Kertzscher G, Rosenfeld A, Beddar S, Tanderup K, Cygler J E
1 Centre for Nuclear Technologies, Technical University of Denmark, Roskilde, Denmark.
Br J Radiol. 2014 Sep;87(1041):20140206. doi: 10.1259/bjr.20140206. Epub 2014 Jul 8.
The error types during brachytherapy (BT) treatments and their occurrence rates are not well known. The limited knowledge is partly attributed to the lack of independent verification systems of the treatment progression in the clinical workflow routine. Within the field of in vivo dosimetry (IVD), it is established that real-time IVD can provide efficient error detection and treatment verification. However, it is also recognized that widespread implementations are hampered by the lack of available high-accuracy IVD systems that are straightforward for the clinical staff to use. This article highlights the capabilities of the state-of-the-art IVD technology in the context of error detection and quality assurance (QA) and discusses related prospects of the latest developments within the field. The article emphasizes the main challenges responsible for the limited practice of IVD and provides descriptions on how they can be overcome. Finally, the article suggests a framework for collaborations between BT clinics that implemented IVD on a routine basis and postulates that such collaborations could improve BT QA measures and the knowledge about BT error types and their occurrence rates.
近距离放射治疗(BT)过程中的误差类型及其发生率尚不清楚。知识有限部分归因于临床工作流程中缺乏治疗进展的独立验证系统。在体内剂量测定(IVD)领域,实时IVD能够提供有效的误差检测和治疗验证已得到证实。然而,人们也认识到,缺乏可供临床工作人员直接使用的高精度IVD系统阻碍了其广泛应用。本文重点介绍了在误差检测和质量保证(QA)背景下的最新IVD技术能力,并讨论了该领域最新发展的相关前景。文章强调了导致IVD实践受限的主要挑战,并说明了如何克服这些挑战。最后,本文提出了一个在常规实施IVD的BT诊所之间开展合作的框架,并假定这种合作可以改进BT的QA措施以及关于BT误差类型及其发生率的知识。