A fully electronic intensity-modulated radiation therapy quality assurance (IMRT QA) process implemented in a network comprised of independent treatment planning, record and verify, and delivery systems
Open Access
- 1 January 2010
- journal article
- Published by Walter de Gruyter GmbH in Radiology and Oncology
- Vol. 44 (2), 124-130
- https://doi.org/10.2478/v10019-010-0017-9
Abstract
The purpose of this study is to implement an electronic method to perform and analyze intensity-modulated radiation therapy quality assurance (IMRT QA) using an aSi megavoltage electronic portal imaging device in a network comprised of independent treatment planning, record and verify (R&V), and delivery systems. A verification plan was generated in the treatment planning system using the actual treatment plan of a patient. After exporting the treatment fields to the R&V system, the fields were delivered in QA mode with the aSi imager deployed. The resulting dosimetric images are automatically stored in a DICOM-RT format in the delivery system treatment console computer. The relative dose density images are subsequently pushed to the R&V system. The absolute dose images are then transferred electronically from the treatment console computer to the treatment planning system and imported into the verification plan in the dosimetry work space for further analysis. Screen shots of the gamma evaluation and isodose comparison are imported into the R&V system as an electronic file (e.g. PDF) to be reviewed prior to initiation of patient treatment. A relative dose image predicted by the treatment planning system can also be sent to the R&V system to be compared with the relative dose density image measured with the aSi imager. Our department does not have integrated planning, R&V, and delivery systems. In spite of this, we are able to fully implement a paperless and filmless IMRT QA process, allowing subsequent analysis and approval to be more efficient, while the QA document is directly attached to its specific patient chart in the R&V system in electronic form. The calculated and measured relative dose images can be compared electronically within the R&V system to analyze the density differences and ensure proper dose delivery to patients. In the absence of an integrated planning, verifying, and delivery system, we have shown that it is nevertheless possible to develop a completely electronic IMRT QA process.Keywords
This publication has 22 references indexed in Scilit:
- Intensity modulated radiotherapy (IMRT) in bilateral retinoblastomaRadiology and Oncology, 2010
- An effective correction algorithm for off‐axis portal dosimetry errorsMedical Physics, 2009
- A simple backprojection algorithm for 3D in vivo EPID dosimetry of IMRT treatmentsMedical Physics, 2009
- Radiation therapy plan checks in a paperless clinicJournal of Applied Clinical Medical Physics, 2009
- The sigmoid colon and bladder shielding in whole pelvic irradiation at prostate cancer (forward planned IMRT from Institute of Oncology Ljubljana)Radiology and Oncology, 2009
- A literature review of electronic portal imaging for radiotherapy dosimetryRadiotherapy and Oncology, 2008
- Establishing action levels for EPID‐based QA for IMRTJournal of Applied Clinical Medical Physics, 2008
- Dosimetric pre-treatment verification of IMRT using an EPID; clinical experienceRadiotherapy and Oncology, 2006
- The electronic patient record in primary care--regression or progression? A cross sectional studyBMJ, 2003
- A Proposal for Electronic Medical Records in U.S. Primary CareJournal of the American Medical Informatics Association, 2003