Alert system for monitoring changes in patient anatomy during radiation therapy of head and neck cancer

Schaly, B; Kempe, J; Venkatesan, Varagur; Mitchell, Sylvia; Chen, Jeff

doi:10.1002/acm2.13342

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Experience with image guidance over many patients' treatments also made the oncology community aware that the tumour region and surroundings could change between planning imaging and the first session at the treatment unit or afterwards during the course of the multiple fractions of radiotherapy [5][6][7][8]. Therefore, strategies were developed to account for and correct these changes, for example, by reassessing a patient's treatment plan and delivery at some dose level or fraction interval [9][10][11] to confirm that the initial plan is still appropriate or, alternatively, to adapt the further treatment to be given through replanning. More advanced Image Guided Adaptive Radiation Therapy (IGART) approaches envisage use of daily online imaging (cone beam computed tomography (CBCT) [2] or magnetic resonance imaging (MRI) [12,13] at the treatment unit) to monitor anatomy changes and provide for replanning without going back to the CT simulator [14].…”

Section: Introductionmentioning

confidence: 99%

End-to-End QA in Radiation Therapy Quality Management

Schreiner

2023

J. Phys.: Conf. Ser.

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End-to-End (E2E) testing is a method originating from computer science that is designed to determine whether an application communicates as required with hardware, networks, databases, and other applications. This paper is to advocate that the quality management (QM) of modern radiation therapy (RT) would benefit from more regular use of E2E based quality assurance (QA) in the local clinic. The argument is that modern RT delivery is performed through some process linked by a chain of interdependent stages and actions mediated by complex interchanges during the patient’s treatment. These actions along the chain are often modified due to decisions by clinical staff who are interpreting information acquired along the process. While physics QA can validate that each of these steps are technically achievable (e.g., through machine QA) such conventional QA does not guarantee that the overall process is being carried out as planned even when it has been described by a well-defined protocol and delivered by well-trained staff. The paper briefly reviews the changes in programmatic design as RT has become more complex, the associated changes in RT QM, and some past examples of E2E testing in RT clinics, usually performed during the implementation of some new RT technique or during external audits of the clinic’s practice. The paper then makes the case for increased E2E QA based on the lessons learned from this experience and ends with some suggestions for implementing effective and sustainable E2E testing in a clinic’s QM program.

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