Phys Med Biol. 2013 Nov 21;58(22):8253-64. doi: 10.1088/0031-9155/58/22/8253.
At our institution EPID (electronic portal imaging device) dosimetry is routinely applied to perform in vivo dose verification of all patient treatments with curative intent since January 2008. The major impediment of the method has been the amount of work required to produce and inspect the in vivo dosimetry reports (a time-consuming and labor-intensive process). In this paper we present an overview of the actions performed to implement an automated in vivo dosimetry solution clinically. We reimplemented the EPID dosimetry software and modified the acquisition software. Furthermore, we introduced new tools to periodically inspect the record-and-verify database and automatically run the EPID dosimetry software when needed. In 2012, 95% of our 3839 treatments scheduled for in vivo dosimetry were analyzed automatically (27,633 portal images of intensity-modulated radiotherapy (IMRT) fields, 5551 portal image data of VMAT arcs, and 2003 portal images of non-IMRT fields). The in vivo dosimetry verification results are available a few minutes after delivery and alerts are immediately raised when deviations outside tolerance levels are detected. After the clinical introduction of this automated solution, inspection of the detected deviations is the only remaining work. These newly developed tools are a major step forward towards full integration of in vivo EPID dosimetry in radiation oncology practice.
自 2008 年 1 月以来，我们机构一直例行使用 EPID（电子射野影像装置）剂量学进行有治愈意图的所有患者治疗的体内剂量验证。该方法的主要障碍一直是生成和检查体内剂量报告所需的工作量（这是一个耗时且劳动密集的过程）。本文介绍了为临床实施自动化体内剂量学解决方案而采取的措施概述。我们重新实现了 EPID 剂量学软件并修改了采集软件。此外，我们引入了新工具定期检查记录和验证数据库，并在需要时自动运行 EPID 剂量学软件。2012 年，我们计划进行体内剂量学分析的 3839 次治疗中有 95%（27633 次调强放疗（IMRT）场的 EPID 剂量图像、5551 次 VMAT 弧形的 EPID 剂量图像和 2003 次非 IMRT 场的 EPID 剂量图像）进行了自动分析。在交付后几分钟内即可获得体内剂量验证结果，并且当检测到超出公差水平的偏差时会立即发出警报。在这种自动化解决方案引入临床后，检测到的偏差的检查是唯一剩下的工作。这些新开发的工具是将体内 EPID 剂量学完全集成到放射肿瘤学实践中的重要一步。
