The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonization Group Recommendations for Сontouring of OARs

2021 ◽  
Vol 91 (3) ◽  
pp. 5-16
Author(s):  
A. V. Bondarenko ◽  
Zh. S. Lebedeva ◽  
A. P. Litvinov
Keyword(s):  
Clinical Trials ◽  
Quality Assurance ◽  
Radiation Therapy ◽  
Organs At Risk ◽  
Healthcare Facility ◽  
Global Quality ◽  
Risk Increase ◽  
Dose Limits ◽  
The Creation ◽  
The Many

QUANTEC report summarized the data of the dose constrains for critical structures in radiotherapy. The authors of this report determined that one of the obstacles to obtaining meaningful data on tolerant doses was inconsistency in the nomenclature of names. And inconsistencies in the guidelines for contouring the organs at risk increase the variability in contouring. Eliminating these inconsistencies increases the speed and safety of the workflow within each individual healthcare facility and improves the accuracy and reliability of the data underlying the dose limits that are developed. The standardization of terminology facilitates the integration of dosimetry data, the creation of various templates and scripts to automate the creation of a prescription for the RT course for similar cases, and the automation of reports. It helps to train the systems supporting artificial intelligence. AAPM report TG-263 resolved the nomenclature problem, however, different anatomical boundaries of different organs were still hidden under the same names in various large research centers. In 2020 The Global Quality Assurance of Radiation Therapy Clinical Trials Harmonization Group published an article. It summarized the many years of work by the scientific radiotherapy community to standardize the approach to delineating the OARs. This article provides an overview of the article key points and provides links to outline guides. A special attention it was paid to clarifying the anatomical boundaries of such OARs: heart, femoral heads, skin, individual structures of the gastrointestinal tract and substructures of the eye.

scholarly journals Multicentre dose audit for clinical trials of radiation therapy in Asia

2016 ◽  
Vol 58 (3) ◽  
pp. 372-377 ◽  
Author(s):  
Hideyuki Mizuno ◽  
Shigekazu Fukuda ◽  
Akifumi Fukumura ◽  
Yuzuru-Kutsutani Nakamura ◽  
Cao Jianping ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Quality Assurance ◽  
Radiation Therapy ◽  
Radiation Dosimetry ◽  
Quality Assurance Program ◽  
Relative Deviation ◽  
Single Beam ◽  
Tolerance Level ◽  
Audit System

Abstract A dose audit of 16 facilities in 11 countries has been performed within the framework of the Forum for Nuclear Cooperation in Asia (FNCA) quality assurance program. The quality of radiation dosimetry varies because of the large variation in radiation therapy among the participating countries. One of the most important aspects of international multicentre clinical trials is uniformity of absolute dose between centres. The National Institute of Radiological Sciences (NIRS) in Japan has conducted a dose audit of participating countries since 2006 by using radiophotoluminescent glass dosimeters (RGDs). RGDs have been successfully applied to a domestic postal dose audit in Japan. The authors used the same audit system to perform a dose audit of the FNCA countries. The average and standard deviation of the relative deviation between the measured and intended dose among 46 beams was 0.4% and 1.5% (k = 1), respectively. This is an excellent level of uniformity for the multicountry data. However, of the 46 beams measured, a single beam exceeded the permitted tolerance level of ±5%. We investigated the cause for this and solved the problem. This event highlights the importance of external audits in radiation therapy.

scholarly journals A dummy-run evaluation of postoperative hypofractionated intensity-modulated radiation therapy (POHIM-RT) trials for cervical cancer

2020 ◽  
Vol 62 (1) ◽  
pp. 149-154
Author(s):  
Won Kyung Cho ◽  
Heejung Kim ◽  
Won Park ◽  
Sang-Won Kim ◽  
Jongwon Kim ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Quality Assurance ◽  
Radiation Therapy ◽  
Organs At Risk ◽  
Treatment Plan ◽  
Intensity Modulated Radiation Therapy ◽  
Target Volume ◽  
Similarity Coefficients ◽  
Intensity Modulated ◽  
And Performance

Abstract The postoperative hypofractionated intensity-modulated radiation therapy (POHIM-RT) trial is a phase II study to evaluate toxicity following hypofractionated intensity modulated radiation therapy (IMRT) for cervical cancer. This study describes the results of a benchmark procedure for RT quality assurance of the POHIM-RT trial. Six participating institutions were provided computed tomography for RT planning and an IMRT plan for a sample and were instructed to delineate volumes, create a treatment plan and quality assurance (QA) plan, and submit the results of all procedures. The inter-institutional agreements on RT volume and plan results were evaluated using the kappa value and dice similarity coefficients. The simultaneous truth and performance level estimation (STAPLE) method was employed to generate a consensus target volume. The treatment volumes, organs-at-risk volumes, and results of the RT plan and QA reported by the institutions were acceptable and adhered well to the protocol. In terms of clinical target volume (CTV) delineation, there were differences between the institutions, particularly in vaginal cuff and paracolpium subsites. Consensus CTV was generated from the collected CTVs with the STAPLE method. The participating institutions showed considerable agreement regarding volume, dose and QA results. To improve CTV agreement in CTV, we provided feedback with images of the consensus target volume and detailed written guidelines for specific subsites that were the most heterogeneous.

scholarly journals External dosimetry audit for quality assurance of carbon-ion radiation therapy clinical trials

2018 ◽  
Vol 20 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Hideyuki Mizuno ◽  
Akifumi Fukumura ◽  
Nobuyuki Kanematsu ◽  
Shunsuke Yonai ◽  
Toshiyuki Shirai ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Quality Assurance ◽  
Radiation Therapy ◽  
Carbon Ion

CRISPR Technology Cracking into Creation

2020 ◽  
Vol 48 (2) ◽  
pp. 144-148
Author(s):  
Alacia J Tarpley
Keyword(s):  
Clinical Trials ◽  
Gene Editing ◽  
New Technology ◽  
Human Beings ◽  
Ethical Debate ◽  
Life Itself ◽  
Medical Directors ◽  
The Creation ◽  
The Many ◽  
Creation Of Life

Medical directors of life and disability companies need to be aware of CRISPR technology and how it has beneficial and potential detrimental impacts to our industry. Clustered Interspaced Short Palindromic Repeats (CRISPR) is only 7 years old, but we are already seeing human clinical trials underway with this powerful but elegantly simple gene editing technology. It has the potential to revolutionize medicine and will bring human beings into an ethical debate like none other including the creation of life itself. This article will give the background of the development of this new technology, the ways that it is currently being used and the many areas of technology and medicine that will be transformed by its use. This article will also touch on the ethical debate that will need to be addressed as this technology becomes more readily available and used in research labs around the globe.

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