制定评估全球临床试验认证和PSQA系统的参考计划。

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Fre'Etta M D Brooks, Mohammad Hussein, Jessica Lye, Christopher L Nelson, Nakamura Mitsuhiro, Mallory C Glenn, Patricia Diez, Rushil Patel, Maddison Shaw, Ileana Silvestre Patallo, Miriam Barry, Catharine H Clark, Joerg Lehmann, Stephen F Kry
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引用次数: 0

摘要

目的:开发一个实用的框架,用于创建一套不同的经过验证的参考计划(复杂程度不同),并实施一个工作流,将光束建模、校准和传递误差引入参考队列,以测试和比较各种剂量学审计方法。方法:基于全球协调组织(GHG)成员已建立的认证案例,使用RayStation软件为4个幻影几何形状创建16个IMRT和VMAT参考计划。这些参考方案首先在一个多离子室模型中得到验证。通过修改光束模型和/或输送参数(mlc偏移量、mlc透射量、叶尖宽度、PDD、光束校准和mlc位置),根据文献记录的误差群落分布,将9个剂量学误差(摄动)引入到计划中;这产生了144张设计图。确定了剂量对临床靶体积(CTV)和危险器官(OARs)的影响,并制定了一系列分类,以确定受干扰的计划是否应该通过审计。结果:在参考方案中引入误差对不同方案的影响不同。剂量扰动范围从平均剂量的10%到CTV和近最大剂量的30%到OAR (D0.03)。144个方案包括明确的“可接受”和“不可接受”方案,剂量有显著变化(相对于基线参考值),以及接近通过/不通过阈值的结果。研究发现,计划复杂性对剂量偏差有很强的影响,平均MLC差距度量最能反映这种关系。结论:本研究提出了一个框架来开发一套参考计划和扰动,可用于评估和比较各种审计和PSQA方法。GHG开发了这个框架,作为我们正在进行的工作的一部分,以测试其审计系统的可比性;该框架支持我们在全球范围内协调国际剂量学审计的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Developing reference plans for evaluating global clinical trials credentialing and PSQA systems.

Purpose: To develop a practical framework for creating a diverse set of validated reference plans (varying in complexity) and implement a workflow to introduce beam modeling, calibration, and delivery errors into the reference cohort to test and compare various dosimetry audit methodologies.

Methods: Sixteen IMRT and VMAT reference plans were created, using RayStation software, for four phantom geometries based on established credentialing cases from participating Global Harmonization Group (GHG) members. These reference plans were first validated in a multi-ion-chamber phantom. Nine dosimetric errors (perturbations) were introduced into the plans by modifying beam model and/or delivery parameters (MLC-offset, MLC-transmission, leaf-tip-width, PDD, beam calibration, and MLC-position) based on documented community distributions of errors; this produced 144 plans. The dose impact on the clinical target volume (CTV) and organs at risk (OARs) was determined, and a range of classifications was developed to determine if the perturbed plan should pass or should fail an audit.

Results: Introducing errors into the reference plans impacted each plan differently. Dose perturbations ranged from <1% to >10% in the mean dose to the CTV and <10% to >30% in the near maximum dose to OAR (D0.03). The 144 plans included clear "acceptable" and "unacceptable" scenarios, with significant changes in dose (relative to baseline reference values), as well as near pass/fail threshold results. Plan complexity was found to have a strong impact on dose deviation, and the mean MLC Gap metric was found to best capture this relationship.

Conclusion: This study presented a framework to develop a set of reference plans and perturbations that can be used to assess and compare various audit and PSQA methodologies. The GHG has developed this framework as part of our ongoing work to test the comparability of their audit systems; this framework supports our work of aligning international dosimetry audits across the globe.

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来源期刊
CiteScore
3.60
自引率
19.00%
发文量
331
审稿时长
3 months
期刊介绍: Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic
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