COMMISSIONING AND QUALITY ASSURANCE OF TREATMENT PLANNING COMPUTERS
COMMISSIONING AND QUALITY ASSURANCE OF TREATMENT PLANNING COMPUTERS
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DOI：
10.1016/0360-3016(93)90206-b
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发表时间：
1993-05-20
影响因子：
7
通讯作者：
SHRAGGE, PC
中科院分区：
文献类型：
--
作者：
VANDYK, J;BARNETT, RB;SHRAGGE, PC
放射治疗的过程很复杂，涉及很多步骤。在每一步，都需要全面的质量保证程序，以确保安全和准确地提供规定的辐射剂量。这份报告涉及专门针对治疗计划计算机的全面调试和持续质量保证计划。在下列主题下提供了详细的指南：(A)计算机程序和系统文档和用户培训，(B)不确定源和建议公差，(C)初始系统检查，(D)重复系统检查，(E)通过人工程序和活体剂量测定的质量保证，以及(F)一些额外考虑，包括管理和人力要求。在商业计算机化治疗计划系统的背景下，提出了以下方面的不确定度估计和可接受标准：(A)外部光子束、(B)电子束、(C)近距离放射治疗和(D)治疗机设置计算。尽管这些可接受性标准看起来很大，但它们接近当今大多数治疗计划系统所能达到的极限。然而，新的或改进的剂量计算算法的开发者应该努力实现国际辐射单位委员会推荐的目标，并在低剂量梯度下测量相对剂量精度2%，或在高剂量梯度区域测量2 mm空间精度。对于近距离放射治疗，对于任何放射源，在任何点上0.5厘米或更远的距离上，目标应该是3%的剂量准确度。提供了初始调试测试和后续重现性测试的详细信息。每个患者的最终质量保证是对剂量分布中的至少一个点进行独立的手动检查，以及机器设置计算。作为对整体治疗计划过程的检查，应对选定数量的患者进行体内剂量测定。
The process of radiation therapy is complex and involves many steps. At each step, comprehensive quality assurance procedures are required to ensure the safe and accurate delivery of a prescribed radiation dose. This report deals with a comprehensive commissioning and ongoing quality assurance program specifically for treatment planning computers. Detailed guidelines are provided under the following topics: (a) computer program and system documentation and user training, (b) sources of uncertainties and suggested tolerances, (c) initial system checks, (d) repeated system-checks, (e) quality assurance through manual procedures, and in vivo dosimetry, and (f) some additional considerations including administration and manpower requirements. In the context of commercial computerized treatment planning systems, uncertainty estimates and achievable criteria of acceptability are presented for: (a) external photon beams, (b) electron beams, (c) brachytherapy, and (d) treatment machine setting calculations. Although these criteria of acceptability appear large, they approach the limit achievable with most of today's treatment planning systems. However, developers of new or improved dose calculation algorithms should strive for the goal recommended by the International Commission of Radiation Units and Measurements of 2% in relative dose accuracy in low dose gradients or 2 mm spatial accuracy in regions with high dose gradients. For brachytherapy, the aim should be 3% accuracy in dose at distances of 0.5 cm or more at any point for any radiation source. Details are provided for initial commissioning tests and follow-up reproducibility tests. The final quality assurance for each patient is to perform an independent manual check of at least one point in the dose distributions, as well as the machine setting calculation. As a check of the overall treatment planning process, in vivo dosimetry should be performed on a select number of patients.