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IAEA quality audits in radiotherapy

IAEA quality audits in radiotherapy. Joanna Izewska Head, Dosimetry Laboratory Dosimetry & Medical Radiation Physics Section, Division of Human Health. IAEA audits in radiotherapy. SINCE 1969: IAEA/WHO TLD postal dose audits of radiotherapy beam calibration (45 years of operation):

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IAEA quality audits in radiotherapy

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  1. IAEA quality audits in radiotherapy Joanna Izewska Head, Dosimetry Laboratory Dosimetry & Medical Radiation Physics Section, Division of Human Health

  2. IAEA auditsin radiotherapy • SINCE 1969:IAEA/WHO TLD postal dose audits of radiotherapy beam calibration (45 years of operation): 130 countries, >2000 hospitals, >10000 beam checks • SINCE 2005: Quality Assurance Team for Radiation Oncology (QUATRO) • SINCE 2010: TPS end-to-end audits

  3. 1969-2013: N = 10226 , m = 1.008, SD = 0.08, 83% res. within 5% limit ±5% 2012-2013: N = 1271 , m = 1.005, SD = 0.068, 92% res. within 5% Currently >90% results are within 5% acceptance limit

  4. TLD results within the 5% limit

  5. TLD results: use of CoPs (2000-2013) TLD results 2000-2013 126 deviations beyond 20% excluded

  6. IAEA TPS audit procedures Set of practical tests for dosimetry calculations reflecting basic treatment techniques in a typical radiotherapy hospital IAEA scientific secretary: S. Vatnitsky

  7. IAEA supported TPS audit in Europe • Eight European countries conducted TPS audits with the IAEA support • Approx. 60 hospitals participated • Approx. 200 datasets have been collected for beam/TPS algorithm combination • Several dosimetry and TPS-related problems were identified and fixed

  8. Comprehensive RT audit: QUATRO

  9. QUATRO audit procedures • Auditors: RO, MP, RTT • Typically 5 days per RT centre • Entrance briefing • Assessment: tour of facility, staff interviews, review & evaluation of procedures and documentation, measurements, tests, observation of practical work • Exit briefing: feedback to the department, preliminary recommendations, questions, discussion.

  10. QUATRO missions lower middle income upper middle income high income • Training of auditors and regional QUATRO workshops in all regions • 70 QUATRO missions to date: Africa – 6; Asia – 18; Europe – 30 + 3 re-audits; Latin America – 13

  11. Europe: recommendations by QUATRO • Support staff continuous development • Strengthen QA programmes and procedures • Equipment: get more, use better • Increase staffing levels: MP, RO, RTT • Staff requires training: RTT, RO, MP • Improve treatment protocols • Improve structure and organization of cancer centres

  12. THANK YOU

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