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Nishio T, Nakamura M, Okamoto H, Kito S, Minemura T, Ozawa S, Kumazaki Y, Ishikawa M, Tohyama N, Kurooka M, Nakashima T, Shimizu H, Suzuki R, Ishikura S, Nishimura Y. An overview of the medical-physics-related verification system for radiotherapy multicenter clinical trials by the Medical Physics Working Group in the Japan Clinical Oncology Group-Radiation Therapy Study Group. JOURNAL OF RADIATION RESEARCH 2020; 61:999-1008. [PMID: 32989445 PMCID: PMC7674673 DOI: 10.1093/jrr/rraa089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/25/2020] [Indexed: 05/14/2023]
Abstract
The Japan Clinical Oncology Group-Radiation Therapy Study Group (JCOG-RTSG) has initiated several multicenter clinical trials for high-precision radiotherapy, which are presently ongoing. When conducting multi-center clinical trials, a large difference in physical quantities, such as the absolute doses to the target and the organ at risk, as well as the irradiation localization accuracy, affects the treatment outcome. Therefore, the differences in the various physical quantities used in different institutions must be within an acceptable range for conducting multicenter clinical trials, and this must be verified with medical physics consideration. In 2011, Japan's first Medical Physics Working Group (MPWG) in the JCOG-RTSG was established to perform this medical-physics-related verification for multicenter clinical trials. We have developed an auditing method to verify the accuracy of the absolute dose and the irradiation localization. Subsequently, we credentialed the participating institutions in the JCOG multicenter clinical trials that were using stereotactic body radiotherapy (SBRT) for lungs, intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) for several disease sites, and proton beam therapy (PT) for the liver. From the verification results, accuracies of the absolute dose and the irradiation localization among the participating institutions of the multicenter clinical trial were assured, and the JCOG clinical trials could be initiated.
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Affiliation(s)
- Teiji Nishio
- Corresponding author. Department of Medical Physics, Graduate School of Medicine, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. Tel: +81-3-3353-8111; Fax: +81-3-5269-7040;
| | - Mitsuhiro Nakamura
- Division of Medical Physics, Department of Information Technology and Medical Engineering, Human He Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Hiroyuki Okamoto
- Department of Medical Physics, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045 Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Satoshi Kito
- Department of Radiology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan
- Department of Radiation Oncology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
- Division of Medical Physics, Department of Information Technology and Medical Engineering, Human He Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawaharacho, Sakyo-ku, Kyoto 606-8507, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Toshiyuki Minemura
- Division of Medical Support and Partnership, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Shuichi Ozawa
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Hiroshima High-Precision Radiotherapy Cancer Center, 3-2-2, Futabanosato, Higashi-ku, Hiroshima 732-0057, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Yu Kumazaki
- Department of Radiation Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Masayori Ishikawa
- Faculty of Health Sciences, Hokkaido University, N-12 W-5 Kita-ku, Sapporo, 060-0812, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Naoki Tohyama
- Division of Medical Physics, Tokyo Bay Advanced Imaging & Radiation Oncology Makuhari Clinic, 1-17 Toyosuna, Mihama-ku, Chiba, 261-0024, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Masahiko Kurooka
- Department of Radiation Therapy, Tokyo Medical University Hospital, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Takeo Nakashima
- Radiation Therapy Section, Department of Clinical Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Hidetoshi Shimizu
- Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi 464-8681, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Ryusuke Suzuki
- Department of Medical Physics, Hokkaido University Hospital, North-14, West-5, Kita-Ku, Sapporo, Hokkaido 060-8638, Japan
- Medical Physics Working Group (MPWG) in Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Satoshi Ishikura
- Department of Radiology, Graduate School of Medical Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
- Radiotherapy Committee (RC) in Japan Clinical Oncology Group, Tokyo, Japan
- Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511, Japan
- Japan Clinical Oncology Group - Radiation Therapy Study Group (JCOG-RTSG), Tokyo, Japan
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Joseph D, Denham JW, Steigler A, Lamb DS, Spry NA, Stanley J, Shannon T, Duchesne G, Atkinson C, Matthews JH, Turner S, Kenny L, Christie D, Tai KH, Gogna NK, Kearvell R, Murray J, Ebert MA, Haworth A, Delahunt B, Oldmeadow C, Attia J. Radiation Dose Escalation or Longer Androgen Suppression to Prevent Distant Progression in Men With Locally Advanced Prostate Cancer: 10-Year Data From the TROG 03.04 RADAR Trial. Int J Radiat Oncol Biol Phys 2020; 106:693-702. [DOI: 10.1016/j.ijrobp.2019.11.415] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 11/17/2019] [Accepted: 11/21/2019] [Indexed: 10/25/2022]
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Miri N, Vial P, Greer PB. Remote dosimetric auditing of clinical trials: The need for vendor specific models to convert images to dose. J Appl Clin Med Phys 2019; 20:175-183. [PMID: 30597730 PMCID: PMC6333142 DOI: 10.1002/acm2.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/02/2018] [Accepted: 11/04/2018] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION A previous pilot study has demonstrated the feasibility of a novel image-based approach for remote dosimetric auditing of clinical trials. The approach uses a model to convert in-air acquired intensity modulated radiotherapy (IMRT) images to delivered dose inside a virtual phantom. The model was developed using images from an electronic portal imaging device (EPID) on a Varian linear accelerator. It was tuned using beam profiles and field size factors (FSFs) of a series of square fields measured in water tank. This work investigates the need for vendor specific conversion models for image-based auditing. The EPID measured profile and FSF data for Varian (vendor 1) and Elekta (vendor 2) systems are compared along with the performance of the existing Varian model (VM) and a new Elekta model (EM) for a series of audit IMRT fields measured on vendor 2 systems. MATERIALS AND METHODS The EPID measured beam profile and FSF data were studied for the two vendors to quantify and understand their relevant dosimetric differences. Then, an EM was developed converting EPID to dose in the virtual water phantom using a vendor 2 water tank data and images from corresponding EPID. The VM and EM were compared for predicting vendor 2 measured dose in water tank. Then, the performance of the new EM was compared to the VM for auditing of 54 IMRT fields from four vendor 2 facilities. Statistical significance of using vendor specific models was determined. RESULTS Observed dosimetry differences between the two vendors suggested developing an EM would be beneficial. The EM performed better than VM for vendor 2 square and IMRT fields. The IMRT audit gamma pass rates were (99.8 ± 0.5)%, (98.6 ± 2.3)% and (97.0 ± 3.0)% at respectively 3%/3 mm, 3%/2 mm and 2%/2 mm with improvements at most fields compared with using the VM. For the pilot audit, the difference between gamma results of the two vendors was reduced when using vendor specific models (VM: P < 0.0001, vendor specific models: P = 0.0025). CONCLUSION A new model was derived to convert images from vendor 2 EPIDs to dose for remote auditing vendor 2 deliveries. Using vendor specific models is recommended to remotely audit systems from different vendors, however, the improvements found were not major.
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Affiliation(s)
- Narges Miri
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, NSW, Australia
| | - Philip Vial
- Department of Medical Physics, Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia.,Ingham Institute of Applied Medical Research, Sydney, Australia.,Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Peter B Greer
- School of Mathematical and Physical Sciences, University of Newcastle, Callaghan, NSW, Australia.,Calvary Mater Newcastle Hospital, Newcastle, New South Wales, Australia
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A virtual dosimetry audit - Towards transferability of gamma index analysis between clinical trial QA groups. Radiother Oncol 2018; 125:398-404. [PMID: 29100698 DOI: 10.1016/j.radonc.2017.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE Quality assurance (QA) for clinical trials is important. Lack of compliance can affect trial outcome. Clinical trial QA groups have different methods of dose distribution verification and analysis, all with the ultimate aim of ensuring trial compliance. The aim of this study was to gain a better understanding of different processes to inform future dosimetry audit reciprocity. MATERIALS Six clinical trial QA groups participated. Intensity modulated treatment plans were generated for three different cases. A range of 17 virtual 'measurements' were generated by introducing a variety of simulated perturbations (such as MLC position deviations, dose differences, gantry rotation errors, Gaussian noise) to three different treatment plan cases. Participants were blinded to the 'measured' data details. Each group analysed the datasets using their own gamma index (γ) technique and using standardised parameters for passing criteria, lower dose threshold, γ normalisation and global γ. RESULTS For the same virtual 'measured' datasets, different results were observed using local techniques. For the standardised γ, differences in the percentage of points passing with γ < 1 were also found, however these differences were less pronounced than for each clinical trial QA group's analysis. These variations may be due to different software implementations of γ. CONCLUSIONS This virtual dosimetry audit has been an informative step in understanding differences in the verification of measured dose distributions between different clinical trial QA groups. This work lays the foundations for audit reciprocity between groups, particularly with more clinical trials being open to international recruitment.
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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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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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Miri N, Lehmann J, Legge K, Zwan BJ, Vial P, Greer PB. Remote dosimetric auditing for intensity modulated radiotherapy: A pilot study. Phys Imaging Radiat Oncol 2017. [DOI: 10.1016/j.phro.2017.11.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Nakamura M, Minemura T, Ishikura S, Nishio T, Narita Y, Nishimura Y. An on-site audit system for dosimetry credentialing of intensity-modulated radiotherapy in Japanese Clinical Oncology Group (JCOG) clinical trials. Phys Med 2016; 32:987-91. [PMID: 27402255 DOI: 10.1016/j.ejmp.2016.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/21/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE This study was undertaken to analyze the results of intensity-modulated radiotherapy (IMRT) dosimetry credentialing using a phantom in the Japanese Clinical Oncology Group clinical trials. METHODS All measurements were performed on-site. The IMRT phantom consisted of a phantom shell and a module. Two types of structures, including a C-shaped planning target volume (PTV) around a column-shaped organ at risk (OAR), were included in the module. Each participating institution was asked to image, plan, and treat the phantom. A prescription dose of 2Gy should cover 95% of the PTV. The plan should limit the maximum doses to the PTV and OAR to less than 110% and 60%, respectively. The pass criteria were ±3% in terms of chamber dosimetry and a difference in profile position ⩽2mm in the high-dose gradient area of film dosimetry. The positional difference was defined as the largest distance between the measured and calculated positions at doses of 60% or 80%. These tolerances were based on the Japanese Society for Radiation Oncology IMRT guidelines. RESULTS Credentialing was performed on a total of 44 treatment machines in 32 institutions from 2009 to 2015. All differences between measured and planned doses at the measurement points of the PTV were within 3%. The means±standard deviations of the positional differences were 1.0±0.4mm and 0.9±0.3mm without and with the phantom shell, respectively. CONCLUSIONS The dose differences and positional differences met the desired criteria in all institutions.
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Affiliation(s)
- Mitsuhiro Nakamura
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Japan.
| | - Toshiyuki Minemura
- Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
| | - Satoshi Ishikura
- Department of Radiology, Koshigaya Municipal Hospital, Saitama, Japan
| | - Teiji Nishio
- Department of Radiation Oncology, Graduate School of Medicine, Hiroshima University, Japan
| | - Yuichiro Narita
- Department of Oncological Radiation, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Japan
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Mukhlisin, Pawiro SA. Dosimetric impact of interplay effect in lung IMRT and VMAT treatment using in-house dynamic thorax phantom. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1742-6596/694/1/012009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Lye J, Kenny J, Lehmann J, Dunn L, Kron T, Alves A, Cole A, Williams I. A 2D ion chamber array audit of wedged and asymmetric fields in an inhomogeneous lung phantom. Med Phys 2015; 41:101712. [PMID: 25281951 DOI: 10.1118/1.4896097] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The Australian Clinical Dosimetry Service (ACDS) has implemented a new method of a nonreference condition Level II type dosimetric audit of radiotherapy services to increase measurement accuracy and patient safety within Australia. The aim of this work is to describe the methodology, tolerances, and outcomes from the new audit. METHODS The ACDS Level II audit measures the dose delivered in 2D planes using an ionization chamber based array positioned at multiple depths. Measurements are made in rectilinear homogeneous and inhomogeneous phantoms composed of slabs of solid water and lung. Computer generated computed tomography data sets of the rectilinear phantoms are supplied to the facility prior to audit for planning of a range of cases including reference fields, asymmetric fields, and wedged fields. The audit assesses 3D planning with 6 MV photons with a static (zero degree) gantry. Scoring is performed using local dose differences between the planned and measured dose within 80% of the field width. The overall audit result is determined by the maximum dose difference over all scoring points, cases, and planes. Pass (Optimal Level) is defined as maximum dose difference ≤3.3%, Pass (Action Level) is ≤5.0%, and Fail (Out of Tolerance) is >5.0%. RESULTS At close of 2013, the ACDS had performed 24 Level II audits. 63% of the audits passed, 33% failed, and the remaining audit was not assessable. Of the 15 audits that passed, 3 were at Pass (Action Level). The high fail rate is largely due to a systemic issue with modeling asymmetric 60° wedges which caused a delivered overdose of 5%-8%. CONCLUSIONS The ACDS has implemented a nonreference condition Level II type audit, based on ion chamber 2D array measurements in an inhomogeneous slab phantom. The powerful diagnostic ability of this audit has allowed the ACDS to rigorously test the treatment planning systems implemented in Australian radiotherapy facilities. Recommendations from audits have led to facilities modifying clinical practice and changing planning protocols.
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Affiliation(s)
- Jessica Lye
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia
| | - John Kenny
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia and Radiation Oncology Queensland, Toowoomba, Queensland 4350, Australia
| | - Joerg Lehmann
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia and School of Applied Science, RMIT University, Melbourne 3000, Australia
| | - Leon Dunn
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia
| | - Tomas Kron
- School of Applied Science, RMIT University, Melbourne 3000, Australia and Peter MacCallum Cancer Centre, Melbourne 3008, Australia
| | - Andrew Alves
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia
| | - Andrew Cole
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia and Australian Radiation Protection and Nuclear Safety Agency, Yallambie, Victoria 3085, Australia
| | - Ivan Williams
- Australian Clinical Dosimetry Service, Yallambie, Victoria 3085, Australia and School of Applied Science, RMIT University, Melbourne 3000, Australia
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Denham JW, Steigler A, Joseph D, Lamb DS, Spry NA, Duchesne G, Atkinson C, Matthews J, Turner S, Kenny L, Tai KH, Gogna NK, Gill S, Tan H, Kearvell R, Murray J, Ebert M, Haworth A, Kennedy A, Delahunt B, Oldmeadow C, Holliday EG, Attia J. Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial. Radiother Oncol 2015; 115:301-7. [DOI: 10.1016/j.radonc.2015.05.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 05/20/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
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Manley S, Last A, Fu K, Greenham S, Kovendy A, Shakespeare TP. Regional cancer centre demonstrates voluntary conformity with the national Radiation Oncology Practice Standards. J Med Radiat Sci 2015; 62:152-9. [PMID: 26229680 PMCID: PMC4462987 DOI: 10.1002/jmrs.102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 02/16/2015] [Accepted: 02/24/2015] [Indexed: 12/05/2022] Open
Abstract
Radiation Oncology Practice Standards have been developed over the last 10 years and were published for use in Australia in 2011. Although the majority of the radiation oncology community supports the implementation of the standards, there has been no mechanism for uniform assessment or governance. North Coast Cancer Institute's public radiation oncology service is provided across three main service centres on the north coast of NSW. With a strong focus on quality management, we embraced the opportunity to demonstrate conformity with the Radiation Oncology Practice Standards. The Local Health District's Clinical Governance units were engaged to perform assessments of our conformity with the standards and this was signed off as complete on 16 December 2013. The process of demonstrating conformity with the Radiation Oncology Practice Standards has enhanced the culture of quality in our centres. We have demonstrated that self-assessment utilising trained auditors is a viable method for centres to demonstrate conformity. National implementation of the Radiation Oncology Practice Standards will benefit individual centres and the broader radiation oncology community to improve the service delivered to our patients.
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Affiliation(s)
- Stephen Manley
- North Coast Cancer InstituteLismore, New South Wales, Australia
| | - Andrew Last
- North Coast Cancer InstituteLismore, New South Wales, Australia
| | - Kenneth Fu
- North Coast Cancer InstituteLismore, New South Wales, Australia
| | - Stuart Greenham
- North Coast Cancer InstituteLismore, New South Wales, Australia
| | - Andrew Kovendy
- North Coast Cancer InstituteLismore, New South Wales, Australia
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Ebert MA, Bulsara M, Haworth A, Kearvell R, Richardson S, Kennedy A, Spry NA, Bydder SA, Joseph DJ, Denham JW. Technical quality assurance during the TROG 03.04 RADAR prostate radiotherapy trial: Are the results reflected in observed toxicity rates? J Med Imaging Radiat Oncol 2014; 59:99-108. [DOI: 10.1111/1754-9485.12212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/15/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Martin A Ebert
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
- School of Physics; University of Western Australia; Perth Australia
| | - Max Bulsara
- School of Health Sciences; University of Notre Dame; Fremantle Western Australia Australia
| | - Annette Haworth
- Department of Physical Sciences; Peter MacCallum Cancer Centre, University of Melbourne; Melbourne Victoria Australia
- Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Victoria Australia
| | - Rachel Kearvell
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
| | - Sharon Richardson
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
| | - Angel Kennedy
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
| | - Nigel A Spry
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
- School of Medicine and Pharmacology; University of Western Australia; Perth Australia
| | - Sean A Bydder
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
- School of Surgery; University of Western Australia; Perth Australia
| | - David J Joseph
- Department of Radiation Oncology; Sir Charles Gairdner Hospital, University of Western Australia; Perth Australia
- School of Surgery; University of Western Australia; Perth Australia
| | - James W Denham
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
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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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Létourneau D, McNiven A, Jaffray DA. Multicenter Collaborative Quality Assurance Program for the Province of Ontario, Canada: First-Year Results. Int J Radiat Oncol Biol Phys 2013; 86:164-9. [DOI: 10.1016/j.ijrobp.2012.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 11/09/2012] [Accepted: 12/07/2012] [Indexed: 11/25/2022]
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Haworth A, Wilfert L, Butler D, Ebert MA, Todd S, Bucci J, Duchesne GM, Joseph D, Kron T. Australasian brachytherapy audit: Results of the ‘end-to-end’ dosimetry pilot study. J Med Imaging Radiat Oncol 2013; 57:490-8. [DOI: 10.1111/1754-9485.12042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 01/06/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Annette Haworth
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
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Denham JW, Wilcox C, Lamb DS, Spry NA, Duchesne G, Atkinson C, Matthews J, Turner S, Kenny L, Tai KH, Gogna NK, Ebert M, Delahunt B, McElduff P, Joseph D. Rectal and urinary dysfunction in the TROG 03.04 RADAR trial for locally advanced prostate cancer. Radiother Oncol 2012; 105:184-92. [DOI: 10.1016/j.radonc.2012.09.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/20/2012] [Accepted: 09/29/2012] [Indexed: 01/03/2023]
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Williams I, Kenny J, Lye J, Lehmann J, Dunn L, Kron T. The Australian Clinical Dosimetry Service: a commentary on the first 18 months. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2012; 35:407-11. [PMID: 23055126 PMCID: PMC3562435 DOI: 10.1007/s13246-012-0161-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 09/11/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Ivan Williams
- Australian Clinical Dosimetry Service, ARPANSA, Australia.
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Harrison KM, Ebert MA, Kron T, Howlett SJ, Cornes D, Hamilton CS, Denham JW. Design, manufacture, and evaluation of an anthropomorphic pelvic phantom purpose-built for radiotherapy dosimetric intercomparison. Med Phys 2011; 38:5330-7. [DOI: 10.1118/1.3626573] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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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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Healy B, Frantzis J, Murry R, Martin J, Middleton M, Catton C, Kron T. Development of a dosimetry inter-comparison for IMRT as part of site credentialing for a TROG multi-centre clinical trial for prostate cancer. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2011; 34:195-202. [DOI: 10.1007/s13246-011-0063-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 03/03/2011] [Indexed: 12/25/2022]
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Schiefer H, Fogliata A, Nicolini G, Cozzi L, Seelentag WW, Born E, Hasenbalg F, Roth J, Schnekenburger B, Münch-Berndl K, Vallet V, Pachoud M, Reiner B, Dipasquale G, Krusche B, Fix MK. The Swiss IMRT dosimetry intercomparison using a thorax phantom. Med Phys 2010; 37:4424-31. [DOI: 10.1118/1.3460795] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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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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