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IAEA International Atomic Energy Agency IAEA quality audits in radiotherapy Joanna Izewska Head,...
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IAEAInternational Atomic Energy Agency
IAEA quality audits in radiotherapy
Joanna Izewska
Head, Dosimetry Laboratory
Dosimetry & Medical Radiation Physics Section, Division of Human Health
IAEA
IAEA audits in 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
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Currently >90% results are within 5% acceptance limit
2012-2013: N = 1271 , m = 1.005, SD = 0.068, 92% res. within 5%
1969-2013: N = 10226 , m = 1.008, SD = 0.08, 83% res. within 5% limit
±5%
IAEA
TLD results within the 5% limit
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IAEA
TLD results: use of CoPs (2000-2013)
126 deviations beyond 20% excluded
TLD results 2000-2013
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2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Per
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e u
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Year of irradiation
ND,w based
Nk based
Nx based
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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
IAEA
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
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Comprehensive RT audit: QUATRO
IAEA
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.
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IAEA
QUATRO missions
lower middle incomeupper middle incomehigh 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
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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
IAEA
THANK YOU
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