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An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

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Date
2017-03
ICR Author
Marsden,
Bernstein, David
Author
Eaton, DJ
Tyler, J
Backshall, A
Bernstein, D
Carver, A
Gasnier, A
Henderson, J
Lee, J
Patel, R
Tsang, Y
Yang, H
Zotova, R
Wells, E
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Type
Journal Article
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Abstract
Purpose External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems.Methods Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array.Results A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy.Conclusion An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice.
URI
https://repository.icr.ac.uk/handle/internal/1404
DOI
https://doi.org/10.1016/j.ejmp.2017.02.012
Collections
  • Radiotherapy and Imaging
Subject
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiometry
Credentialing
Quality Assurance, Health Care
Radiotherapy, Intensity-Modulated
Clinical Trials as Topic
United Kingdom
Research team
Radiotherapy Physics Modelling
Language
eng
Date accepted
2017-02-14
License start date
2017-03
Citation
Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB), 2017, 35 pp. 25 - 30

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