Minicourse: Radiation Oncology Physics—Acceptance Testing and Quality Assurance of Treatment Planning Systems
Conference: Radiological Society of North America 2008 Scientific Assembly and Annual Meeting
1) To demonstrate the importance of the quality assurance (QA) of radiation treatment planning systems (RTPS) by reviewing significant treatment errors associated with their use. 2) To review the major functionality of a modern RTPS. 3) To highlight and summarize various reports that have made recommendations regarding acceptance, commissioning and QA of RTPSs with special emphasis on IEC-62083 and IAEA TRS-430. 4) To discuss accuracy requirements and criteria of acceptability of the modern RTPS. 5) To summarize acceptance testing procedures as proposed by the IAEA for a modern RTPS. 6) To provide an overview of commissioning a modern RTPS. 7) To provide an overview of the quality control associated with a modern RTPS.
During the last decade there has been a technological revolution in radiation oncology. Enhanced use of imaging combined with computer-controlled methods of dose delivery provides a capability of escalating tumor doses without increasing morbidity. A pivotal component of this modern technology is the computerized radiation treatment planning system (RTPS) which is used to develop optimal treatment techniques for individual patients. Modern RTPSs make increased use of patient images, enhanced 3-D displays, more sophisticated dose calculation algorithms, more complex treatment plan evaluation tools, combined with the generation of images which can be used for treatment verification. The implementation of intensity modulated radiation therapy (IMRT) combined with automated optimization software has added a further complexity to the RTPS. In recent years, various national and international organizations have developed reports that have made recommendations regarding the commissioning and quality assurance (QA) of RTPSs. In 1998, the AAPM published the TG53 report giving guidelines for users and vendors on QA for radiation therapy planning. In 2000, the International Electrotechnical Commission (IEC) produced a report (IEC 62083) identifying safety requirements for manufacturers of RTPSs. In 2004, both the International Atomic Energy Agency (IAEA) and the European Society of Therapeutic Radiation Oncology (ESTRO) published reports on commissioning and QA of RTPSs. Furthermore, the IAEA has recently developed a protocol for the acceptance testing of RTPSs. In 2006, the Netherlands Commission of Radiation Dosimetry also produced a report on QA of RTPSs. All of these reports indicate that a thorough commissioning of a modern 3-D RTPS has become a daunting task. This refresher course will specifically look at the IEC and IAEA reports and review issues associated with acceptance testing, commissioning, and quality assurance of the modern RTPS.