Institutional patient-specific IMRT QA does not predict unacceptable plan delivery.
Institutional patient-specific IMRT QA does not predict unacceptable plan delivery.
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DOI：
10.1016/j.ijrobp.2014.08.334
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发表时间：
2014-12-01
影响因子：
7
通讯作者：
Followill, David S.
中科院分区：
文献类型：
--
作者：
Kry, Stephen F.;Molineu, Andrea;Kerns, James R.;Faught, Austin M.;Huang, Jessie Y.;Pulliam, Kiley B.;Tonigan, Jackie;Alvarez, Paola;Stingo, Francesco;Followill, David S.
确定内部患者特定IMRT QA结果是否可预测成像和放射肿瘤学核心（IROC）-休斯顿体模结果。作为临床试验认证的一部分，IROC Houston的IMRT头部和颈部体模已被多家机构辐照。我们回顾性地比较了这些体模结果与2003年至2013年期间进行的855次辐照的内部IMRT QA结果（遵循机构的临床过程）。IMRT QA检测不可接受或可接受计划的灵敏度和特异性是相对于IROC Houston体模结果确定的。其他分析评价了特定IMRT QA剂量计和分析方法。调强放射治疗质量保证普遍显示相对于头颈部体模的灵敏度较差，即，预测失败IROC Houston体模结果的能力较差。根据IMRT QA结果的解释，总体灵敏度范围为2%至18%。对于不同的调强放射治疗质量保证方法，灵敏度范围从3%到54%。尽管观察到的灵敏度在临床阈值处特别差（例如，3%剂量差异或90%的像素通过伽马），接受者操作者特征分析表明，没有阈值显示出所评价器械的良好灵敏度和特异性。调强放射治疗质量保证不是合格体模的合理替代品。此外，IMRT QA和IROC Houston Phantomy之间的一致性特别差，突出了QA过程中令人惊讶的不一致性。
To determine whether in-house patient-specific IMRT QA results predict the Imaging and Radiation Oncology Core (IROC)-Houston phantom results. IROC Houston’s IMRT head and neck phantoms have been irradiated by numerous institutions as part of clinical trial credentialing. We retrospectively compared these phantom results with those of in-house IMRT QA (following the institution’s clinical process) for 855 irradiations performed between 2003 and 2013. The sensitivity and specificity of IMRT QA to detect unacceptable or acceptable plans was determined relative to the IROC Houston phantom results. Additional analyses evaluated specific IMRT QA dosimeters and analysis methods. IMRT QA universally showed poor sensitivity relative to the head and neck phantom i.e., poor ability to predict a failing IROC Houston phantom result. Depending on how the IMRT QA results were interpreted, overall sensitivity ranged from 2% to 18%. For different IMRT QA methods, sensitivity ranged from 3% to 54%. Although the observed sensitivity was particularly poor at clinical thresholds (e.g., 3% dose difference or 90% of pixels passing gamma), receiver operator characteristic analysis indicated that no threshold showed good sensitivity and specificity for the devices evaluated. IMRT QA is not a reasonable replacement for a credentialing phantom. Moreover, the particularly poor agreement between IMRT QA and the IROC Houston phantoms highlights surprising inconsistency in the QA process.
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影响因子：
3.8
作者：
Kruse, Jon J.
通讯作者：
Kruse, Jon J.
影响因子：
3.8
作者：
Nelms, Benjamin E.;Chan, Maria F.;Feygelman, Vladimir
通讯作者：
Feygelman, Vladimir
影响因子：
3.8
作者：
Scarboro, Sarah B.;Followill, David S.;Kry, Stephen F.
通讯作者：
Kry, Stephen F.
DOI：
10.1016/j.ijrobp.2005.05.021
发表时间：
2005-10-01
影响因子：
7
作者：
Molineu, A;Followill, DS;Ibbott, GS
通讯作者：
Ibbott, GS
影响因子：
2.1
作者：
Nelms BE;Simon JA
通讯作者：
Simon JA