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利用自动化跟踪工具改善放射治疗直线加速器质量保证计划的管理与合规性

Improving Management and Compliance of Radiation Therapy Linear Accelerator Quality Assurance Program With Automated Tracking Tools.

作者信息

Lyatskaya Yulia, Killoran Joseph, Kukluk Jacek, Cormack Robert, Quirk Sarah

机构信息

Department of Radiation Oncology, Dana Farber Cancer Institute, Brigham and Women's Hospital, Boston, Massachusetts.

Harvard Medical School, Boston, Massachusetts.

出版信息

Adv Radiat Oncol. 2024 Feb 9;9(5):101469. doi: 10.1016/j.adro.2024.101469. eCollection 2024 May.

Abstract

PURPOSE

Although quality assurance (QA) is crucial in radiation oncology departments, substantial efforts are required to monitor and ensure compliance to high standards. This work aims to analyze the impact of implementing a centralized and automated tracking dashboard on compliance and variance observed in radiation therapy QA results for linear accelerators.

METHODS AND MATERIALS

The study was performed in a large academic center with 7 linear accelerators. An in-house QA Dashboard was implemented in 2019 with design specifications including automated monitoring and visualization of QA progress, ease of use and accessibility, ease of integration, adaptability to new technologies, and facilitation of automated reminders. Monthly QA data were collected between 2016 and 2022 to analyze compliance pre- and post-dashboard implementation. Compliance was characterized as the percentage of tests completed on time. In addition, variance trends for linear accelerator dosimetry measurements and imaging were analyzed over 7 years.

RESULTS

In total, 76,066 records were analyzed. Of these records, 73,187 QA measurements were completed on time. Overall QA compliance increased from 75% in 2016 to >99% in 2019 after successful implementation of the QA Dashboard. The main improvement was observed for tests that were implemented more recently, eg, imaging QA and formal recording of daily QA review by physicists. The coefficient of variation was reduced by approximately a factor of 2 for imaging QA after the implementation of the QA Dashboard. For recorded dosimetry measurements, no substantial change in variance was observed.

CONCLUSIONS

Implementation of the QA Dashboard resulted in a distinct increase in QA compliance. Reduction in the variance in QA measurements was observed for all imaging modalities. These findings demonstrate high impact of automated tracking QA tools on improved compliance and accuracy of QA.

摘要

目的

尽管质量保证(QA)在放射肿瘤学部门至关重要,但需要付出大量努力来监测并确保符合高标准。本研究旨在分析实施集中式自动化跟踪仪表板对直线加速器放射治疗QA结果中观察到的合规性和差异的影响。

方法与材料

该研究在一个拥有7台直线加速器的大型学术中心进行。2019年实施了一个内部QA仪表板,其设计规格包括QA进度的自动监测和可视化、易用性和可访问性、易于集成、对新技术的适应性以及自动提醒功能。收集了2016年至2022年期间的月度QA数据,以分析仪表板实施前后的合规情况。合规性以按时完成测试的百分比来表征。此外,还分析了7年期间直线加速器剂量测量和成像的差异趋势。

结果

总共分析了76,066条记录。其中,73,187次QA测量按时完成。成功实施QA仪表板后,总体QA合规率从2016年的75%提高到2019年的>99%。对于最近实施的测试,如成像QA和物理学家对每日QA审查的正式记录,观察到了主要的改进。实施QA仪表板后,成像QA的变异系数降低了约2倍。对于记录的剂量测量,未观察到差异有实质性变化。

结论

QA仪表板的实施导致QA合规性显著提高。所有成像模式的QA测量差异均有所降低。这些发现表明自动化跟踪QA工具对提高QA的合规性和准确性具有重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2953/10972807/7ebea51b596f/gr1.jpg

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