Results of the IAEA supported national end-to-end audit of the IMRT technique in Poland

Abstract

The dosimetry audit services were established in Poland in 1991, since then new audits have been introduced. The recently developed IAEA audit methodology for IMRT H&N treatments was tested nationally. Anthropomorphic SHANE phantom (CIRS) was used to perform measurements in 8 hospitals which voluntarily participated in the study. Each participant had to complete successfully pre-visit activities to take part in an onsite visit. During the visit, auditors together with the local staff, did a CT scan using local protocol, recalculated the plan and verified all the relevant parameters and performed measurements with an ionization chamber and films in SHANE. The adoption of IAEA methodology to the national circumstances was done with no major issues. Participants plans were verified and the results of ionization chamber were all within the 5 % tolerance limit for PTV (max 4,5%) and 7 % for OAR (max 5,3%). Film global gamma results (3 %, 3 mm, 90 % acceptance limit) were within 91,5–99,7% range. The IAEA established acceptance criteria which were achievable for most tests except for CTtoRED conversion curve. The locally performed study allowed establishing new limits. The audit gave interesting results and showed that the procedure is very thorough and capable to identify issues related with suboptimal treatment preparation and delivery. The new limits for CTtoRED conversion curve were adopted for national study. Such an audit gives an opportunity to verify the quality of locally implemented procedures and should be available for Polish hospitals on a daily basis.