National survey of patient specific IMRT quality assurance in China

Yuxi Pan,Junjie Wang,Shuming Zhang,Ruijie Yang,Jiaqi Li,Jianrong Dai,Jing Cai

doi:10.1186/s13014-019-1273-5

Abstract

BackgroundTo analyze and present the China’s national survey on patient-specific IMRT quality assurance (QA).MethodsA national survey was conducted in all radiotherapy centers in China to collect comprehensive information on status of IMRT QA practice, including machine, technique, equipment, issues and suggestions.ResultsFour hundred and three centers responded to this survey, accounting for 56.92% of all the centers implementing IMRT in China. The total number of medical physicists and the total number of patients treated with IMRT annually in these centers was 1599 and 305,000 respectively. All centers implemented measurement-based verification. Point dose verification and 2D dose verification was implemented in 331 and 399 centers, respectively. Three hundred forty-eight centers had 2D arrays, and 52 centers had detector devices designed to measure VMAT beams. EPID and film were used in 78 and 70 centers, respectively. Seventeen and 20 centers used log file and 3D DVH analysis, respectively. One hundred sixty-eight centers performed measurement-based verification not for each patient based on different selection criteria. The techniques and methods varied significantly in both point dose and dose distribution verification, from evaluation metrics, criteria, tolerance limit, and steps to check failed IMRT QA plans. Major issues identified in this survey were the limited resources of physicists, QA devices, and linacs.ConclusionsIMRT QA was implemented in all the surveyed centers. The practice of IMRT QA varied significantly between centers. An increase in personnel, QA devices and linacs is highly desired. National standard, guideline, regulation and training programs are urgently needed in China for consistent and effective implementation of IMRT QA.

Highlights

To analyze and present the China’s national survey on patient-specific intensity-modulated radiotherapy (IMRT) quality assurance (QA)
Patient-specific intensity-modulated radiotherapy (IMRT) quality assurance (QA) is critically important to the successful implementation of IMRT. It ensures correct machine-sided delivery of the prescribed dose by checking the accuracy of dose calculation, plan transfer, and treatment delivery. It is strongly recommended as part of the IMRT clinical process by the professional societies such as the American Association of Physicists in Medicine (AAPM), the American Society for Radiation Oncology (ASTRO), the American College of Radiology (ACR), and the Netherlands Commission on Radiation Dosimetry [1,2,3,4,5]
A national survey on patient-specific IMRT QA was successfully conducted in China

Summary

Introduction

To analyze and present the China’s national survey on patient-specific IMRT quality assurance (QA). Patient-specific intensity-modulated radiotherapy (IMRT) quality assurance (QA) is critically important to the successful implementation of IMRT It ensures correct machine-sided delivery of the prescribed dose by checking the accuracy of dose calculation, plan transfer, and treatment delivery. IMRT has been implemented in more than 700 centers in China, and volumetricmodulated arc therapy (VMAT) has been introduced in more than 110 centers in a much faster pace than that of the fixed gantry IMRT [11]. Despite these advances, to date, there is no national standard or practice guideline on patient-specific IMRT QA in China

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Conclusion