Patient-related quality assurance with different combinations of treatment planning systems, techniques, and machines : A multi-institutional survey.
OBJECTIVE
This project compares the different patient-related quality assurance systems for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques currently used in the central Germany area with an independent measuring system.


METHODS
The participating institutions generated 21 treatment plans with different combinations of treatment planning systems (TPS) and linear accelerators (LINAC) for the QUASIMODO (Quality ASsurance of Intensity MODulated radiation Oncology) patient model. The plans were exposed to the ArcCHECK measuring system (Sun Nuclear Corporation, Melbourne, FL, USA). The dose distributions were analyzed using the corresponding software and a point dose measured at the isocenter with an ionization chamber.


RESULTS
According to the generally used criteria of a 10 % threshold, 3 % difference, and 3 mm distance, the majority of plans investigated showed a gamma index exceeding 95 %. Only one plan did not fulfill the criteria and three of the plans did not comply with the commonly accepted tolerance level of ±3 % in point dose measurement.


CONCLUSIONS
Using only one of the two examined methods for patient-related quality assurance is not sufficiently significant in all cases.
Department of Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany. beatrice.steiniger@med.uni-jena.de.
Beatrice
http://orcid.org/0000-0001-8940-8448
B
Steiniger
Department of Radiation Oncology, SRH Hospital Gera, Straße des Friedens 122, 07548, Gera, Germany.
René
R
Berger
Radiation therapy Berlin southwest, site Martin-Luther-Hospital, Caspar-Theyß-Straße 33, 14193, Berlin, Germany.
Sabine
S
Eilzer
Department of Radiation Oncology, University Hospital Halle, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.
Christine
C
Kornhuber
Department for Radiation Oncology, Hospital of Chemnitz, Bürgerstraße 2, 09113, Chemnitz, Germany.
Kathleen
K
Lorenz
MVZ Center for Radiation Oncology Halle GmbH, Niemeyerstraße 24, 06110, Halle (Saale), Germany.
Torsten
T
Peil
Department of Radiation Oncology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01304, Dresden, Germany.
Carsten
C
Reiffenstuhl
Department of Radiation Oncology, Helios Hospital Erfurt, Nordhäuser Straße 74, 99089, Erfurt, Germany.
Johannes
J
Schilz
Department of Radiation Oncology, SRH Central Hospital Suhl, Albert-Schweitzer-Straße 2, 98527, Suhl, Germany.
Dirk
D
Schröder
Department of Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany.
Michael
M
Schwedas
Department of Radiation Oncology, Community Hospital Dresden-Friedrichstadt, Friedrichstraße 41, 01067, Dresden, Germany.
Stephanie
S
Pensold
Department of Radiation Oncology, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
Mathias
M
Walke
Department of Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany.
Kirsten
K
Weibert
Department of Radiation Oncology, University Hospital Leipzig, Stephanstraße 9a, 04103, Leipzig, Germany.
Ulrich
U
Wolf
Department of Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany.
Tilo
T
Wiezorek
D019544:Equipment Failure Analysis; D005858:Germany; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*; D018802:Patient-Centered Care / Q000592:standards; D011785:Quality Assurance, Health Care / Q000592:standards*; D018787:Radiation Oncology; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000592:standards*; D020266:Radiotherapy, Conformal / Q000295:instrumentation* / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
Calibration; Linear accelerators; Organs at risk; Radiation oncology; Radiotherapy, intensity-modulated