A practical implementation of physics quality assurance for photon adaptive radiotherapy.

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.

[1]  Stephanie E. Filpansick,et al.  Improving treatment plan evaluation with automation. , 2016 .

[2]  Sasa Mutic,et al.  Quality control quantification (QCQ): a tool to measure the value of quality control checks in radiation oncology. , 2012, International journal of radiation oncology, biology, physics.

[3]  Yun Yang,et al.  Quality assurance for online adapted treatment plans: benchmarking and delivery monitoring simulation. , 2014, Medical physics.

[4]  Sasa Mutic,et al.  The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management. , 2016, Medical physics.

[5]  J. Sempau,et al.  DPM, a fast, accurate Monte Carlo code optimized for photon and electron radiotherapy treatment planning dose calculations , 2000 .

[6]  D. Jaffray.  Image-guided radiotherapy: from current concept to future perspectives , 2012, Nature Reviews Clinical Oncology.

[7]  Sasa Mutic,et al.  The ViewRay system: magnetic resonance-guided and controlled radiotherapy. , 2014, Seminars in radiation oncology.

[8]  Sasa Mutic,et al.  Quality Assurance with Plan Veto: reincarnation of a record and verify system and its potential value. , 2014, International journal of radiation oncology, biology, physics.

[9]  J. Mechalakos,et al.  IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119. , 2009, Medical physics.

[10]  Kristy K Brock,et al.  Quality assurance of serial 3D image registration, fusion, and segmentation. , 2008, International journal of radiation oncology, biology, physics.

[11]  Sasa Mutic,et al.  Process-based quality management for clinical implementation of adaptive radiotherapy. , 2014, Medical physics.

[12]  Murty S. Goddu,et al.  Evaluation of the efficiency and effectiveness of independent dose calculation followed by machine log file analysis against conventional measurement based IMRT QA , 2012, Journal of applied clinical medical physics.

[13]  D. Yan,et al.  Developing quality assurance processes for image-guided adaptive radiation therapy. , 2008, International journal of radiation oncology, biology, physics.

[14]  Fang-Fang Yin,et al.  Task Group 142 report: quality assurance of medical accelerators. , 2009, Medical physics.

[15]  F. Tang,et al.  Monte Carlo-based QA for IMRT of head and neck cancers , 2007 .

[16]  Ali Amer,et al.  Online adaptive radiotherapy of the bladder: small bowel irradiated-volume reduction. , 2006, International journal of radiation oncology, biology, physics.

[17]  Sasa Mutic,et al.  Development of a fast Monte Carlo dose calculation system for online adaptive radiation therapy quality assurance , 2017, Physics in medicine and biology.

[18]  Michelle Passarge,et al.  A Swiss cheese error detection method for real‐time EPID‐based quality assurance and error prevention , 2017, Medical physics.

[19]  Fang-Fang Yin,et al.  Adaptive Radiation Therapy: Technical Components and Clinical Applications , 2011, Cancer journal.

[20]  X Allen Li,et al.  Validation of an online replanning technique for prostate adaptive radiotherapy. , 2011, Physics in medicine and biology.

[21]  Sasa Mutic,et al.  A software tool to automatically assure and report daily treatment deliveries by a cobalt-60 radiation therapy device. , 2016, Journal of applied clinical medical physics.

[22]  D. Low,et al.  Experience-based quality control of clinical intensity-modulated radiotherapy planning. , 2011, International Journal of Radiation Oncology, Biology, Physics.

[23]  G. Starkschall,et al.  American Association of Physicists in Medicine Radiation Therapy Committee Task Group 53: quality assurance for clinical radiotherapy treatment planning. , 1998, Medical physics.

[24]  T. K. Yeung,et al.  Quality assurance in radiotherapy: evaluation of errors and incidents recorded over a 10 year period. , 2005, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[25]  J Wong,et al.  Adaptive modification of treatment planning to minimize the deleterious effects of treatment setup errors. , 1997, International journal of radiation oncology, biology, physics.

[26]  Sasa Mutic,et al.  Quality of Intensity Modulated Radiation Therapy Treatment Plans Using a ⁶⁰Co Magnetic Resonance Image Guidance Radiation Therapy System. , 2015, International journal of radiation oncology, biology, physics.

[27]  P. Lambin,et al.  A literature review of electronic portal imaging for radiotherapy dosimetry. , 2008, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[28]  Deshan Yang,et al.  Automated radiotherapy treatment plan integrity verification. , 2012, Medical physics.

[29]  J. Seco,et al.  Head-and-neck IMRT treatments assessed with a Monte Carlo dose calculation engine , 2005, Physics in medicine and biology.

[30]  Sasa Mutic,et al.  SU‐E‐T‐352: Commissioning and Quality Assurance of the First Commercial Hybrid MRI‐IMRT System , 2012 .

[31]  Jean M. Moran,et al.  Improving treatment plan evaluation with automation , 2016, Journal of applied clinical medical physics.

[32]  R Mohan,et al.  Monte Carlo dose calculations for dynamic IMRT treatments. , 2001, Physics in medicine and biology.

[33]  Tianyu Zhao,et al.  Online Magnetic Resonance Image Guided Adaptive Radiation Therapy: First Clinical Applications. , 2016, International journal of radiation oncology, biology, physics.

[34]  Fang-Fang Yin,et al.  A planning quality evaluation tool for prostate adaptive IMRT based on machine learning. , 2011, Medical physics.

[35]  Tianyu Zhao,et al.  Simulated Online Adaptive Magnetic Resonance-Guided Stereotactic Body Radiation Therapy for the Treatment of Oligometastatic Disease of the Abdomen and Central Thorax: Characterization of Potential Advantages. , 2016, International journal of radiation oncology, biology, physics.

[36]  Frank Verhaegen,et al.  Monte Carlo Techniques in Radiation Therapy , 2021 .

[37]  Jonas D. Fontenot,et al.  Evaluation of a novel secondary check tool for intensity‐modulated radiotherapy treatment planning , 2014, Journal of applied clinical medical physics.

[38]  S Mutic,et al.  A framework for automated contour quality assurance in radiation therapy including adaptive techniques , 2015, Physics in medicine and biology.