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%

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TLD results within the 5% limit

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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

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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

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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

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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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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

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THANK YOU

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