Exhibit Hall | Forum 4
Purpose: The evaluation of an in-house web-based automatic plan quality assurance verification system for online adaptive radiotherapy (ART). Current commercial systems were found lacking in the speed for ART treatments with a patient waiting on the treatment machine for the quality assurance (QA) to be completed post plan generation. This bottleneck worsens with simultaneous ART sessions. An application was developed to efficiently handle the clinical need for speed with a near negligible wait time to generate the physician and physicist approved QA reports.
Methods: ART plans from two Varian Ethos systems were used in real-time to evaluate the application compared to the current commercial offering. A total of 53 cases were collected simultaneously on both systems. The time from DICOM file reception to report generation of the QA results was collected from each system directly and results were analyzed cumulatively and per treatment site. Each system utilized reference beam data provided by Varian, with the commercial system configured by the vendor and the in-house system modeled in an in-house, fast Monte Carlo based calculation.
Results: The in-house application was found to generate ART QA documentation with efficiency and ease of use. The average time for the in-house system to generate a QA report was 68+-10 sec., while the commercial system took 274+-169 sec. for the same plan QA calculations. Both systems were found to generate acceptable clinical QA criteria for 3D Gamma-analysis. The commercial system was susceptible to pile-up due to indiscriminate calculation of unnecessary plans, an issue exasperated with simultaneous sessions.
Conclusion: The in-house ART QA solution has been implemented. The system accomplished its primary task of expediting the ART QA process. It introduced greater automation of the QA process and also allows for the clinical ART data to be transferred to an external plan review/tracking system.