Australasian recommendations for quality assurance in kilovoltage radiation therapy from the Kilovoltage Dosimetry Working Group of the Australasian College of Physical Scientists and Engineers in Medicine

Hill, Robin; Healy, Brendan; Butler, Duncan; Odgers, David; Gill, Simran; Lye, Jessica; Gorjiara, Tina; Pope, Dane; Hill, Brendan

doi:10.1007/s13246-018-0692-1

Cited by 20 publications

(33 citation statements)

References 152 publications

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“…Energy dependence of the detectors and size of the detectors compared to the dose gradients of kV X-ray beams are other challenging factors in choosing the suitable detector for the relative dosimetric measurements. 10 Even though ionization chambers are considered to be the gold standard [11][12][13][14][15][16][17] for the dosimetry of X-ray beam due to their stable energy response, the size of the chambers, especially cylindrical chambers, causes artefacts near to the surface region, which leads to the difference in the surface dose. 18 Therefore, it would be ideal to use a detector with the right size, low energy dependence, and fewer correction factors for the kV relative dosimetric measurements.…”

Section: Introductionmentioning

confidence: 99%

“…The former method needs inverse square correction for the accurate dose measurements, and the latter needs extrapolation of the measured data to predict the surface dose. Energy dependence of the detectors and size of the detectors compared to the dose gradients of kV X‐ray beams are other challenging factors in choosing the suitable detector for the relative dosimetric measurements 10 . Even though ionization chambers are considered to be the gold standard 11–17 for the dosimetry of X‐ray beam due to their stable energy response, the size of the chambers, especially cylindrical chambers, causes artefacts near to the surface region, which leads to the difference in the surface dose 18 .…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of solid state detectors for the relative dosimetry of kilovoltage X‐ray beams

et al. 2022

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Introduction Kilovoltage (kV) X‐ray beams are an essential modality in radiotherapy. Solid state detectors are widely available in radiotherapy departments, but their use for kV dosimetry has been limited to date. This study aimed to evaluate the dosimetric performance of a range of solid state detectors for kV dosimetry. Method Percentage depth doses (PDDs) and relative output factors (ROFs) were measured on an XStrahl 300 unit (XStrahl‐Ltd., UK) using 60, 100, 150, and 300 kVp X‐ray beams. The fields were defined by circular applicators with field sizes of 2, 5, 8, and 10 cm diameter and square applicators of field sizes 10 × 10 and 20 × 20 cm2. The following Physikalisch‐Technische Werkstätten (PTW) dosimeters were used for measurements: Advanced Markus, PinPoint 3D and Semiflex ionization chambers; photon, electron, and stereotactic radiosurgery (SRS) diodes plus the microDiamond detector. All PDDs were normalized at 5 mm depth, and ROFs were measured at 3 mm depth to avoid collisions with the end of the applicators. ROFs measured using chambers were corrected for polarity and ion‐recombination effects. Results and discussion PDD measurements for 60, 100, and 150 kVp beams exhibited good agreement between all diodes and the ionization chambers over the entire range of depths except in the first few millimeters near the surface. However, for the 300 kVp, all diode detectors exhibited an overresponding behavior compared to reference depth dose data measured with the Advanced Markus chamber. ROFs with the diodes were higher than the Advanced Markus chamber at low energy, and the magnitude of these differences is inversely proportional to the field sizes. The PTW P diode showed the highest variation of up to 15% in the output factor compared to the Advanced Markus chamber. Conclusion This study evaluated the dosimetric performance of a range of solid state detectors in kV relative dosimetry. This study showed that diode detectors are a suitable replacement for ionization chambers for the PDD measurement of low energy kV beams (60–150 kVp) except for the PDD of 60 kVp with the smaller field sizes. However, an overresponding behavior of diode detectors at 300 kVp beams shows that diode detectors are not suitable for the PDD measurement of high energy kV beams. Generally, all solid state detectors overresponded to ROF measurements, indicating that it is not suitable for ROF measurements. In general, both shielded and unshielded diodes produced a similar dosimetric response, which demonstrates that the energy dependence of solid state detectors should be considered before they are used for any kV relative dosimetric measurements.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An evaluation of solid state detectors for the relative dosimetry of kilovoltage X‐ray beams

et al. 2022

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“…[38][39][40][41] Different issues arise for treatment modalities that are less frequently used or just emerging. Superficial (kV) treatment units 24 and brachytherapy 42 treat fewer patients than linacs. Even though the equipment is common, used for a long time and often more likely than linac based external beam radiotherapy to result in accidents, 43 there is less literature and generally no audits that support these units.…”

Section: Action and Tolerance Levelsmentioning

confidence: 99%

Quality management in radiotherapy treatment delivery

et al. 2022

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Radiation Oncology continues to rely on accurate delivery of radiation, in particular where patients can benefit from more modulated and hypofractioned treatments that can deliver higher dose to the target while optimising dose to normal structures. These deliveries are more complex, and the treatment units are more computerised, leading to a re-evaluation of quality assurance (QA) to test a larger range of options with more stringent criteria without becoming too time and resource consuming. This review explores how modern approaches of risk management and automation can be used to develop and maintain an effective and efficient QA programme. It considers various tools to control and guide radiation delivery including image guidance and motion management. Links with typical maintenance and repair activities are discussed, as well as patient-specific quality control activities. It is demonstrated that a quality management programme applied to treatment delivery can have an impact on individual patients but also on the quality of treatment techniques and future planning. Developing and customising a QA programme for treatment delivery is an important part of radiotherapy. Using modern multidisciplinary approaches can make this also a useful tool for department management.

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“…My esteemed opponent has reviewed areas of development in kilovoltage dosimetry [13], which have provided a rich vein of research and professional guidance for physicists, right up to the present day [22][23][24]. However, the clinical acceptance of techniques such as electronic brachytherapy for partial breast or skin treatments is not widespread.…”

Section: Opening Statementmentioning

confidence: 99%

“…By following this process, any radiotherapy department looking to establish a kilovoltage treatment service can do so with confidence in providing quality care. In cases where the kilovoltage X-ray unit cannot be directly integrated into the radiation oncology information system (including the record and verification software), safety processes can be developed based on well-established process like checklists and risk assessments such as those published in the AAPM TG-100 report [22,27].…”

Section: Rebuttal Statementmentioning

confidence: 99%

Kilovoltage therapy is well and truly alive and needed in a modern radiotherapy centre

2021

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Australasian recommendations for quality assurance in kilovoltage radiation therapy from the Kilovoltage Dosimetry Working Group of the Australasian College of Physical Scientists and Engineers in Medicine

Cited by 20 publications

References 152 publications

An evaluation of solid state detectors for the relative dosimetry of kilovoltage X‐ray beams

An evaluation of solid state detectors for the relative dosimetry of kilovoltage X‐ray beams

Quality management in radiotherapy treatment delivery

Kilovoltage therapy is well and truly alive and needed in a modern radiotherapy centre

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