Abstract
BackgroundIndependent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes.MethodsThe audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported.ResultsThe measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected.ConclusionsThe audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.
Highlights
Independent external audits play an important role in quality assurance programme in radiation oncology
From the comparison of different phantoms for clinical commissioning of treatment planning systems (TPSs) following an IAEA protocol given in TECDOC 1583 [9], it was chosen that the clinical test case measurements will be conducted on the semi-anthropomorphic phantom CIRS Thorax 002 LFC (CIRS Inc., Norfolk, Virginia)
computed tomography unit (CT) to relative electron density (RED) conversion All systems reviewed in this audit had generic or TPS manufacturer supplied CT to RED conversion curves
Summary
Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. Quality Assurance (QA) in radiotherapy treatment planning process is essential to ensure that the dose calculation is performed correctly and to minimize the likelihood of accidental exposure [1,2]. This document has been used as the basis to conduct the dosimetric audit of TPSs in Serbia. The methodology of this audit focuses on dosimetry part of the treatment planning and delivery processes. The audit methodology verifies the chain in external beam radiotherapy workflow, from patient data acquisition to treatment planning and dose delivery
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