scholarly journals Radiotherapy Dosimetry Audits in Taiwan Hospitals

2020 ◽  
Author(s):  
An-Cheng Shiau ◽  
Shih-Ming Hsu ◽  
Pei-Yun Huang ◽  
Chiu-Ping Chen ◽  
Yi-Ting Huang ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Treatment ◽  
Electron Beams ◽  
Beam Quality ◽  
Ion Beam ◽  
Quality Measurement ◽  
High Dose Rate ◽  
Site Quality ◽  
High Dose ◽  
Photon Beams

Abstract Purpose: This study examines the practice of the regulation of Standards for Medical Exposure Quality Assurance (SMEQA) in Taiwan based on on-site quality audit for radiation therapy systems from 2016 to 2019. Methods and Materials: about 81 radiation therapy departments, 141 medical linear accelerators, 9 gamma knifes, 34 high dose rate brachytherapy systems, 20 Tomotherapys and 6 Cyberknives were audited yearly. The inspection was implemented in two stages. Data collection and analysis for each institute’s documents including QA operating procedure, ion chamber and electrometer calibration reports, and a questionnaire relating to machine type and staffing, were requested first and reviewed by specially trained auditors. On-site measurements of SMEQA core items, including beam output, beam profile and energy constancy for external beam therapy systems, and the source strength, positioning and timer accuracy for brachytherapy systems were audited second. More than 300 photon beams were measured from linacs, Gamma knives, Cyberknives and Tomotherapys, and more than 400 electron beams from linacs each year.Results: The radiation treatment resource is about 8.9 therapy machines or 7.5 MV/MeV/ion beam therapy machines per million population, respectively, and there are on average about 1.20 medical physicists per radiation therapy unit in Taiwan. There were more than 78% and 75% of photon and electron beams respectively from linacs with deviations measured to the stated reference-point dose within 1.0%. Photon beams have lower beam quality measurement deviations than electron beams, and more than 90% of photon beams from linacs were within 1.0%. Including in-plane and cross-plane measurements, more than 90% and 85% of photon and electron beams respectively with flatness consistency within 1.0%. Beam symmetry as an absolute value has more than 75% of measurements within 1.0%. All audit measurements in this study were within the SMEQA acceptance criteria.Conclusions: On-site machine QA audits have been implemented from 2016 to 2019 for all radiation therapy units each year. The measurement results have shown a high quality machine performance in Taiwan.

scholarly journals Dosimetry audits in Taiwan radiotherapy departments

BJR|Open ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 20210002
Author(s):  
An-Cheng Shiau ◽  
Shih-Ming Hsu ◽  
Pei-Yun Huang ◽  
Chiu-Ping Chen ◽  
Yi-Ting Huang ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Electron Beams ◽  
Beam Quality ◽  
Quality Measurement ◽  
High Dose Rate ◽  
Site Quality ◽  
Regulation System ◽  
High Dose ◽  
Photon Beams ◽  
Core Item

Objectives: This study examines the practice of the regulation of Standards for Medical Exposure Quality Assurance (SMEQA) in Taiwan based on on-site quality audit for radiation therapy systems from 2016 to 2019. Methods: 81 radiation therapy departments, 141 linacs, 9 γ knife systems, 34 high dose rate brachytherapy systems, 20 Tomotherapys, and 6 Cyberknives were audited yearly. Data collection and analysis for each institute’s documents including QA procedure, ion chamber and electrometer calibration reports, and a questionnaire relating to machine type and staffing, were requested first and reviewed by auditors. On-site SMEQA core item measurements, including beam output, beam profile and energy constancy for external beam therapy systems, and the source strength, positioning, and timer accuracy for brachytherapy systems were audited second. More than 300 photon beams and more than 400 electron beams were measured each year. Results: There were approximately 8.9 radiotherapy units per million population, and 1.2 medical physicists per unit in Taiwan. For the output measurements, more than 78 and 75% of the photon beams and electron beams, respectively, from linacs were with deviations within ±1.0%. Photon beams have lower beam quality measurement deviations than electron beams. Including in-plane and cross-plane measurements, more than 90 and 85% photon and electron beams, respectively, were with flatness consistency within 1.0%. All audit measurements were within the SMEQA acceptance criteria. Conclusions: According to SMEQA regulations on-site QA audits were successfully carried out from 2016 to 2019 for all Taiwan radiotherapy units. The measurement results showed high quality machine performance in Taiwan. Advances in knowledge: Dosimetry audits with directly acquired measurement readings have lower uncertainties; allow immediate feedback, discussion, and adjustment in a timely manner. In addition to regulation system establishment and education and training implementation, the machine quality is closely related to machine maintenance implementation.

Radiobiological characterization of the very high dose rate and dose per pulse electron beams produced by an IORT (intra operative radiation therapy) dedicated linac

2017 ◽  
Vol 6 (S5) ◽  
pp. S761-S768 ◽  
Author(s):  
Paola Scampoli ◽  
Carmela Carpentieri ◽  
Marco Giannelli ◽  
Vera Magaddino ◽  
Lorenzo Manti ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Dose Rate ◽  
Electron Beams ◽  
High Dose Rate ◽  
High Dose ◽  
Pulse Electron ◽  
Very High

Intraoperative phosphorus-32 brachytherapy plaque for multiply recurrent high-risk epidural neuroblastoma

2014 ◽  
Vol 13 (4) ◽  
pp. 388-392 ◽  
Author(s):  
William Y. Tong ◽  
Michael R. Folkert ◽  
Jeffrey P. Greenfield ◽  
Yoshiya Yamada ◽  
Suzanne L. Wolden
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
High Risk ◽  
Local Control ◽  
Therapeutic Target ◽  
Radiation Treatment ◽  
High Dose Rate ◽  
High Dose ◽  
Crucial Component ◽  
Dose Radiation

Achieving local control is a crucial component in the management of neuroblastoma, but this may be complicated in the setting of prior radiation treatment, especially when the therapeutic target is in proximity to critical structures such as the spinal cord. The authors describe a pediatric patient with multiply recurrent neuroblastoma and prior high-dose radiation therapy to the spine who presented with progressive epidural disease. The patient was managed with resection and intraoperative high-dose-rate brachytherapy using a phosphorus-32 (32P) plaque previously developed for the treatment of brain and spine lesions.

Radiation therapy in the management of gynaecological cancer

2020 ◽  
pp. 832-843
Author(s):  
Anthony Fyles ◽  
Anuja Jhingran ◽  
David Gaffney ◽  
Dustin Boothe ◽  
Marco Carlone ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
World War Ii ◽  
Radiation Treatment ◽  
Uterine Cancer ◽  
High Dose Rate ◽  
Gynaecological Cancer ◽  
High Dose ◽  
External Beam ◽  
X Rays ◽  
Dose Rates

Therapeutic applications for radiation therapy followed quickly from the discovery of X-rays by Roentgen in 1895. The first radiation treatment is credited to Grubbe, who reported the external beam treatment of breast cancer in 1896. Application to gynaecological cancers was almost immediate. However, the limited penetrating ability of the low-energy radiation of early X-ray tubes and isotopes was a major limitation. Consequently, brachytherapy and near-contact external beam therapy were preferred for gynaecological cancer until the advent of cobalt-60—the first source of a penetrating beam of megavoltage photons with a high dose rate, long half-life, and reasonable cost. This led to cobalt-60 machines becoming the most widely utilized treatment machine from the 1950s to 1970s. Radar research during World War II dramatically improved microwave technology. Linear accelerator-based machines (linacs) applied these advances to use microwaves to accelerate electrons onto a tungsten target and emit a fraction of their kinetic energy as mega-electron volt energy X-rays. The emitted X-rays are collimated into a beam and directed towards the patient. Advantages of linacs over cobalt-60 include higher dose rates, sharper beam edges, higher energies, and simplified radiation protection. This chapter describes the basic principles of radiotherapy and the role of radiotherapy in the management of gynaecological cancers, including cervix cancer, uterine cancer, and rarer tumours such as those arising from vaginal, vulvar, and ovarian cancers.

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