Purpose: Online adaptive radiotherapy (ART) is characterized by time sensitivity on the daily treatment. Quality assurance (QA) is a necessary component involved in online ART workflow before treatment. Intensive, time-sensitive work is required to transfer data, calculate, and review the QA. Current commercial verification software was found to hinder the efficiency of online ART. We have developed a specialized application using an in-house infrastructure to streamline the online ART workflow.
Methods: A dedicated in-house infrastructure was developed to expedite the secondary dose verification for LINACs. Based on this resource, a web-based dashboard application was designed to integrate the infrastructure into clinical workflow for online ART. After the final adaptive plan is ready in the treatment planning system (TPS) and exported to the infrastructure, the entire QA workflow will be implemented through the application with minimal user effort.
Results: A web-based application, quality assurance dashboard, was developed to connect the in-house secondary dose verification module and clinical treatment management systems. It provides a user interface that offers plan selection, progress monitoring, QA report generation, report review and approval, and QA report upload to the treatment management system. It simplifies the QA workflow to a) select the adaptive plan, b) monitor the calculation progress, c) view and approve the QA reports. The QA reports are automatically uploaded to the treatment management systems when approved. The updated workflow can complete the quality assurance process within minutes with an average of 68±11 seconds on performing secondary dose verification under clinical criteria of 3D-Gamma and point-dose difference QA metrics. The system also allows for the plan data to be automatically forwarded to an outside plan tracking software or TPS.
Conclusion: The quality assurance dashboard is an efficient tool for streamlining the clinical workflow and benefiting patients under online adaptive radiotherapy.