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Title: Quality Assurance Needs for Modern Image-Based Radiotherapy: Recommendations From 2007 Interorganizational Symposium on 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology'

Abstract

This report summarizes the consensus findings and recommendations emerging from 2007 Symposium, 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology.' The Symposium was held in Dallas February 20-22, 2007. The 3-day program, which was sponsored jointly by the American Society for Therapeutic Radiology and Oncology (ASTRO), American Association of Physicists in Medicine (AAPM), and National Cancer Institute (NCI), included >40 invited speakers from the radiation oncology and industrial engineering/human factor communities and attracted nearly 350 attendees, mostly medical physicists. A summary of the major findings follows. The current process of developing consensus recommendations for prescriptive quality assurance (QA) tests remains valid for many of the devices and software systems used in modern radiotherapy (RT), although for some technologies, QA guidance is incomplete or out of date. The current approach to QA does not seem feasible for image-based planning, image-guided therapies, or computer-controlled therapy. In these areas, additional scientific investigation and innovative approaches are needed to manage risk and mitigate errors, including a better balance between mitigating the risk of catastrophic error and maintaining treatment quality, complimenting the current device-centered QA perspective by a more process-centered approach, and broadening community participation in QA guidance formulation and implementation. Industrial engineers andmore » human factor experts can make significant contributions toward advancing a broader, more process-oriented, risk-based formulation of RT QA. Healthcare administrators need to appropriately increase personnel and ancillary equipment resources, as well as capital resources, when new advanced technology RT modalities are implemented. The pace of formalizing clinical physics training must rapidly increase to provide an adequately trained physics workforce for advanced technology RT. The specific recommendations of the Symposium included the following. First, the AAPM, in cooperation with other advisory bodies, should undertake a systematic program to update conventional QA guidance using available risk-assessment methods. Second, the AAPM advanced technology RT Task Groups should better balance clinical process vs. device operation aspects-encouraging greater levels of multidisciplinary participation such as industrial engineering consultants and use-risk assessment and process-flow techniques. Third, ASTRO should form a multidisciplinary subcommittee, consisting of physician, physicist, vendor, and industrial engineering representatives, to better address modern RT quality management and QA needs. Finally, government and private entities committed to improved healthcare quality and safety should support research directed toward addressing QA problems in image-guided therapies.« less

Authors:
 [1];  [2];  [3];  [4];  [5]
  1. University of Calgary, Calgary, AB (Canada)
  2. Princess Margaret Hospital, Toronto, ON (Canada)
  3. University of Wisconsin, Madison, WI (United States)
  4. University of California-Davis, Sacramento, CA (United States)
  5. National Cancer Institute, Bethesda, MD (United States)
Publication Date:
OSTI Identifier:
21124215
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 71; Journal Issue: 1; Conference: 2007 interorganizational symposium on quality assurance of radiation therapy: Challenges of advanced technology, Dallas, TX (United States), 20-22 Feb 2007; Other Information: DOI: 10.1016/j.ijrobp.2007.08.080; PII: S0360-3016(07)04286-1; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; COMPUTER CODES; CONSULTANTS; IMAGES; NEOPLASMS; QUALITY ASSURANCE; RECOMMENDATIONS; RISK ASSESSMENT; TRAINING

Citation Formats

Williamson, Jeffrey F., Dunscombe, Peter B, Sharpe, Michael B, Thomadsen, Bruce R, Purdy, James A, and Deye, James A. Quality Assurance Needs for Modern Image-Based Radiotherapy: Recommendations From 2007 Interorganizational Symposium on 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology'. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.08.080.
Williamson, Jeffrey F., Dunscombe, Peter B, Sharpe, Michael B, Thomadsen, Bruce R, Purdy, James A, & Deye, James A. Quality Assurance Needs for Modern Image-Based Radiotherapy: Recommendations From 2007 Interorganizational Symposium on 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology'. United States. https://doi.org/10.1016/j.ijrobp.2007.08.080
Williamson, Jeffrey F., Dunscombe, Peter B, Sharpe, Michael B, Thomadsen, Bruce R, Purdy, James A, and Deye, James A. 2008. "Quality Assurance Needs for Modern Image-Based Radiotherapy: Recommendations From 2007 Interorganizational Symposium on 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology'". United States. https://doi.org/10.1016/j.ijrobp.2007.08.080.
@article{osti_21124215,
title = {Quality Assurance Needs for Modern Image-Based Radiotherapy: Recommendations From 2007 Interorganizational Symposium on 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology'},
author = {Williamson, Jeffrey F. and Dunscombe, Peter B and Sharpe, Michael B and Thomadsen, Bruce R and Purdy, James A and Deye, James A},
abstractNote = {This report summarizes the consensus findings and recommendations emerging from 2007 Symposium, 'Quality Assurance of Radiation Therapy: Challenges of Advanced Technology.' The Symposium was held in Dallas February 20-22, 2007. The 3-day program, which was sponsored jointly by the American Society for Therapeutic Radiology and Oncology (ASTRO), American Association of Physicists in Medicine (AAPM), and National Cancer Institute (NCI), included >40 invited speakers from the radiation oncology and industrial engineering/human factor communities and attracted nearly 350 attendees, mostly medical physicists. A summary of the major findings follows. The current process of developing consensus recommendations for prescriptive quality assurance (QA) tests remains valid for many of the devices and software systems used in modern radiotherapy (RT), although for some technologies, QA guidance is incomplete or out of date. The current approach to QA does not seem feasible for image-based planning, image-guided therapies, or computer-controlled therapy. In these areas, additional scientific investigation and innovative approaches are needed to manage risk and mitigate errors, including a better balance between mitigating the risk of catastrophic error and maintaining treatment quality, complimenting the current device-centered QA perspective by a more process-centered approach, and broadening community participation in QA guidance formulation and implementation. Industrial engineers and human factor experts can make significant contributions toward advancing a broader, more process-oriented, risk-based formulation of RT QA. Healthcare administrators need to appropriately increase personnel and ancillary equipment resources, as well as capital resources, when new advanced technology RT modalities are implemented. The pace of formalizing clinical physics training must rapidly increase to provide an adequately trained physics workforce for advanced technology RT. The specific recommendations of the Symposium included the following. First, the AAPM, in cooperation with other advisory bodies, should undertake a systematic program to update conventional QA guidance using available risk-assessment methods. Second, the AAPM advanced technology RT Task Groups should better balance clinical process vs. device operation aspects-encouraging greater levels of multidisciplinary participation such as industrial engineering consultants and use-risk assessment and process-flow techniques. Third, ASTRO should form a multidisciplinary subcommittee, consisting of physician, physicist, vendor, and industrial engineering representatives, to better address modern RT quality management and QA needs. Finally, government and private entities committed to improved healthcare quality and safety should support research directed toward addressing QA problems in image-guided therapies.},
doi = {10.1016/j.ijrobp.2007.08.080},
url = {https://www.osti.gov/biblio/21124215}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 71,
place = {United States},
year = {Thu May 01 00:00:00 EDT 2008},
month = {Thu May 01 00:00:00 EDT 2008}
}