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Jeong, Yoon, and Lee: The Results of the Survey about Present Situation of Quality Assurance for Radiotherapy Machine of Korea
Original Article

Progress in Medical Physics 2015;26(3):185-191.

Published online: 20 September 2015

DOI: https://doi.org/10.14316/pmp.2015.26.3.185

The Results of the Survey about Present Situation of Quality Assurance for Radiotherapy Machine of Korea

Seonghoon Jeong, Myonggeun Yoon, Hyunho Lee

Department of Bio-convergence Engineering, Korea University, Seoul, Korea

Correspondence: Myonggeun Yoon (radioyoon@korea.ac.kr) Tel: 82-2-940-2752, Fax: 82-2-921-6434

Copyright © 2015 Korean Society of Medical Physics

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

As radiation therapy is one of three major cancer treatment methods, many cancer patients get radiation therapy. Because of the invisible and scattering characteristics of radiation, it is impossible to identify the quality and the amount of radiation and secondary cancer could be induced by scattered radiation. Because of advanced technique of radiation therapy and the reasons mentioned above, quality assurance of radiotherapy machine should be performed completely. International organizations such as International Atomic Energy Agency (IAEA), American Association of Physicists in Medicine (AAPM) suggest report of quality assurance to recommend united method of radiotherapy machine quality assurance. Domestic society of medical physics, however, is too small to make such a report, domestic hospitals selectively choose some of contents in global suggestions. As there are no suggestions for domestic hospitals and global suggestions are being updated, we did a survey about quality assurance for radiotherapy machine. The questionnaire is composed of possession of radiotherapy machine, items performed for quality assurance and manpower, etc. 37 of 72 hospitals answered to survey. These results could be used for making domestic standard quality assurance procedure.

Keywords: Radiation therapy, Quality assurance, Domestic situation, Procedure of quality assurance

References

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Fig. 1.
Manpower rate of quality assurance classified by academic level (a), major (b).
pmp-26-185f1.tif
Table 1.
Radiation therapy machine retention.
Present condition of possession Retention Average Number of hospital
Linear accelerator   61 97.30 1.69 36
Brachytherapy   15 40.54 1.00 15
Radiosurgery machine Gammaknife 1 24.32 0.11 9
  Cyberknife 5 24.32 0.56  
  Novalis 4 24.32 0.44  
Tomotherapy   10 18.92 1.43 7
Table 2.
Execution rate and execution manpower of quality assurance for each radiation therapy machine.
Periodical fulfillment ratio (%)/ Manpower (people) LINAC Brachytherapy Radiosurgery machine Tomotherapy
Daily 100.00/1.6 66.67/1.08 77.78/1.00 100.00/1.29
Weekly 48.57/1.63     14.29/1.00
Monthly 100.00/1.94 46.67/1.14 77.78/1.43 100.00/1.43
Annually 77.14/2.00 20.00/1.50 33.33/1.67 57.14/2.50
Before treatment   86.67/1.00 22.22/1.00  
Replacement of radiation source   93.34/1.00 11.11/1.50  
Table 3.
Periodical execution rate of quality assurance for linear accelera
  Item Weekly Daily Monthly Annually
Safety Patient monitoring devices, video & audio 97.1 11.8 22.9 33.3
  Radiation ON/OFF switch 100.0 11.8 22.9 37.0
  Beam on indicator & Door interlock 100.0 11.8 25.7 37.0
  Emergency off switches 68.6 23.5 37.1 40.7
Mechanical The temperature and the pressure of the cooling water 85.7 23.5 20.0 25.9
  The temperature and the atmosphere of the treatment room 88.6 23.5 28.6 33.3
  Laser alignment (cross hair line) 71.4 64.7 62.9 51.9
  ODI 42.9 70.6 60.0 59.3
  Electron applicator placement accuracy 14.3 47.1 51.4 44.4
  Accessary trays 11.4 23.5 42.9 37.0
  Wedge placement accuracy 11.4 29.4 45.7 37.0
  Radiation field indicators 14.3 47.1 71.4 48.1
  Gantry rotation isocenter 14.3 41.2 74.3 59.3
  Collimator rotation isocenter 8.6 41.2 74.3 63.0
  Light/radiation field coincidence (symmetric & asymmetric) 5.7 35.3 77.1 63.0
  Picket fence test 0.0 5.9 48.6 44.4
  Table top sag 2.9 11.8 34.3 55.6
  Treatment couch position indicators 5.7 35.3 60.0 51.9
  Table travel maximum range movement in all directions 2.9 11.8 31.4 37.0
  Cross hair centering 5.7 29.4 77.1 59.3
  Radiation field isocenter alignment – gantry rotation 2.9 23.5 77.1 81.5
  Radiation field isocenter alignment – collimator rotation 2.9 23.5 74.3 81.5
  Radiation field isocenter alignment – table rotation 2.9 23.5 74.3 81.5
Dosimetry X-ray beam output constancy 48.6 64.7 71.4 48.1
  X-ray beam output calibration 2.9 47.1 82.9 51.9
  X-ray beams dose rate 11.4 23.5 48.6 40.7
  X-ray beam symmetry and flatness 25.7 5.9 68.6 81.5
  Electron beam output constancy 40.0 64.7 74.3 48.1
  Electron beam output calibration 2.9 47.1 80.0 51.9
  Electron beam dose rate 8.6 23.5 45.7 37.0
  Electron beam symmetry and flatness 22.9 0.0 71.4 77.8
  Photon beam quality, PDD or TMR 8.6 5.9 65.7 77.8
  Electron beam quality, R50 2.9 11.8 54.3 81.5
  Leakage dose measurement 2.9 23.5 74.3 40.7
Table 4.
Periodical execution rate of quality assurance for brachytherapy.
  Item Weekly Treatment Monthly Annually Source replacemen
Safety Beam on indicator 90.0 76.9 28.6 33.3 35.7
  Door interlock 90.0 76.9 28.6 33.3 35.7
  Patient monitoring tools, audio & video 80.0 84.6 28.6 33.3 42.9
  Emergency stop switches 50.0 53.8 42.9 66.7 35.7
  Emergency instruction & devices 50.0 46.2 28.6 33.3 35.7
  Treatment room locking devices 70.0 53.8 57.1 66.7 35.7
  GM counter 60.0 69.2 42.9 33.3 35.7
  Console or computer locking devices 70.0 53.8 28.6 33.3 21.4
  The survey after the treatment 30.0 69.2 57.1 33.3 14.3
Operation Console ON / OFF switch 60.0 69.2 28.6 33.3 42.9
  Time, Date 70.0 76.9 42.9 33.3 42.9
  Location of radiation source 40.0 38.5 57.1 33.3 71.4
  Comparison between radiation attenuation and 20.0 46.2 42.9 33.3 28.6
  attenuation table          
Dosimetry Accuracy of source and dummy loading 40.0 30.8 42.9 66.7 64.3
  Source calibration 20.0 15.4 85.7 66.7 85.7
  Dose calculation algorithm 20.0 15.4 42.9 66.7 35.7
Treatment Device condition 50.0 92.3 28.6 66.7 7.1
  Patient information 30.0 100.0 0.0 66.7 7.1
Table 5.
Periodical execution rate of quality assurance for radiosurgery machine.
  Item Daily Weekly Monthly Annually
Safety Patient monitoring tools, audio & video 85.7 0.0 42.9 100.0
  Beam on indicator & Door interlock) 100.0 0.0 42.9 100.0
  Emergency ON/OFF switches 57.1 0.0 57.1 100.0
Dosimetry Energy constancy 42.9 0.0 71.4 66.7
  Beam symmetry 14.3 50.0 71.4 100.0
  Beam shape 14.3 50.0 42.9 66.7
  Output 71.4 100.0 71.4 100.0
  AQA test 42.9 50.0 28.6 33.3
  Isocentric end-to-end test 14.3 100.0 57.1 66.7
  Nonisocentric patient QA or DQA 0.0 50.0 28.6 66.7
Mechanical Imager alignment 57.1 50.0 57.1 100.0
  Verify relative location of beam laser vs. radiation CAX 57.1 50.0 57.1 100.0
Table 6.
Periodical execution rate of quality assurance for tomotherapy.
  Item Weekly Daily Monthly Annually
Safety Patient monitoring devices, video & audio 100.0 0.0 57.1 75.0
  Radiation ON/OFF switch 100.0 0.0 57.1 75.0
  Beam on indicator & Door interlock 100.0 0.0 57.1 75.0
  Emergency ON/OFF switches 57.1 0.0 71.4 75.0
Mechanica l y-jaw centering 0.0 0.0 57.1 75.0
  x-alignment of source 0.0 0.0 42.9 75.0
  y-jaw divergence / beam centering 0.0 0.0 28.6 75.0
  y-jaw / gantry rotation plane alignment 0.0 0.0 42.9 75.0
  Treatment beam field centering 0.0 0.0 42.9 75.0
  MLC lateral offset 0.0 0.0 57.1 75.0
  MLC twist 0.0 0.0 42.9 75.0
Dosimetry Output – rotational (IC) 28.6 100.0 57.1 50.0
  Output – static (IC) 57.1 100.0 57.1 75.0
  Rotation output variation 28.6 100.0 42.9 50.0
  PDD or TMR 42.9 0.0 71.4 75.0
  Transverse beam profile 0.0 0.0 42.9 50.0
  Longitudinal beam profiles – each slide width 0.0 0.0 57.1 50.0
Alignment Red laser movement 85.7 0.0 57.1 75.0
  Axial green laser-distance and twist, Sagittal/coronal green laser 57.1 0.0 71.4 75.0
  Couch speed uniformity 14.3 0.0 14.3 75.0
  Couch translation per gantry rotation 14.3 0.0 28.6 75.0
MV/CT Uniformity 0.0 0.0 28.6 50.0
  HU – water test plug 0.0 0.0 28.6 50.0
  HU – lugn/bone test plug 0.0 0.0 28.6 50.0
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