TY - JOUR
T1 - A critical review of the practices of proton daily quality assurance programs
AU - Ding, Xiaoning
AU - Younkin, James E.
AU - Shen, Jiajian
AU - Bues, Martin
AU - Liu, Wei
N1 - Funding Information:
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi. org/10.21037/tro-21-11). XD serves as an unpaid editorial board member of Therapeutic Radiology and Oncology from March 2021 to February 2023. Dr. WL reports grants from Arizona Biomedical Research Commissioning, grants from the Lawrence W. and Marilyn W. Matteson Fund for Cancer Research, grants from the Kemper Marley Foundation, outside the submitted work; Dr. WL has 4 US patents (either issued or pending). In addition, Dr. WL has a patent, an accurate and efficient hybrid method based on ray casting to calculate physical dose and linear energy transfer (LET) distribution for intensity-modulated proton therapy with royalties paid to Decimal LLC. The other authors have no conflicts of interest to declare.
Publisher Copyright:
© 2021 Therapeutic Radiology and Oncology.
PY - 2021/12
Y1 - 2021/12
N2 - Demand for proton therapy (PT) continues to grow due to its dosimetric advantages over conventional radiotherapy. New PT facilities being constructed to meet this demand will need quality assurance (QA) programs to ensure that treatments are delivered safely and accurately. However, in contrast to conventional radiotherapy, proton QA practices are constantly evolving and few commercial solutions are available. As a result, QA programs at most operational proton facilities rely on a variety of in-house developed hardware and software. An important part of these QA programs is proton daily QA, which verifies clinically-acceptable proton delivery system operation each morning before starting patient treatment. In this review article, we summarize current proton daily QA practices by providing a brief introduction to PT, describing proton delivery techniques and their particular QA requirements, and then reviewing implementations of several proton daily QA programs. Although the QA instrumentation is quite heterogeneous, the literature shows that the dosimetric daily QA results among proton facilities are comparable. We also present a typical set of proton daily QA data from our institution that includes output, range, and spot position measurements. Based on the literature review and our institutional experience, we make recommendations for future proton daily QA programs.
AB - Demand for proton therapy (PT) continues to grow due to its dosimetric advantages over conventional radiotherapy. New PT facilities being constructed to meet this demand will need quality assurance (QA) programs to ensure that treatments are delivered safely and accurately. However, in contrast to conventional radiotherapy, proton QA practices are constantly evolving and few commercial solutions are available. As a result, QA programs at most operational proton facilities rely on a variety of in-house developed hardware and software. An important part of these QA programs is proton daily QA, which verifies clinically-acceptable proton delivery system operation each morning before starting patient treatment. In this review article, we summarize current proton daily QA practices by providing a brief introduction to PT, describing proton delivery techniques and their particular QA requirements, and then reviewing implementations of several proton daily QA programs. Although the QA instrumentation is quite heterogeneous, the literature shows that the dosimetric daily QA results among proton facilities are comparable. We also present a typical set of proton daily QA data from our institution that includes output, range, and spot position measurements. Based on the literature review and our institutional experience, we make recommendations for future proton daily QA programs.
KW - Daily quality assurance (daily QA)
KW - Pencil beam scanning (PBS)
KW - Proton therapy (PT)
KW - Range verification
KW - Spot position verification
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U2 - 10.21037/TRO-21-11
DO - 10.21037/TRO-21-11
M3 - Review article
AN - SCOPUS:85123282420
VL - 5
JO - Therapeutic Radiology and Oncology
JF - Therapeutic Radiology and Oncology
SN - 2616-2768
M1 - 22
ER -