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Setup in a clinical workflow and impact on radiotherapy routine of an in vivo dosimetry procedure with an electronic portal imaging device

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机构: [1]Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, China [2]UOC Fisica Sanitaria, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
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High conformal techniques such as intensity-modulated radiation therapy and volumetric-modulated arc therapy are widely used in overloaded radiotherapy departments. In vivo dosimetric screening is essential in this environment to avoid important dosimetric errors. This work examines the feasibility of introducing in vivo dosimetry (IVD) checks in a radiotherapy routine. The causes of dosimetric disagreements between delivered and planned treatments were identified and corrected during the course of treatment. The efficiency of the corrections performed and the added workload needed for the entire procedure were evaluated. The IVD procedure was based on an electronic portal imaging device. A total of 3682 IVD tests were performed for 147 patients who underwent head and neck, abdomen, pelvis, breast, and thorax radiotherapy treatments. Two types of indices were evaluated and used to determine if the IVD tests were within tolerance levels: the ratio R between the reconstructed and planned isocentre doses and a transit dosimetry based on the gamma-analysis of the electronic portal images. The causes of test outside tolerance level were investigated and corrected and IVD test was repeated during subsequent fraction. The time needed for each step of the IVD procedure was registered. Pelvis, abdomen, and head and neck treatments had 10% of tests out of tolerance whereas breast and thorax treatments accounted for up to 25%. The patient setup was the main cause of 90% of the IVD tests out of tolerance and the remaining 10% was due to patient morphological changes. An average time of 42 min per day was sufficient to monitor a daily workload of 60 patients in treatment. This work shows that IVD performed with an electronic portal imaging device is feasible in an overloaded department and enables the timely realignment of the treatment quality indices in order to achieve a patient's final treatment compliant with the one prescribed.

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出版当年[2018]版:
大类 | 3 区 生物
小类 | 3 区 综合性期刊
最新[2023]版:
大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
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出版当年[2018]版:
Q2 MULTIDISCIPLINARY SCIENCES
最新[2023]版:
Q1 MULTIDISCIPLINARY SCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2018版] 出版当年五年平均 出版前一年[2017版] 出版后一年[2019版]

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第一作者机构: [1]Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, China
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