Quality assurance in external radiotherapy

Transcription

1 Quality assurance in external radiotherapy dr. Marius Laurikaitis medical physicist Oncological Hospital of Kaunas Medical University Hospital Kaunas,

2 Acceptance and Commissioning

3 Acceptance Test Testing if machine and radiation parameters is within specified limits Used Customer Acceptance Procedures or International protocols Tests for all equipment: machines, planning systems, verification systems and et. 3

4 Acceptance Test 4 Customer Acceptance Procedures, Varian

5 Commissioning Acquiring all radiation beam data required for treatment Entering these data into a computerized treatment planning system Developing all dosimetry, treatment planning and treatment procedures Verifying the accuracy of these procedures Establishing quality control tests and procedures Training all personnel 5

6 Commissioning 6 Faiz M. Khan, The Physics of Radiation Therapy, 2003

7 Quality Assurance 7

8 Daily QA (Linac) 8 Klein et al., Task Group 142 Report: QA of Medical Accelerators, Med. Phys.,36 (9), 2009, p

9 Monthly QA (Linac) 9 Klein et al., Task Group 142 Report: QA of Medical Accelerators, Med. Phys.,36 (9), 2009, p

10 Annual QA (Linac) 10 Klein et al., Task Group 142 Report: QA of Medical Accelerators, Med. Phys.,36 (9), 2009, p

11 Annual QA (Linac) 11 Klein et al., Task Group 142 Report: QA of Medical Accelerators, Med. Phys.,36 (9), 2009, p

12 Wedges, MLC, Imaging QA (Linac) 12 Klein et al., Task Group 142 Report: QA of Medical Accelerators, Med. Phys.,36 (9), 2009, p

13 QA of Cobalt-60 Kutchar et al., Report of AAPM Radiation Therapy Committee Task Group 40, Med. Phys., 21(4), 1994, p

14 QA of Simulator Kutchar et al., Report of AAPM Radiation Therapy Committee Task Group 40, Med. Phys., 21(4), 1994, p

15 QA of Kilavoltage Equipment J.R. Williams et al., Radiotherapy Physics in Practice,

16 QA after Service (Linac) Beam Quality Assurance Guidelines High Energy Clinacs, Customer Technical Bulletin, Varian 16

17 Real Situation 17

18 Roles and Responsibilities of Medical Physicists Faiz M. Khan, The Physics of Radiation Therapy,

19 Radiotherapy Clinics 5 Clinics: Institute of Oncology, Vilnius University Hospital of Kaunas University of Medicine Oncological Hospital of Kaunas Medical University Hospital Klaipėda University Hospital Šiauliai Hospital 19

20 Radiotherapy (external) Equipment Equipment Linac Simulator Institute of Oncology, Vilnius University 3 Varian (2) 6, 15 MV Varian (1) 6 MV IMRT Varian Hospital of Kaunas University of Medicine 3 Varian (2) 6, 15 MV Siemens 6, 18 MV Stereotactic CT simulator GE X-ray therapy In future plans - Oncological Hospital of Kaunas Medical University Hosp. 1 Varian 6, 15 MV Varian Gulmay kv Klaipėda University Hospital 1 Siemens 6, 18 MV CT simulator Siemens Gulmay kv Šiauliai Hospital 1 Elekta 6, 15 MV CT Gulmay kv Treatment planning Eclipse Eclipse Eclipse Xio Precise Plan system Co-60 Russia - - Russia - Verification system Aria Aria Aria Lantis Mosaiq 20

21 Medical Physicists Institute of Oncology, Vilnius University: 8 medical physicists Hospital of Kaunas University of Medicine: 6 medical physicists Oncological Hospital of Kaunas Medical University Hospital: 4 medical physicists Klaipėda University Hospital: 4+1 (arriving) medical physicists Šiauliai County Hospital: 2+3 (arriving) medical physicists 21

22 Equipment for QA Lithuanian Hygiene Standard HN 95:2005 Radiation Protection and Quality Control in Radiotherapy 22

23 QA in Oncological Hospital (Linac) Daily (Rad. Technologist): Door interlock Beam on indicator Audiovisual monitor Laser localization Optical distance indicator X-ray output constancy X-ray beam symmetry X-ray beam flatness Photon beam energy constancy Radiation field size Monthly: X-ray output constancy Photon beam energy constancy Light/ radiation field coincidence Emergency beam off Quarterly: PDD constancy X-ray symmetry constancy X-ray flatness constancy Mechanical tests Annually: Customer Acceptance procedures Commissioning procedures (part) 23

24 QA in Oncological Hospital (Kilavoltage Unit) Weekly: Door interlock Beam on indicator Calibration constancy Annually: Absolute calibration Beam Quality (HVL) 24

25 QA in Oncological Hospital (Simulator, CT) Simulator (Quarterly, Annually): Lithuanian Hygiene Standard HN 78:2009 Quality Control in Radiology CT (Daily, Weekly, Annually): Lithuanian Hygiene Standard HN 78:2009 Quality Control in Radiology 25

26 QA Procedure QA in Lithuania (Linac) Institute of Oncology, Vilnius University Oncological Hospital of Kaunas Medical University Hospital Klaipėda University Hospital Šiauliai Hospital Daily Dosimetry (quick check) Dosimetrist Rad. Technologist Med. Physicist Rad. Technologist Mechanical Dosimetrist Rad. Technologist Rad. Technologist Rad. Technologist Safety Dosimetrist Rad. Technologist Rad. Technologist Rad. Technologist Weekly Mechanical Med. Physicist Med. Physicist Safety Med. Physicist Monthly Dosimetry (water phantom) Med. Physicist Med. Physicist Med. Physicist Med. Physicist Mechanical Med. Physicist Med. Physicist Med. Physicist Med. Physicist Safety Med. Physicist 3 Months Dosimetry (big water phantom) Mechanical Dosimetry (big water phantom) Med. Physicist Med. Physicist 6 Months Med. Physicist Med. Physicist Med. Physicist Annually Dosimetry (big water phantom) Med. Physicist Med. Physicist Med. Physicist Med. Physicist Mechanical Med. Physicist Med. Physicist Med. Physicist Med. Physicist Safety Med. Physicist Med. Physicist 26

27 QA in Lithuania (Kilavoltage Unit) QA Procedure Oncological Hospital of Kaunas Medical University Hospital Klaipėda University Hospital Šiauliai Hospital Daily Safety Rad. Technologist Rad. Technologist Weekly Dosimetry Med. Physicist Safety Med. Physicist Monthly Dosimetry Med. Physicist Med. Physicist 3 Months Dosimetry Annually Dosimetry Med. Physicist Med. Physicist Med. Physicist 27

28 Thank you for your attention