title: QA issues for computer-controlled treatment delivery: this is not your old R/V system any more!
abstract: State-of-the-art radiotherapy treatment delivery has changed dramatically during the past decade, moving from manual individual field setup and treatment to automated computer-controlled delivery of complex treatments, including intensity-modulated radiotherapy and other similarly complex delivery strategies. However, the quality assurance methods typically used to ensure treatment is performed precisely and correctly have not evolved in a similarly dramatic way. This paper reviews the old manual treatment process and use of record-and-verify systems, and describes differences with modern computer-controlled treatment delivery. The process and technology used for computer-controlled treatment delivery are analyzed in terms of potential (and actual) problems, as well as relevant published guidance on quality assurance. The potential for improved quality assurance for computer-controlled delivery is discussed.
authors.affiliation: Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, MI 48109-5010, USA. bfraass@umich.edu
authors.forename: Benedick A
authors.initials: BA
authors.lastname: Fraass
mesh_terms: D002985:Clinical Protocols / Q000592:standards; D006801:Humans; D055585:Physical Phenomena; D010825:Physics; D017410:Practice Guidelines as Topic; D011786:Quality Control; D018788:Radioactive Hazard Release; D011878:Radiotherapy / Q000379:methods / Q000592:standards; D011881:Radiotherapy, Computer-Assisted / Q000379:methods / Q000592:standards*; D050397:Radiotherapy, Intensity-Modulated / Q000592:standards; D012984:Software; D013679:Technology, Radiologic / Q000379:methods / Q000639:trends