An IAEA survey of radiotherapy practice including quality assurance extent and depth.

Background: The IAEA recommends a quality assurance program in radiotherapy to ensure safe and effective treatments. In this study, radiotherapy departments were surveyed on their current practice including the extent and depth of quality assurance activities.Methods: Radiotherapy departments were voluntarily surveyed in three stages, firstly, in basic facility information, secondly, in quality assurance activities and treatment techniques, and thirdly, in a snapshot of quality assurance, departmental and treatment activities.Results: The IAEA received completed surveys from 381 radiotherapy departments throughout the world with 100 radiotherapy departments completing all three surveys. Dominant patterns were found in linac-based radiotherapy with access to treatment planning systems for 3D-CRT and 3D imaging. Staffing levels for major staff groups were on average in the range recommended by the IAEA. The modal patient workload per EBRT unit was as expected in the range of 21-30 patients per day, however significant instances of high workload (more than 50 patients per day per treatment unit) were reported. Staffing levels were found to correlate with amount of treatment equipment and patient workload. In a self-assessment of quality assurance performance, most radiotherapy departments reported that they would perform at least 60% of the quality assurance activities itemized in the second survey, with particular strength in equipment quality control. In a snapshot survey of quality assurance performance, again equipment quality control practice was well developed, particularly for the treatment equipment.Conclusions: The IAEA surveys provide a snapshot of current radiotherapy practice including quality assurance activities.

Optically stimulated luminescence in vivo dosimetry for radiotherapy: physical characterization and clinical measurements in (60)Co beams.

A commercial optically stimulated luminescence (OSL) dosimetry system was investigated for in vivo dosimetry in radiation therapy. Dosimetric characteristics of InLight dot dosimeters and a microStar reader (Landauer Inc.) were tested in (60)Co beams. The reading uncertainty of a single dosimeter was 0.6%. The reproducibility of a set of dosimeters after a single irradiation was 1.6%, while in repeated irradiations of the same dosimeters it was found to be 3.5%. When OSL dosimeters were optically bleached between exposures, the reproducibility of repeated measurements improved to 1.0%. Dosimeters were calibrated for the entrance dose measurements and a full set of correction factors was determined. A pilot patient study that followed phantom validation testing included more than 100 measured fields with a mean relative difference of the measured entrance dose from the expected dose of 0.8% and the standard deviation of 2.5%. In conclusion, these results demonstrate that OSL dot dosimeters represent a valid alternative to already established in vivo dosimetry systems.

Comparison of doses calculated by the Monte Carlo method and measured by LiF TLD in the buildup region for a 60Co photon beam.

This work studied the percent depth doses of (60)Co photon beams in the buildup region of a plastic phantom by LiF TLD measurements and by Monte Carlo calculations. An agreement within +/-1.5% was found between PDDs measured by TLD and calculated by the Monte Carlo method with the TLD in a plastic phantom. The dose in the plastic phantom was scored in voxels, with thickness scaled by physical and electron density. PDDs calculated by electron density scaling showed a better match with PDD(TLD)(MC); the difference is within +/-1.5% in the buildup region for square and rectangular field sizes.