A Survey Towards Standardization of Dosimetric Verification in Intensity-modulated Radiation Therapy

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  • Nakamura Mitsuhiro
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Iramina Hiraku
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Takamiya Masanori
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Ono Tomohiro
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Akimoto Mami
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Mukumoto Nobutaka
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Ishihara Yoshitomo
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Utsunomiya Satoru
    Division of Radiation Oncology, Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences
  • Shiinoki Takehiro
    Department of Therapeutic Radiology, Graduate School of Medicine, Yamaguchi University
  • Miyabe Yuki
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Sato Sayaka
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University
  • Monzen Hajime
    Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University

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Other Title
  • 強度変調放射線治療における線量検証の標準化に向けた調査研究
  • キョウド ヘンチョウ ホウシャセン チリョウ ニ オケル センリョウ ケンショウ ノ ヒョウジュンカ ニ ムケタ チョウサ ケンキュウ

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Abstract

Purpose: The purpose of this study was to investigate the status of the implementation of quality assurance (QA) for intensity-modulated radiation therapy (IMRT) in Japan using a questionnaire survey.<br>Methods: The questionnaire consisted of seven sections: (1) clinical uses of IMRT, (2) treatment planning systems, treatment machines, phantoms for verification and CT scanning, (3) absorbed dose verification, (4) dose distribution verification, (5) fluence map verification, (6) acceptance criteria for each verification, and (7) comments.<br>Results: The questionnaire was completed by 129 institutions (response rate: 76.8%). IMRT was performed for prostate cancer in 125 institutions (96.9%), followed by head and neck cancer in 83 (64.3%), and brain tumors in 69 (53.5%). Although at least three individuals were engaged in IMRT QA in 77.5% of the institutions, the number of full-time persons involved in IMRT QA was one or less in 94 institutions (72.9%). This indicated that most institutions in Japan have a staff shortage. More than 90% of the institutions verified both the absorbed dose and dose distribution. The acceptance criterion for the absorbed dose verification was set to ±3% in at least 80% of the institutions. Gafchromic film was used for the majority of dose distribution verifications. The acceptance criteria for dose distribution verification mainly involved gamma analysis and a comparison of dose profiles; however, the judgment of acceptance did not depend on the results of the gamma analysis.<br>Conclusion: This survey increases our understanding of how institutions currently perform IMRT QA analysis. This understanding will help to move institutions toward more standardization of IMRT QA in Japan.

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