Journal List > Prog Med Phys > v.24(4) > 1098406

Huh, Cho, Cho, Choi, Kim, Hwang, Kim, Min, Choi, Oh, Lee, Park, Park, and Ji: Report on the External Audits Conducted by Korean Society of Medical Physics

Abstract

The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of −0.8%∼4.5%, −0.79%∼3.01%, and −0.7%∼0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ±2 mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ±1 mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

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Fig. 1.
Meeting for the precheck up of the preparation items for the external audit.
pmp-24-315f1.tif
Fig. 2.
Star patterns to determine radiation isocenter of (a) gantry rotation and (b) collimator rotation. These angles are 0o, 30o, 90o, 135o, 225o, 300o.
pmp-24-315f2.tif
Fig. 3.
Picket and fence test to determine the positional accuracy of MLC movement.
pmp-24-315f3.tif
Fig. 4.
Distribution of outputs for 6, 10, and 15 MV photon beams performed in 25 hospitals.
pmp-24-315f4.tif
Fig. 5.
Distribution of radiation isocenters of gantry rotation and collimator rotation in 25 hospitals.
pmp-24-315f5.tif
Fig. 6.
Distribution of MLC positional erors determined by the Picket and fence test.
pmp-24-315f6.tif
Fig. 7.
Distribution of TPR10/20 ratios for 6, 10, and 15 MV photon beams in 25 hospitals.
pmp-24-315f7.tif
Table 1.
Areas of a participated hospitals for external audit.
Areas Number of participated hospitals Number of Auditors
서울 남부 3 2
서울 북부 5 2
경기, 인천 4 2
호남, 호서 5 2
대구, 경북 5 3
부산, 경남 3 2
Total 25 13
Table 2.
To be used dosimetries for external audit.
Areas Ion chamber Electrometer Thermometer Barometer
서울 남부 PTW TM30013 UNIDOS Lufft C100 Lufft C300
서울 북부 IBA FC65-G Dose 1 Lufft C100 Lufft C300
경기, 인천 PTW TM30013 UNIDOS Lufft C100 Lufft C300
호남, 호서 IBA FC65-G Dose 1 Lufft C100 Lufft C300
대구, 경북 IBA FC65-G Dose 1 Lufft C100 Lufft C300
부산, 경남 IBA FC65-P Dose 1 Lufft C100 Lufft C300
Table 3.
Contents of external audit.
Contents Tolerance Remarks
광자선 출력조사 ±2% 물 흡수선량 기반
갠트리 조사 회전 중심점 2 mm 필름 조사
일치도    
콜리메이터 조사 회전 2 mm 필름 조사
중심점 일치도    
다엽콜리메이터 이동 1 mm Picket and fence test
위치 정확도    
TPR10/20 조사 - 현황분석
선량 측정 기준서 조사 - 현황분석
출력선량 측정방법 조사 - 현황분석
Table 4.
To be showed the radiation measurement protocol in participated hospitals.
  Protocol Hospitals
선량측정 기준서 KSMP 및 TRS-398 18
  TRS-277 3
  TG-51 3
  TG-21 1
선량 측정방법 SSD 22
  SAD 3
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