The requirement of an independent verification of the monitor units ͑MU͒ or time calculated to deliver the prescribed dose to a patient has been a mainstay of radiation oncology quality assurance. The need for and value of such a verification was obvious when calculations were performed by hand using look-up tables, and the verification was achieved by a second person independently repeating the calculation. However, in a modern clinic using CT/MR/PET simulation, computerized 3D treatment planning, heterogeneity corrections, and complex calculation algorithms such as convolution/superposition and Monte Carlo, the purpose of and methodology for the MU verification have come into question. In addition, since the verification is often performed using a simpler geometrical model and calculation algorithm than the primary calculation, exact or almost exact agreement between the two can no longer be expected. Guidelines are needed to help the physicist set clinically reasonable action levels for agreement. This report addresses the following charges of the task group: ͑1͒ To re-evaluate the purpose and methods of the "independent second check" for monitor unit calculations for non-IMRT radiation treatment in light of the complexities of modernday treatment planning. ͑2͒ To present recommendations on how to perform verification of monitor unit calculations in a modern clinic. ͑3͒ To provide recommendations on establishing action levels for agreement between primary calculations and verification, and to provide guidance in addressing discrepancies outside the action levels. These recommendations are to be used as guidelines only and shall not be interpreted as requirements.

This report provides guidelines for a peer review process between two clinical radiation oncology physicists. While the Task Group's work was primarily focused on ensuring timely and productive independent reviews for physicists in solo practice, these guidelines may also be appropriate for physicists in a group setting, particularly when dispersed over multiple separate clinic locations. To ensure that such reviews enable a collegial exchange of professional ideas and productive critique of the entire clinical physics program, the reviews should not be used as an employee evaluation instrument by the employer. Such use is neither intended nor supported by this Task Group. Detailed guidelines are presented on the minimum content of such reviews, as well as a recommended format for reporting the findings of a review. In consideration of the full schedules faced by most clinical physicists, the process outlined herein was designed to be completed in one working day.PACS numbers: 87.53.Xd, 87.90.+y

No abstract

No abstract

No abstract