DOE OSTI2015
Recent high profile reports of technical failures and human errors causing severe radiation- induced injuries and deaths come in support of the sustained efforts to ensure patient safety in the delivery of radiation treatments. In addition, highly conformal radiation therapies and escalated fraction doses mandate increased and sustained accuracy of the entire radiotherapy process. Consequently, and as a Result of AAPM and ASTRO led efforts patient specific quality assurance for specialized radiation treatments such as IMRT, SRS/SBRT and Arc Therapy had become a three-tier process: Pre-treatment, during treatment, and post treatment patient specific QA. Traditional patient QA consists of pre-treatment data transfer integrity dosimetric verifications and during-treatment geometric verifications. However, as treatment adaptation becomes closer to deployment in the clinics, during treatment validation via exit detectors had become a realistic QA option, permitting plan assessment in near real time. Post-treatment, machine logs allow comparisons of a range of mechanical parameters. A combination of these techniques could be used in evaluating inter-fraction, and intra-fraction delivery over a long time period such as an year, to evaluate the significant errors per site, per treatment technique. This type of data mining over longer periods of time provides the potential to recognize suboptimal radiation treatments, while allowing to identify systematic, possibly significant errors. This would allow creation of a data base of realized errors, small and large in dosimetry that could be for process or equipment improvement. This educational symposium will describe and review patient QA techniques, results, and strategies for patient specific quality assurance. Learning Objectives: review the goals of pre-treatment QA for various specialized procedures review methods and means for pre-treatment QA, limitations and tolerances review the scenarios where Varian/Tomo Log files could be used. review error detection via log file analysis Learn how exit detector signal recorded in log file could be used to improve patient safety understand real-time EPID-based transmission dosimetry methods understand the goals of real-time delivery monitoring CMS Innovation grant. Rapid response supportive and palliative care program for patients with advanced cancer, starts July, 2012; Accuray Inc. Exit detector based QA software evaluation, Sept, 2012-Sept, 2013; ROI GRant from ASTRO “Safety and Quality: IMRT treatment delivery accuracy”.
60 APPLIED LIFE SCIENCES↗