A practical implementation of physics quality assurance for photon adaptive radiotherapy

Bin Cai; Olga L Green; Rojano Kashani; Vivian L Rodriguez; Sasa Mutic; Deshan Yang

doi:10.1016/j.zemedi.2018.02.002

A practical implementation of physics quality assurance for photon adaptive radiotherapy

Z Med Phys. 2018 Aug;28(3):211-223. doi: 10.1016/j.zemedi.2018.02.002. Epub 2018 Mar 14.

Authors

Bin Cai¹, Olga L Green¹, Rojano Kashani², Vivian L Rodriguez¹, Sasa Mutic¹, Deshan Yang³

Affiliations

¹ Department of Radiation Oncology, Washington University, St. Louis, MO 63110, USA.
² Department of Radiation Oncology, University of Michigan, Ann Abor, MI, 48109, USA.
³ Department of Radiation Oncology, Washington University, St. Louis, MO 63110, USA. Electronic address: yangdeshan@wustl.edu.

PMID: 29550014
DOI: 10.1016/j.zemedi.2018.02.002

Abstract

The fast evolution of technology in radiotherapy (RT) enabled the realization of adaptive radiotherapy (ART). However, the new characteristics of ART pose unique challenges for efficiencies and effectiveness of quality assurance (QA) strategies. In this paper, we discuss the necessary QAs for ART and introduce a practical implementation. A previously published work on failure modes and effects analysis (FMEA) of ART is introduced first to explain the risks associated with ART sub-processes. After a brief discussion of QA challenges, we review the existing QA strategies and tools that might be suitable for each ART step. By introducing the MR-guided online ART QA processes developed at our institute, we demonstrate a practical implementation. The limitations and future works to develop more robust and efficient QA strategies are discussed at the end.

Keywords: Adaptive radiotherapy; Image guided radiotherapy; Quality assurance.

MeSH terms

Humans
Photons
Physics
Quality Assurance, Health Care*
Radiotherapy / standards*

Grants and funding

R01 HS022888/HS/AHRQ HHS/United States