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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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3
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Kry SF, Peterson CB, Howell RM, Izewska J, Lye J, Clark CH, Nakamura M, Hurkmans C, Alvarez P, Alves A, Bokulic T, Followill D, Kazantsev P, Lowenstein J, Molineu A, Palmer J, Smith SA, Taylor P, Wesolowska P, Williams I. Remote beam output audits: a global assessment of results out of tolerance. PHYSICS & IMAGING IN RADIATION ONCOLOGY 2018; 7:39-44. [PMID: 31872085 PMCID: PMC6927685 DOI: 10.1016/j.phro.2018.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background and purpose Remote beam output audits, which independently measure an institution’s machine calibration, are a common component of independent radiotherapy peer review. This work reviews the results and trends of these audit results across several organisations and geographical regions. Materials and methods Beam output audit results from the Australian Clinical Dosimetry Services, International Atomic Energy Agency, Imaging and Radiation Oncology Core, and Radiation Dosimetry Services were evaluated from 2010 to the present. The rate of audit results outside a ±5% tolerance was evaluated for photon and electron beams as a function of the year of irradiation and nominal beam energy. Additionally, examples of confirmed calibration errors were examined to provide guidance to clinical physicists and auditing bodies. Results Of the 210,167 audit results, 1323 (0.63%) were outside of tolerance. There was a clear trend of improved audit performance for more recent dates, and while all photon energies generally showed uniform rates of results out of tolerance, low (6 MeV) and high (≥18 MeV) energy electron beams showed significantly elevated rates. Twenty nine confirmed calibration errors were explored and attributed to a range of issues, such as equipment failures, errors in setup, and errors in performing the clinical reference calibration. Forty-two percent of these confirmed errors were detected during ongoing periodic monitoring, and not at the time of the first audit of the machine. Conclusions Remote beam output audits have identified, and continue to identify, numerous and often substantial beam calibration errors.
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Affiliation(s)
- Stephen F Kry
- Imaging and Radiation Oncology Core, MD Anderson Cancer Center, Houston USA.,Department of Radiation Physics, MD Anderson Cancer Center, Houston USA
| | | | - Rebecca M Howell
- Department of Radiation Physics, MD Anderson Cancer Center, Houston USA.,Radiation Dosimetry Services, MD Anderson Cancer Center, Houston USA
| | - Joanna Izewska
- Dosimetry Laboratory, Dosimetry and Medical Radiation Physics Section, Division of Human Health, International Atomic Energy Agency, Vienna Austria
| | - Jessica Lye
- Australian Clinical Dosimetry Service, ARPANSA, Melbourne, Australia
| | - Catharine H Clark
- RadioTherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, London UK.,Metrology for Medical Physics, National Physical Laboratory, Teddington UK.,Department of Medical Physics, Royal Surrey County Hospital, Surrey UK
| | - Mitsuhiro Nakamura
- JCOG Division of Medical Physics, Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University
| | - Coen Hurkmans
- EORTC Radiation Oncology Group, Brussels, Belgium.,Department of radiation Oncology, Catharina Hospital Eindhoven, The Netherlands
| | - Paola Alvarez
- Imaging and Radiation Oncology Core, MD Anderson Cancer Center, Houston USA.,Department of Radiation Physics, MD Anderson Cancer Center, Houston USA
| | - Andrew Alves
- Australian Clinical Dosimetry Service, ARPANSA, Melbourne, Australia
| | - Tomislav Bokulic
- Dosimetry Laboratory, Dosimetry and Medical Radiation Physics Section, Division of Human Health, International Atomic Energy Agency, Vienna Austria
| | - David Followill
- Imaging and Radiation Oncology Core, MD Anderson Cancer Center, Houston USA.,Department of Radiation Physics, MD Anderson Cancer Center, Houston USA
| | - Pavel Kazantsev
- Dosimetry Laboratory, Dosimetry and Medical Radiation Physics Section, Division of Human Health, International Atomic Energy Agency, Vienna Austria
| | - Jessica Lowenstein
- Imaging and Radiation Oncology Core, MD Anderson Cancer Center, Houston USA.,Department of Radiation Physics, MD Anderson Cancer Center, Houston USA
| | - Andrea Molineu
- Imaging and Radiation Oncology Core, MD Anderson Cancer Center, Houston USA.,Department of Radiation Physics, MD Anderson Cancer Center, Houston USA
| | - Jacob Palmer
- Department of Radiation Physics, MD Anderson Cancer Center, Houston USA.,Radiation Dosimetry Services, MD Anderson Cancer Center, Houston USA
| | - Susan A Smith
- Department of Radiation Physics, MD Anderson Cancer Center, Houston USA.,Radiation Dosimetry Services, MD Anderson Cancer Center, Houston USA
| | - Paige Taylor
- Imaging and Radiation Oncology Core, MD Anderson Cancer Center, Houston USA.,Department of Radiation Physics, MD Anderson Cancer Center, Houston USA
| | - Paulina Wesolowska
- Dosimetry Laboratory, Dosimetry and Medical Radiation Physics Section, Division of Human Health, International Atomic Energy Agency, Vienna Austria
| | - Ivan Williams
- Australian Clinical Dosimetry Service, ARPANSA, Melbourne, Australia
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4
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Okamoto H, Minemura T, Nakamura M, Mizuno H, Tohyama N, Nishio T, Wakita A, Nakamura S, Nishioka S, Iijima K, Fujiyama D, Itami J, Nishimura Y. Establishment of postal audit system in intensity-modulated radiotherapy by radiophotoluminescent glass dosimeters and a radiochromic film. Phys Med 2018; 48:119-126. [DOI: 10.1016/j.ejmp.2018.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/24/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022] Open
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6
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Park JM, Park SY, Chun M, Kim ST. On-site audits to investigate the quality of radiation physics of radiation therapy institutions in the Republic of Korea. Phys Med 2017; 40:110-114. [PMID: 28784573 DOI: 10.1016/j.ejmp.2017.07.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/30/2017] [Accepted: 07/30/2017] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate and improve the domestic standard of radiation therapy in the Republic of Korea. METHODS On-site audits were performed for 13 institutions in the Republic of Korea. Six items were investigated by on-site visits of each radiation therapy institution, including collimator, gantry, and couch rotation isocenter check; coincidence between light and radiation fields; photon beam flatness and symmetry; electron beam flatness and symmetry; physical wedge transmission factors; and photon beam and electron beam outputs. RESULTS The average deviations of mechanical collimator, gantry, and couch rotation isocenter were less than 1mm. Those of radiation isocenter were also less than 1mm. The average difference between light and radiation fields was 0.9±0.6mm for the field size of 20cm×20cm. The average values of flatness and symmetry of the photon beams were 2.9%±0.6% and 1.1%±0.7%, respectively. Those of electron beams were 2.5%±0.7% and 0.6%±1.0%, respectively. Every institutions showed wedge transmission factor deviations less than 2% except one institution. The output deviations of both photon and electron beams were less than ±3% for every institution. CONCLUSIONS Through the on-site audit program, we could effectively detect an inappropriately operating linacs and provide some recommendations. The standard of radiation therapy in Korea is expected to improve through such on-site audits.
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Affiliation(s)
- Jong Min Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Center for Convergence Research on Robotics, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
| | - So-Yeon Park
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea; Center for Convergence Research on Robotics, Advanced Institutes of Convergence Technology, Suwon, Republic of Korea
| | - Minsoo Chun
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sang-Tae Kim
- Nuclear Emergency Division, Radiation Protection and Emergency Preparedness Bureau, Nuclear Safety and Security Commission, Seoul, Republic of Korea.
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