say that all doses are correct. In addition, this external dosimetry audit encouraged centers to improve the quality of their dosimetry systems.
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Affiliation(s)
| | | | | | - Shunsuke Yonai
- National Institute of Radiological Sciences, QSTChibaJapan
| | | | - Ken Yusa
- Gunma University Heavy Ion Medical CenterGunmaJapan
| | | | - Masaki Suga
- Hyogo Ion Beam Medical CenterTatsunoHyōgoJapan
| | - Manabu Mizota
- Ion Beam Therapy CenterSAGA HIMAT FoundationSagaJapan
| | | | - Tatsuaki Kanai
- Gunma University Heavy Ion Medical CenterGunmaJapan
- Present address:
Tatsuaki KanaiOsaka Heavy Ion Therapy CenterOsakaJapan
| | - Tadashi Kamada
- National Institute of Radiological Sciences, QSTChibaJapan
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Dunn L, Jolly D. Automated data mining of a plan-check database and example application. J Appl Clin Med Phys 2018; 19:739-748. [PMID: 29956454 PMCID: PMC6123163 DOI: 10.1002/acm2.12396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/15/2018] [Accepted: 05/24/2018] [Indexed: 12/02/2022] Open
Abstract
Purpose The aim of this work was to present the development and example application of an automated data mining software platform that preforms bulk analysis of results and patient data passing through the 3D plan and delivery QA system, Mobius3D. Methods Python, matlab, and Java were used to create an interface that reads JavaScript Object Notation (JSON) created for every approved Mobius3D pre‐treatment plan‐check. The aforementioned JSON files contain all the information for every pre‐treatment QA check performed by Mobius3D, including all 3D dose, CT, structure set information, as well as all plan information and patient demographics. Two Graphical User Interfaces (GUIs) were created, the first is called Mobius3D‐Database (M3D‐DB) and presents the check results in both filterable tabular and graphical form. These data are presented for all patients and includes mean dose differences, 90% coverage, 3D gamma pass rate percentages, treatment sites, machine, beam energy, Multi‐Leaf Collimator (MLC) mode, treatment planning system (TPS), plan names, approvers, dates and times. Group statistics and statistical process control levels are then calculated based on filter settings. The second GUI, called Mobius3D organ at risk (M3DOAR), analyzes dose‐volume histogram data for all patients and all Organs‐at‐Risk (OAR). The design of the software is such that all treatment parameters and treatment site information are able to be filtered and sorted with the results, plots, and statistics updated. Results The M3D‐DB software can summarize and filter large numbers of plan‐checks from Mobius3D. The M3DOAR software is also able to analyze large amounts of dose‐volume data for patient groups which may prove useful in clinical trials, where OAR doses for large numbers of patients can be compared and correlated. Target DVHs can also be analyzed en mass. Conclusions This work demonstrates a method to extract the large amount of treatment data for every patient that is stored by Mobius3D but not easily accessible. With scripting, it is possible to mine this data for research and clinical trials as well as patient and TPS QA.
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Affiliation(s)
- Leon Dunn
- Icon Cancer Centre - The Valley, Mulgrave, Melbourne, Vic, Australia
| | - David Jolly
- Icon Cancer Centre - Richmond, Richmond, Melbourne, Vic, Australia
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Jafari S, Distefano G, Lee J, Gouldstone C, Mayles H, Jupp T, Nisbet A, Clark C. Feasibility study of silica bead thermoluminescence detectors (TLDs) in an external radiotherapy dosimetry audit programme. Radiat Phys Chem Oxf Engl 1993 2017. [DOI: 10.1016/j.radphyschem.2017.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Kunst J, Kopeć R, Kukołowicz P, Mojżeszek N, Sadowski B, Stolarczyk L, Ślusarczyk-Kacprzyk W, Toboła A, Olko P. Mailed dosimetric audit of therapeutic proton beams using thermoluminescence MTS-N (LiF:Mg,Ti) powder – First results. RADIAT MEAS 2017. [DOI: 10.1016/j.radmeas.2017.03.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Hurkmans CW, Christiaens M, Collette S, Weber DC. Beam Output Audit results within the EORTC Radiation Oncology Group network. Radiat Oncol 2016; 11:160. [PMID: 27978843 PMCID: PMC5159966 DOI: 10.1186/s13014-016-0733-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/25/2016] [Indexed: 11/23/2022] Open
Abstract
Beam Output Auditing (BOA) is one key process of the EORTC radiation therapy quality assurance program. Here the results obtained between 2005 and 2014 are presented and compared to previous results. For all BOA reports the following parameters were scored: centre, country, date of audit, beam energies and treatment machines audited, auditing organisation, percentage of agreement between stated and measured dose. Four-hundred and sixty-one BOA reports were analyzed containing the results of 1790 photon and 1366 electron beams, delivered by 755 different treatment machines. The majority of beams (91.1%) were within the optimal limit of ≤ 3%. Only 13 beams (0.4%; n = 9 electrons; n = 4 photons), were out of the range of acceptance of ≤ 5%. Previous reviews reported a much higher percentage of 2.5% or more of the BOAs with >5% deviation. The majority of EORTC centres present beam output variations within the 3% tolerance cutoff value and only 0.4% of audited beams presented with variations of more than 5%. This is an important improvement compared to previous BOA results.
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Affiliation(s)
- Coen W Hurkmans
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands. .,EORTC ROG RTQA Strategic Committee, EORTC, Brussels, Belgium.
| | - Melissa Christiaens
- EORTC HQ, Brussels, Belgium.,Clinic for Particle Therapy, West German Proton Therapy Centre Essen, University Hospital Essen, Essen, Germany
| | | | - Damien Charles Weber
- EORTC ROG RTQA Strategic Committee, EORTC, Brussels, Belgium.,Centre for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
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Gasinska A. The contribution of women to radiobiology: Marie Curie and beyond. Rep Pract Oncol Radiother 2016; 21:250-8. [PMID: 27601958 PMCID: PMC5002019 DOI: 10.1016/j.rpor.2015.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/26/2015] [Accepted: 11/30/2015] [Indexed: 01/09/2023] Open
Abstract
Marie Sklodowska-Curie, an extraordinary woman, a Polish scientist who lived and worked in France, led to the development of nuclear energy and the treatment of cancer. She was the laureate of two Nobel Prizes, the first woman in Europe who obtained the degree of Doctor of Science and opened the way for women to enter fields which had been previously reserved for men only. As a result of her determination and her love of freedom, she has become an icon for many female scientists active in radiation sciences. They are successors of Maria Curie and without the results of their work, improvement in radiation oncology will not be possible. Many of them shared some elements of Maria Curie's biography, like high ethical and moral standards, passionate dedication to work, strong family values, and scientific collaboration with their husbands. The significance of Tikvah Alper, Alma Howard, Shirley Hornsey, Juliana Denekamp, Helen Evans, Eleanor Blakely, Elizabeth L. Travis, Fiona Stewart, Andree Dutreix, Catharine West, Peggy Olive, Ingela Turesson, Penny Jeggo, Irena Szumiel, Eleonor Blakely, Sara Rockwell and Carmel Mothersill contribution to radiation oncology is presented. All the above mentioned ladies made significant contribution to the development of radiotherapy (RT) and more efficient cancer treatment. Due to their studies, new schedules of RT and new types of ionizing radiation have been applied, lowering the incidence of normal tissue toxicity. Their achievements herald a future of personalized medicine.
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Affiliation(s)
- Anna Gasinska
- Department of Applied Radiobiology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Poland
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Choi WH, Cho J. Evolving Clinical Cancer Radiotherapy: Concerns Regarding Normal Tissue Protection and Quality Assurance. J Korean Med Sci 2016; 31 Suppl 1:S75-87. [PMID: 26908993 PMCID: PMC4756347 DOI: 10.3346/jkms.2016.31.s1.s75] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 10/23/2015] [Indexed: 11/20/2022] Open
Abstract
Radiotherapy, which is one of three major cancer treatment methods in modern medicine, has continued to develop for a long period, more than a century. The development of radiotherapy means allowing the administration of higher doses to tumors to improve tumor control rates while minimizing the radiation doses absorbed by surrounding normal tissues through which radiation passes for administration to tumors, thereby reducing or removing the incidence of side effects. Such development of radiotherapy was accomplished by the development of clinical radiation oncology, the development of computers and machine engineering, the introduction of cutting-edge imaging technology, a deepened understanding of biological studies on the effects of radiation on human bodies, and the development of quality assurance (QA) programs in medical physics. The development of radiotherapy over the last two decades has been quite dazzling. Due to continuous improvements in cancer treatment, the average five-year survival rate of cancer patients has been close to 70%. The increases in cancer patients' complete cure rates and survival periods are making patients' quality of life during or after treatment a vitally important issue. Radiotherapy is implemented in approximately 1/3 to 2/3s of all cancer patients; and has improved the quality of life of cancer patients in the present age. Over the last century, as a noninvasive treatment, radiotherapy has unceasingly enhanced complete tumor cure rates and the side effects of radiotherapy have been gradually decreasing, resulting in a tremendous improvement in the quality of life of cancer patients.
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Affiliation(s)
- Won Hoon Choi
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Jaeho Cho
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea
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Clark CH, Aird EGA, Bolton S, Miles EA, Nisbet A, Snaith JAD, Thomas RAS, Venables K, Thwaites DI. Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials. Br J Radiol 2015; 88:20150251. [PMID: 26329469 DOI: 10.1259/bjr.20150251] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed.
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Affiliation(s)
- Catharine H Clark
- 1 Department of Medical Physics, Royal Surrey County Hospital, Guildford, Surrey, UK.,2 Radiation Dosimetry Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Edwin G A Aird
- 3 RTTQA Group, Mount Vernon Hospital, Northwood, Middlesex, UK
| | - Steve Bolton
- 4 Medical Physics and Engineering Department, Christie Hospital NHS Foundation Trust, Manchester, UK.,5 Institute of Physics and Engineering in Medicine, York, UK
| | | | - Andrew Nisbet
- 1 Department of Medical Physics, Royal Surrey County Hospital, Guildford, Surrey, UK.,6 Department of Physics, University of Surrey, Guildford, UK
| | - Julia A D Snaith
- 2 Radiation Dosimetry Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Russell A S Thomas
- 2 Radiation Dosimetry Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Karen Venables
- 3 RTTQA Group, Mount Vernon Hospital, Northwood, Middlesex, UK
| | - David I Thwaites
- 7 Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW, Australia
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Design and implementation of a "cheese" phantom-based Tomotherapy TLD dose intercomparison. Strahlenther Onkol 2015; 191:855-61. [PMID: 26087907 DOI: 10.1007/s00066-015-0850-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The unique beam-delivery technique of Tomotherapy machines (Accuray Inc., Sunnyvale, Calif.) necessitates tailored quality assurance. This requirement also applies to external dose intercomparisons. Therefore, the aim of the 2014 SSRMP (Swiss Society of Radiobiology and Medical Physics) dosimetry intercomparison was to compare two set-ups with different phantoms. MATERIALS AND METHODS A small cylindrical Perspex phantom, which is similar to the IROC phantom (Imaging and Radiation Oncology Core, Houston, Tex.), and the "cheese" phantom, which is provided by the Tomotherapy manufacturer to all institutions, were used. The standard calibration plans for the TomoHelical and TomoDirect irradiation techniques were applied. These plans are routinely used for dose output calibration in Tomotherapy institutions. We tested 20 Tomotherapy machines in Germany and Switzerland. The ratio of the measured (Dm) to the calculated (Dc) dose was assessed for both phantoms and irradiation techniques. The Dm/Dc distributions were determined to compare the suitability of the measurement set-ups investigated. RESULTS The standard deviations of the TLD-measured (thermoluminescent dosimetry) Dm/Dc ratios for the "cheese" phantom were 1.9 % for the TomoHelical (19 measurements) and 1.2 % (11 measurements) for the TomoDirect irradiation techniques. The corresponding ratios for the Perspex phantom were 2.8 % (18 measurements) and 1.8 % (11 measurements). CONCLUSION Compared with the Perspex phantom-based set-up, the "cheese" phantom-based set-up without individual planning was demonstrated to be more suitable for Tomotherapy dose checks. Future SSRMP dosimetry intercomparisons for Tomotherapy machines will therefore be based on the "cheese" phantom set-up.
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Lee JH, Chang LT, Shiau AC, Chen CW, Liao YJ, Li WJ, Lee MS, Hsu SM. A novel simple phantom for verifying the dose of radiation therapy. BIOMED RESEARCH INTERNATIONAL 2015; 2015:934387. [PMID: 25883980 PMCID: PMC4391650 DOI: 10.1155/2015/934387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 10/21/2014] [Accepted: 10/22/2014] [Indexed: 12/02/2022]
Abstract
A standard protocol of dosimetric measurements is used by the organizations responsible for verifying that the doses delivered in radiation-therapy institutions are within authorized limits. This study evaluated a self-designed simple auditing phantom for use in verifying the dose of radiation therapy; the phantom design, dose audit system, and clinical tests are described. Thermoluminescent dosimeters (TLDs) were used as postal dosimeters, and mailable phantoms were produced for use in postal audits. Correction factors are important for converting TLD readout values from phantoms into the absorbed dose in water. The phantom scatter correction factor was used to quantify the difference in the scattered dose between a solid water phantom and homemade phantoms; its value ranged from 1.084 to 1.031. The energy-dependence correction factor was used to compare the TLD readout of the unit dose irradiated by audit beam energies with (60)Co in the solid water phantom; its value was 0.99 to 1.01. The setup-condition factor was used to correct for differences in dose-output calibration conditions. Clinical tests of the device calibrating the dose output revealed that the dose deviation was within 3%. Therefore, our homemade phantoms and dosimetric system can be applied for accurately verifying the doses applied in radiation-therapy institutions.
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Affiliation(s)
- J. H. Lee
- Health Physics Division, Institute of Nuclear Energy Research, Longtan 325, Taiwan
| | - L. T. Chang
- Health Physics Division, Institute of Nuclear Energy Research, Longtan 325, Taiwan
| | - A. C. Shiau
- Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei 112, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei 112, Taiwan
| | - C. W. Chen
- Department of Anesthesiology, China Medical University Hospital, Taichung 404, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung 404, Taiwan
| | - Y. J. Liao
- School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei 110, Taiwan
| | - W. J. Li
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung 404, Taiwan
| | - M. S. Lee
- School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| | - S. M. Hsu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei 112, Taiwan
- Biophotonics and Molecular Imaging Research Center, National Yang-Ming University, Taipei 112, Taiwan
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Vũ Bezin J, Veres A, Lefkopoulos D, Chavaudra J, Deutsch E, de Vathaire F, Diallo I. Field size dependent mapping of medical linear accelerator radiation leakage. Phys Med Biol 2015; 60:2103-6. [DOI: 10.1088/0031-9155/60/5/2103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Srinivas C, Kumar PS, Ravichandran R, Banerjee S, Saxena PU, Kumar ESA, Pai DK. Dose verification in carcinoma of uterine cervix patients undergoing 3D conformal radiotherapy with Farmer type ion chamber. J Med Phys 2014; 39:247-50. [PMID: 25525313 PMCID: PMC4258733 DOI: 10.4103/0971-6203.144492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/31/2014] [Accepted: 08/01/2014] [Indexed: 11/30/2022] Open
Abstract
External beam radiotherapy (EBRT) for carcinoma of uterine cervix is a basic line of treatment with three dimensional conformal radiotherapy (3DCRT) in large number of patients. There is need for an established method for verification dosimetry. We tried to document absorbed doses in a group of carcinoma cervix patients by inserting a 0.6 cc Farmer type ion chamber in the vaginal cavity. A special long perspex sleeve cap is designed to cover the chamber for using in the patient's body. Response of ionization chamber is checked earlier in water phantom with and without cap. Treatment planning was carried out with X-ray computed tomography (CT) scan and with the chamber along with cap in inserted position, and with the images Xio treatment planning system. Three measurements on 3 days at 5-6 fraction intervals were recorded in 12 patients. Electrometer measured charges are converted to absorbed dose at the chamber center, in vivo. Our results show good agreement with planned dose within 3% against prescribed dose. This study, is a refinement over our previous studies with transmission dosimetry and chemicals in ampules. This preliminary work shows promise that this can be followed as a routine dose check with special relevance to new protocols in the treatment of carcinoma cervix with EBRT.
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Affiliation(s)
- Challapalli Srinivas
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India
| | - P Suman Kumar
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India
| | - Ramamoorthy Ravichandran
- Department of Medical Physics Unit, National Oncology Center, Royal Hospital, Muscat, Sultanate of Oman
| | - S Banerjee
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India
| | - P U Saxena
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India
| | - E S Arun Kumar
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India
| | - Dinesh K Pai
- Department of Radiotherapy and Oncology, Kasturba Medical College Hospital, Attavar, Mangalore, Karnataka, India
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Oliveira PA, Santos JAM. Innovative methodology for intercomparison of radionuclide calibrators using short half-life in situ prepared radioactive sources. Med Phys 2014; 41:072507. [PMID: 24989410 DOI: 10.1118/1.4884035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE An original radionuclide calibrator method for activity determination is presented. The method could be used for intercomparison surveys for short half-life radioactive sources used in Nuclear Medicine, such as(99m)Tc or most positron emission tomography radiopharmaceuticals. METHODS By evaluation of the resulting net optical density (netOD) using a standardized scanning method of irradiated Gafchromic XRQA2 film, a comparison of the netOD measurement with a previously determined calibration curve can be made and the difference between the tested radionuclide calibrator and a radionuclide calibrator used as reference device can be calculated. To estimate the total expected measurement uncertainties, a careful analysis of the methodology, for the case of(99m)Tc, was performed: reproducibility determination, scanning conditions, and possible fadeout effects. Since every factor of the activity measurement procedure can influence the final result, the method also evaluates correct syringe positioning inside the radionuclide calibrator. RESULTS As an alternative to using a calibrated source sent to the surveyed site, which requires a relatively long half-life of the nuclide, or sending a portable calibrated radionuclide calibrator, the proposed method uses a source preparedin situ. An indirect activity determination is achieved by the irradiation of a radiochromic film using (99m)Tc under strictly controlled conditions, and cumulated activity calculation from the initial activity and total irradiation time. The irradiated Gafchromic film and the irradiator, without the source, can then be sent to a National Metrology Institute for evaluation of the results. CONCLUSIONS The methodology described in this paper showed to have a good potential for accurate (3%) radionuclide calibrators intercomparison studies for(99m)Tc between Nuclear Medicine centers without source transfer and can easily be adapted to other short half-life radionuclides.
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Affiliation(s)
- P A Oliveira
- Centro de Investigação do Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal and Departamento de Física e Astronomia, Faculdade de Ciências da Universidade do Porto, Portugal
| | - J A M Santos
- Centro de Investigação do Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal; Serviço de Física Médica do Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal; Serviço de Medicina Nuclear do Instituto Português de Oncologia do Porto Francisco Gentil, EPE, Porto, Portugal; and Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
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Abstract
Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace.
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Affiliation(s)
- A L Palmer
- Department of Physics, Faculty of Engineering and Physical Science, University of Surrey, UK
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Noor NM, Hussein M, Kadni T, Bradley D, Nisbet A. Characterization of Ge-doped optical fibres for MV radiotherapy dosimetry. Radiat Phys Chem Oxf Engl 1993 2014. [DOI: 10.1016/j.radphyschem.2013.12.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Lye J, Dunn L, Kenny J, Lehmann J, Kron T, Oliver C, Butler D, Alves A, Johnston P, Franich R, Williams I. Remote auditing of radiotherapy facilities using optically stimulated luminescence dosimeters. Med Phys 2014; 41:032102. [DOI: 10.1118/1.4865786] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Rah JE, Oh DH, Shin D, Lee SB, Kim TH, Kim JY, Kase Y, Li Z, Ibbott GS, Koss PJ, Lin L, McDonough J, Arjomandy B, Park SY. Feasibility study of glass dosimeter for postal dose intercomparison of high-energy proton therapy beams. RADIAT MEAS 2013. [DOI: 10.1016/j.radmeas.2013.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Guinement L, Marchesi V, Veres A, Lacornerie T, Buchheit I, Peiffert D. [Development of external quality control protocol for CyberKnife beams dosimetry: preliminary tests multicentre]. Cancer Radiother 2013; 17:288-96. [PMID: 23871458 DOI: 10.1016/j.canrad.2013.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 04/09/2013] [Accepted: 04/11/2013] [Indexed: 12/31/2022]
Abstract
PURPOSE To develop an external quality control procedure for CyberKnife(®) beams. This work conducted in Nancy, has included a test protocol initially drawn by the medical physicist of Nancy and Lille in collaboration with Equal-Estro Laboratory. MATERIALS AND METHODS A head and neck anthropomorphic phantom and a water-equivalent homogeneous cubic plastic test-object, so-called "MiniCube", have been used. Powder and solid thermoluminescent dosimeters as well as radiochromic films have been used to perform absolute and relative dose studies, respectively. The comparison between doses calculated by Multiplan treatment planning system and measured doses have been studied in absolute dose. The dose distributions measured with films and treatment planning system calculations have been compared via the gamma function, configured with different tolerance criteria. RESULTS This work allowed, via solid thermoluminescent dosimeter measurements, verifying the beam reliability with a reproducibility of 1.7 %. The absolute dose measured in the phantom irradiated by the seven participating centres has shown an error inferior to the standard tolerance limits (± 5 %), for most of participating centres. The relative dose measurements performed at Nancy and by the Equal-Estro laboratory allowed defining the most adequate parameters for gamma index (5 %/2mm--with at least 95 % of pixels satisfying acceptability criteria: γ<1). These parameters should be independent of the film analysis software. CONCLUSION This work allowed defining a dosimetric external quality control for CyberKnife(®) systems, based on a reproducible irradiation plan through measurements performed with thermoluminescent dosimeters and radiochromic films. This protocol should be validated by a new series of measurement and taking into account the lessons of this work.
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Affiliation(s)
- L Guinement
- Institut de Cancérologie de Lorraine, Avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy, France.
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A methodology for dosimetry audit of rotational radiotherapy using a commercial detector array. Radiother Oncol 2013; 108:78-85. [DOI: 10.1016/j.radonc.2013.05.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 04/29/2013] [Accepted: 05/18/2013] [Indexed: 11/17/2022]
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26
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Ableitinger A, Vatnitsky S, Herrmann R, Bassler N, Palmans H, Sharpe P, Ecker S, Chaudhri N, Jäkel O, Georg D. Dosimetry auditing procedure with alanine dosimeters for light ion beam therapy. Radiother Oncol 2013; 108:99-106. [DOI: 10.1016/j.radonc.2013.04.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 04/15/2013] [Accepted: 04/27/2013] [Indexed: 11/16/2022]
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Kron T, Haworth A, Williams I. Dosimetry for audit and clinical trials: challenges and requirements. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/444/1/012014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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28
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Benadjaoud MA, Bezin J, Veres A, Lefkopoulos D, Chavaudra J, Bridier A, de Vathaire F, Diallo I. A multi-plane source model for out-of-field head scatter dose calculations in external beam photon therapy. Phys Med Biol 2012; 57:7725-39. [DOI: 10.1088/0031-9155/57/22/7725] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kadoya N, Shimomura K, Kitou S, Shiota Y, Fujita Y, Dobashi S, Takeda K, Jingu K, Matsushita H, Namito Y, Ban S, Koyama S, Tabushi K. Dosimetric properties of radiophotoluminescent glass detector in low-energy photon beams. Med Phys 2012; 39:5910-6. [DOI: 10.1118/1.4747261] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Yegingil Z, DeWerd LA, Davis SD, Hammer C, Kunugi K. Photon beam audits for radiation therapy clinics: a pilot mailed dosemeter study in Turkey. RADIATION PROTECTION DOSIMETRY 2012; 148:249-257. [PMID: 21362695 DOI: 10.1093/rpd/ncr017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A thermoluminescent dosemeter (TLD) mailed dose audit programme was performed at five radiotherapy clinics in Turkey. The intercomparison was organised by the University of Wisconsin Radiation Calibration Laboratory (UWRCL), which was responsible for the technical aspects of the study including reference irradiations, distribution, collection and evaluation. The purpose of these audits was to perform an independent dosimetry check of the radiation beams using TLDs sent by mail. Acrylic holders, each with five TLD chips inside and instructions for their irradiation to specified absorbed dose to water of 2 Gy, were mailed to all participating clinics. TLD irradiations were performed with a 6 MV linear accelerator and (60)Co photon beams. The deviations from the TL readings of UWRCL were calculated. Discrepancies inside the limits of ±5 % between the participant-stated dose, and the TLD-measured dose were considered acceptable. One out of 10 beams checked was outside this limit, with a difference of 5.8 %.
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Affiliation(s)
- Z Yegingil
- Department of Physics, Faculty of Art-Sciences, University of Cukurova, Adana, Turkey.
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31
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Espinosa MDM, Núñez L, Muñiz JL, Lagares JI, Embid M, Gómez-Ros JM. Postal dosimetry audit test for small photon beams. Radiother Oncol 2012; 102:135-41. [DOI: 10.1016/j.radonc.2011.06.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 06/03/2011] [Accepted: 06/04/2011] [Indexed: 10/18/2022]
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Fenoglietto P, Laliberté B, Aillères N, Riou O, Dubois JB, Azria D. Eight years of IMRT quality assurance with ionization chambers and film dosimetry: experience of the Montpellier Comprehensive Cancer Center. Radiat Oncol 2011; 6:85. [PMID: 21774795 PMCID: PMC3155475 DOI: 10.1186/1748-717x-6-85] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2011] [Accepted: 07/20/2011] [Indexed: 12/03/2022] Open
Abstract
Background To present the results of quality assurance (QA) in IMRT of film dosimetry and ionization chambers measurements with an eight year follow-up. Methods All treatment plans were validated under the linear accelerator by absolute and relative measures obtained with ionization chambers (IC) and with XomatV and EDR2 films (Kodak). Results The average difference between IC measured and computed dose at isocenter with the gantry angle of 0° was 0.07 ± 1.22% (average ± 1 SD) for 2316 prostate, 1.33 ± 3.22% for 808 head and neck (h&n), and 0.37 ± 0.62% for 108 measurements of prostate bed fields. Pelvic treatment showed differences of 0.49 ± 1.86% in 26 fields for prostate cases and 2.07 ± 2.83% in 109 fields of anal canal. Composite measurement at isocenter for each patient showed an average difference with computed dose of 0.05 ± 0.87% for 386 prostate, 1.49 ± 1.86% for 158 h&n, 0.37 ± 0.34% for 23 prostate bed, 0.80 ± 0.28% for 4 pelvis, and 2.31 ± 0.56% for 17 anal canal cases. On the first 250 h&n analyzed by film in absolute dose, the average of the points crossing a gamma index 3% and 3 mm was 93%. This value reached 99% for the prostate fields. Conclusion More than 3500 beams were found to be within the limits defined as validated for treatment between 2001 and 2008.
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Affiliation(s)
- Pascal Fenoglietto
- Département de Cancérologie Radiothérapie et de Radiophysique, CRLC Val d'Aurelle-Paul Lamarque, Montpellier, France.
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Quality assurance for prospective EORTC radiation oncology trials: The challenges of advanced technology in a multicenter international setting. Radiother Oncol 2011; 100:150-6. [DOI: 10.1016/j.radonc.2011.05.073] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Revised: 05/23/2011] [Accepted: 05/29/2011] [Indexed: 11/20/2022]
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Implementation of alanine/EPR as transfer dosimetry system in a radiotherapy audit programme in Belgium. Radiother Oncol 2011; 99:94-6. [DOI: 10.1016/j.radonc.2011.01.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2010] [Revised: 01/25/2011] [Accepted: 01/31/2011] [Indexed: 11/19/2022]
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Hultqvist M, Fernández-Varea JM, Izewska J. Monte Carlo simulation of correction factors for IAEA TLD holders. Phys Med Biol 2010; 55:N161-6. [DOI: 10.1088/0031-9155/55/6/n03] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Unintended exposure in radiotherapy: Identification of prominent causes. Radiother Oncol 2009; 93:609-17. [DOI: 10.1016/j.radonc.2009.08.044] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 08/26/2009] [Accepted: 08/27/2009] [Indexed: 11/21/2022]
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Isambert A, Ferreira I, Bossi A, Beaudré A, Nicula L, Lefkopoulos D. Dose délivrée au patient lors de l’acquisition d’images par tomographie conique de haute énergie. Cancer Radiother 2009; 13:358-64. [DOI: 10.1016/j.canrad.2009.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2009] [Revised: 05/20/2009] [Accepted: 05/20/2009] [Indexed: 10/20/2022]
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Kolybaba M, Kron T, Harris J, O'Brien P, Kenny L. Survey of Radiation Oncology Centres in Australia: Report of the Radiation Oncology Treatment Quality Program. J Med Imaging Radiat Oncol 2009; 53:382-95. [DOI: 10.1111/j.1754-9485.2009.02080.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sanuki-Fujimoto N, Ishikura S, Hayakawa K, Kubota K, Nishiwaki Y, Tamura T. Radiotherapy quality assurance review in a multi-center randomized trial of limited-disease small cell lung cancer: the Japan Clinical Oncology Group (JCOG) trial 0202. Radiat Oncol 2009; 4:16. [PMID: 19490617 PMCID: PMC2698865 DOI: 10.1186/1748-717x-4-16] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Accepted: 06/02/2009] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to analyze the radiotherapy (RT) quality assurance (QA) assessment in Japan Clinical Oncology Group (JCOG) 0202, which was the first trial that required on-going RT QA review in the JCOG. Methods JCOG 0202 was a multi-center phase III trial comparing two types of consolidation chemotherapy after concurrent chemoradiotherapy for limited-disease small cell lung cancer. RT requirements included a total dose of 45 Gy/30 fx (bis in die, BID/twice a day) without heterogeneity correction; elective nodal irradiation (ENI) of 30 Gy; at least 1 cm margin around the clinical target volume (CTV); and interfraction interval of 6 hours or longer. Dose constraints were defined in regards to the spinal cord and the lung. The QA assessment was classed as per protocol (PP), deviation acceptable (DA), violation unacceptable (VU), and incomplete/not evaluable (I/NE). Results A total of 283 cases were accrued, of which 204 were fully evaluable, excluding 79 I/NE cases. There were 18 VU in gross tumor volume (GTV) coverage (8% of 238 evaluated); 4 VU and 23 DA in elective nodal irradiation (ENI) (2% and 9% of 243 evaluated, respectively). Some VU were observed in organs at risk (1 VU in the lung and 5 VU in the spinal cord). Overall RT compliance (PP + DA) was 92% (187 of 204 fully evaluable). Comparison between the former and latter halves of the accrued cases revealed that the number of VU and DA had decreased. Conclusion The results of the RT QA assessment in JCOG 0202 seemed to be acceptable, providing reliable results.
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Affiliation(s)
- Naoko Sanuki-Fujimoto
- Clinical Trials and Practice Support Division, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
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Begnozzi L, Benassi M, Bertanelli M, Bonini A, Cionini L, Conte L, Fiorino C, Gabriele P, Gardani G, Giani A, Magri S, Morelli M, Morrica B, Olmi P, Orecchia R, Penduzzu G, Raffaele L, Rosi A, Tabocchini MA, Valdagni R, Viti V. Quality assurance of 3D-CRT: Indications and difficulties in their applications. Crit Rev Oncol Hematol 2009; 70:24-38. [DOI: 10.1016/j.critrevonc.2008.07.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Revised: 06/12/2008] [Accepted: 07/18/2008] [Indexed: 12/25/2022] Open
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Feasibility study of radiophotoluminescent glass rod dosimeter postal dose intercomparison for high energy photon beam. Appl Radiat Isot 2009; 67:324-8. [DOI: 10.1016/j.apradiso.2008.09.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 08/22/2008] [Accepted: 09/24/2008] [Indexed: 11/20/2022]
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Bekelman JE, Yahalom J. Quality of Radiotherapy Reporting in Randomized Controlled Trials of Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma: A Systematic Review. Int J Radiat Oncol Biol Phys 2009; 73:492-8. [DOI: 10.1016/j.ijrobp.2008.04.058] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 04/14/2008] [Accepted: 04/14/2008] [Indexed: 10/21/2022]
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Ebert MA, Harrison KM, Cornes D, Howlett SJ, Joseph DJ, Kron T, Hamilton CS, Denham JW. Comprehensive Australasian multicentre dosimetric intercomparison: Issues, logistics and recommendations. J Med Imaging Radiat Oncol 2009; 53:119-31. [DOI: 10.1111/j.1754-9485.2009.02047.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Linear-accelerator X-ray output: a multicentre chamber-based intercomparison study in Australia and New Zealand. ACTA ACUST UNITED AC 2008; 31:268-79. [DOI: 10.1007/bf03178596] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Johansson KA, Nilsson P, Zackrisson B, Ohlson B, Kjellén E, Mercke C, Alvarez-Fonseca M, Billström A, Björk-Eriksson T, Björ O, Ekberg L, Friesland S, Karlsson M, Lagerlund M, Lundkvist L, Löfroth PO, Löfvander-Thapper K, Nilsson A, Nyman J, Persson E, Reizenstein J, Rosenbrand HO, Wiklund F, Wittgren L. The quality assurance process for the ARTSCAN head and neck study – A practical interactive approach for QA in 3DCRT and IMRT. Radiother Oncol 2008; 87:290-9. [DOI: 10.1016/j.radonc.2007.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2007] [Revised: 12/08/2007] [Accepted: 12/11/2007] [Indexed: 11/16/2022]
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Kapanen M, Sipilä P, Bly R, Järvinen H, Tenhunen M. Accuracy of central axis dose calculations for photon external radiotherapy beams in Finland: The quality of local beam data and the use of averaged data. Radiother Oncol 2008; 86:264-71. [DOI: 10.1016/j.radonc.2007.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 12/11/2007] [Indexed: 10/22/2022]
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Izewska J, Hultqvist M, Bera P. Analysis of uncertainties in the IAEA/WHO TLD postal dose audit system. RADIAT MEAS 2008. [DOI: 10.1016/j.radmeas.2008.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mizuno H, Kanai T, Kusano Y, Ko S, Ono M, Fukumura A, Abe K, Nishizawa K, Shimbo M, Sakata S, Ishikura S, Ikeda H. Feasibility study of glass dosimeter postal dosimetry audit of high-energy radiotherapy photon beams. Radiother Oncol 2008; 86:258-63. [DOI: 10.1016/j.radonc.2007.10.024] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 10/16/2007] [Accepted: 10/17/2007] [Indexed: 11/25/2022]
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Georg D, Nyholm T, Olofsson J, Kjaer-Kristoffersen F, Schnekenburger B, Winkler P, Nyström H, Ahnesjö A, Karlsson M. Clinical evaluation of monitor unit software and the application of action levels. Radiother Oncol 2007; 85:306-15. [PMID: 17904234 DOI: 10.1016/j.radonc.2007.04.035] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2006] [Revised: 03/09/2007] [Accepted: 04/24/2007] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was the clinical evaluation of an independent dose and monitor unit verification (MUV) software which is based on sophisticated semi-analytical modelling. The software was developed within the framework of an ESTRO project. Finally, consistent handling of dose calculation deviations applying individual action levels is discussed. MATERIALS AND METHODS A Matlab-based software ("MUV") was distributed to five well-established treatment centres in Europe (Vienna, Graz, Basel, Copenhagen, and Umeå) and evaluated as a quality assurance (QA) tool in clinical routine. Results were acquired for 226 individual treatment plans including a total of 815 radiation fields. About 150 beam verification measurements were performed for a portion of the individual treatment plans, mainly with time variable fluence patterns. The deviations between dose calculations performed with a treatment planning system (TPS) and the MUV software were scored with respect to treatment area, treatment technique, geometrical depth, radiological depth, etc. RESULTS In general good agreement was found between calculations performed with the different TPSs and MUV, with a mean deviation per field of 0.2+/-3.5% (1 SD) and mean deviations of 0.2+/-2.2% for composite treatment plans. For pelvic treatments less than 10% of all fields showed deviations larger than 3%. In general, when using the radiological depth for verification calculations the results and the spread in the results improved significantly, especially for head-and-neck and for thorax treatments. For IMRT head-and-neck beams, mean deviations between MUV and the local TPS were -1.0+/-7.3% for dynamic, and -1.3+/-3.2% for step-and-shoot IMRT delivery. For dynamic IMRT beams in the pelvis good agreement was obtained between MUV and the local TPS (mean: -1.6+/-1.5%). Treatment site and treatment technique dependent action levels between +/-3% and +/-5% seem to be clinically realistic if a radiological depth correction is performed, even for dynamic wedges and IMRT. CONCLUSION The software MUV is well suited for patient specific treatment plan QA applications and can handle all currently available treatment techniques that can be applied with standard linear accelerators. The highly sophisticated dose calculation model implemented in MUV allows investigation of systematic TPS deviations by performing calculations in homogeneous conditions.
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Affiliation(s)
- Dietmar Georg
- Department of Radiotherapy, Medical University Vienna/AKH Vienna, Austria.
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Girard N, Mornex F. La radiothérapie thoracique et ses exigences actuelles de qualité. Application aux essais cliniques anciens et actuels. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)78139-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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