We develop guidelines for the quality assurance of radiation treatment planning systems (TPS) by comparing and reviewing recommendations from major countries and organizations, as well as by analyzing the AAPM, ESTRO, and IAEA TPS quality assurance guidelines. We establish quality assurance items for acceptance testing, commissioning, periodic testing, system management, and security, and propose methods to perform each item within acceptable standards. Acceptance includes tests of hardware and network environments, data transmission, software, and benchmarking as specified by the system supplier, and apply the IAEA classification criteria. Commissioning includes dosimetric and non-dosimetric items for assessing TPS performance by applying the AAPM classification criteria and the latest technical items from the IAEA. Periodic quality assurance tests include daily, weekly, monthly, yearly, and occasional items by applying the AAPM classification criteria. System management and security items include the state and network connectivity of TPS, periodic data backup, and data access security. The guidelines for TPS quality assurance proposed in this study will help to improve the safety and quality of radiotherapy by preventing incidents related to radiotherapy.Keywords: Radiation treatment planning system, Acceptance test, Commissioning, Quality assurance Copyright ยฉ 2017 Korean Society of Medical Physics CC This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. IntroductionBecause of the rapidly aging population, the number of cancer patients has increased continually by 5.5% each year. were over 1,000 instances of patients receiving the wrong radiation treatment. 4)The key reasons behind the incidents related to radiation treatment planning included an insufficient understanding of the radiation treatment planning system (RTPS), a lack of commissioning, and no verification of independent calculations, and that educational training and quality assurance processes were not properly managed. However, currently quality assurance guidelines for RTPS do not exist. Thus, in this research, to improve the quality assurance of treatment planning, which when poorly executed is one of the causes behind main radiation therapy incidents and accidents, the current state of international quality assurance is analyzed, and RTPS quality assurance guidelines are proposed. Materials and Methods Current state of foreign radiation treatment planning quality assuranceRadiation treatment planning and the current state of QA from related foreign organizations were analyzed and organized, from which relevant standards and procedures were prepared. Several quality control items and methods were separated by type, compared, and evaluated. These Radiation treatment planning system quality assuranc...
The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.
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