A multi-institutional evaluation of machine performance check system on treatment beam output and symmetry using statistical process control. 2019

Diana Binny, and Trent Aland, and Ben R Archibald-Heeren, and Jamie V Trapp, and Tanya Kairn, and Scott B Crowe
Icon Cancer Centres, Northlakes, QLD, Australia.

BACKGROUND The automated and integrated machine performance check (MPC) tool was verified against independent detectors to evaluate its beam uniformity and output detection abilities to consider it suitable for daily quality assurance (QA). METHODS Measurements were carried out on six linear accelerators (each located at six individual sites) using clinically available photon and electron energies for a period up to 12 months (n = 350). Daily constancy checks on beam symmetry and output were compared against independent devices such as the SNC Daily QA 3, PTW Farmer ionization chamber, and SNC field size QA phantom. MPC uniformity detection of beam symmetry adjustments was also assessed. Sensitivity of symmetry and output measurements were assessed using statistical process control (SPC) methods to derive tolerances for daily machine QA and baseline resets to account for drifts in output readings. I-charts were used to evaluate systematic and nonsystematic trends to improve error detection capabilities based on calculated upper and lower control levels (UCL/LCL) derived using standard deviations from the mean dataset. RESULTS This study investigated the vendor's method of uniformity detection. Calculated mean uniformity variations were within ± 0.5% of Daily QA 3 vertical symmetry measurements. Mean MPC output variations were within ± 1.5% of Daily QA 3 and ±0.5% of Farmer ionization chamber detected variations. SPC calculated UCL values were a measure of change observed in the output detected for both MPC and Daily QA 3. CONCLUSIONS Machine performance check was verified as a daily quality assurance tool to check machine output and symmetry while assessing against an independent detector on a weekly basis. MPC output detection can be improved by regular SPC-based trend analysis to measure drifts in the inherent device and control systematic and random variations thereby increasing confidence in its capabilities as a QA device. A 3-monthly MPC calibration assessment was recommended based on SPC capability and acceptability calculations.

UI MeSH Term Description Entries
D010315 Particle Accelerators Devices which accelerate electrically charged atomic or subatomic particles, such as electrons, protons or ions, to high velocities so they have high kinetic energy. Betatrons,Linear Accelerators,Accelerator, Linear,Accelerator, Particle,Accelerators, Linear,Accelerators, Particle,Betatron,Linear Accelerator,Particle Accelerator
D011785 Quality Assurance, Health Care Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps. Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D011874 Radiometry The measurement of radiation by photography, as in x-ray film and film badge, by Geiger-Mueller tube, and by SCINTILLATION COUNTING. Geiger-Mueller Counters,Nuclear Track Detection,Radiation Dosimetry,Dosimetry, Radiation,Geiger Counter,Geiger-Mueller Counter Tube,Geiger-Mueller Probe,Geiger-Mueller Tube,Radiation Counter,Counter Tube, Geiger-Mueller,Counter Tubes, Geiger-Mueller,Counter, Geiger,Counter, Radiation,Counters, Geiger,Counters, Geiger-Mueller,Counters, Radiation,Detection, Nuclear Track,Dosimetries, Radiation,Geiger Counters,Geiger Mueller Counter Tube,Geiger Mueller Counters,Geiger Mueller Probe,Geiger Mueller Tube,Geiger-Mueller Counter Tubes,Geiger-Mueller Probes,Geiger-Mueller Tubes,Probe, Geiger-Mueller,Probes, Geiger-Mueller,Radiation Counters,Radiation Dosimetries,Tube, Geiger-Mueller,Tube, Geiger-Mueller Counter,Tubes, Geiger-Mueller,Tubes, Geiger-Mueller Counter
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D011880 Radiotherapy Planning, Computer-Assisted Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy. Computer-Assisted Radiotherapy Planning,Dosimetry Calculations, Computer-Assisted,Planning, Computer-Assisted Radiotherapy,Calculation, Computer-Assisted Dosimetry,Calculations, Computer-Assisted Dosimetry,Computer Assisted Radiotherapy Planning,Computer-Assisted Dosimetry Calculation,Computer-Assisted Dosimetry Calculations,Dosimetry Calculation, Computer-Assisted,Dosimetry Calculations, Computer Assisted,Planning, Computer Assisted Radiotherapy,Radiotherapy Planning, Computer Assisted
D002138 Calibration Determination, by measurement or comparison with a standard, of the correct value of each scale reading on a meter or other measuring instrument; or determination of the settings of a control device that correspond to particular values of voltage, current, frequency or other output. Calibrations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013223 Statistics as Topic Works about the science and art of collecting, summarizing, and analyzing data that are subject to random variation. Area Analysis,Estimation Technics,Estimation Techniques,Indirect Estimation Technics,Indirect Estimation Techniques,Multiple Classification Analysis,Service Statistics,Statistical Study,Statistics, Service,Tables and Charts as Topic,Analyses, Area,Analyses, Multiple Classification,Area Analyses,Classification Analyses, Multiple,Classification Analysis, Multiple,Estimation Technic, Indirect,Estimation Technics, Indirect,Estimation Technique,Estimation Technique, Indirect,Estimation Techniques, Indirect,Indirect Estimation Technic,Indirect Estimation Technique,Multiple Classification Analyses,Statistical Studies,Studies, Statistical,Study, Statistical,Technic, Indirect Estimation,Technics, Estimation,Technics, Indirect Estimation,Technique, Estimation,Technique, Indirect Estimation,Techniques, Estimation,Techniques, Indirect Estimation
D017785 Photons Discrete concentrations of energy, apparently massless elementary particles, that move at the speed of light. They are the unit or quantum of electromagnetic radiation. Photons are emitted when electrons move from one energy state to another. (From Hawley's Condensed Chemical Dictionary, 11th ed)
D050397 Radiotherapy, Intensity-Modulated CONFORMAL RADIOTHERAPY that combines several intensity-modulated beams to provide improved dose homogeneity and highly conformal dose distributions. Helical Tomotherapy,Intensity-Modulated Arc Therapy,Volumetric-Modulated Arc Therapy,Arc Therapies, Intensity-Modulated,Arc Therapies, Volumetric-Modulated,Arc Therapy, Intensity-Modulated,Arc Therapy, Volumetric-Modulated,Helical Tomotherapies,Intensity Modulated Arc Therapy,Intensity-Modulated Arc Therapies,Intensity-Modulated Radiotherapies,Intensity-Modulated Radiotherapy,Radiotherapies, Intensity-Modulated,Radiotherapy, Intensity Modulated,Therapies, Intensity-Modulated Arc,Therapies, Volumetric-Modulated Arc,Therapy, Intensity-Modulated Arc,Therapy, Volumetric-Modulated Arc,Tomotherapies, Helical,Tomotherapy, Helical,Volumetric Modulated Arc Therapy,Volumetric-Modulated Arc Therapies

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