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. 2017 Apr;90(1072):20160915.
doi: 10.1259/bjr.20160915. Epub 2017 Feb 16.

In vivo dosimetry in UK external beam radiotherapy: current and future usage

Niall D MacDougall  1 , Michael Graveling  2 , Vibeke N Hansen  3 , Kevin Brownsword  4 , Andrew Morgan  5
Affiliations

In vivo dosimetry in UK external beam radiotherapy: current and future usage

Niall D MacDougall et al. Br J Radiol. 2017 Apr.

Abstract

Objective: Towards Safer Radiotherapy recommended that radiotherapy (RT) centres should have protocols in place for in vivo dosimetry (IVD) monitoring at the beginning of patient treatment courses (Donaldson S. Towards safer radiotherapy. R Coll Radiol 2008). This report determines IVD implementation in the UK in 2014, the methods used and makes recommendations on future use.

Methods: Evidence from peer-reviewed journals was used in conjunction with the first survey of UK RT centre IVD practice since the publication of Towards Safer Radiotherapy. In March 2014, profession-specific questionnaires were sent to radiographer, clinical oncologist and physics staff groups in each of the 66 UK RT centres.

Results: Response rates from each group were 74%, 45% and 74%, respectively. 73% of RT centres indicated that they performed IVD. Diodes are the most popular IVD device. Thermoluminescent dosimeter (TLD) is still in use in a number of centres but not as a sole modality, being used in conjunction with diodes and/or electronic portal imaging device (EPID). The use of EPID dosimetry is increasing and is considered of most potential value for both geometric and dosimetric verification.

Conclusion: Owing to technological advances, such as electronic data transfer, independent monitor unit checking and daily image-guided radiotherapy, the overall risk of adverse treatment events in RT has been substantially reduced. However, the use of IVD may prevent a serious radiation incident. Point dose IVD is not considered suited to the requirements of verifying advanced RT techniques, leaving EPID dosimetry as the current modality likely to be developed as a future standard. Advances in knowledge: An updated perspective on UK IVD use and provision of professional guidelines for future implementation.

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Figures

Figure A3.
Figure A3.
IVD by patient group (physics and radiographers).
Figure A4.
Figure A4.
IVD by patient group (clinicians).
Figure A5.
Figure A5.
Is IVD an appropriate use of resources? (clinicians).
Figure A7.
Figure A7.
Reasons for performing IVD (physics and radiographers).
Figure A9.
Figure A9.
Errors detectable with IVD? (physics and radiographers).
Figure A12.
Figure A12.
In vivo pass and fail rates (physics).
Figure A13.
Figure A13.
Point dose tolerances for IVD.
Figure A15.
Figure A15.
Radiographer roles in IVD.
Figure A16.
Figure A16.
Linear accelerator time required for IVD (radiographers).
Figure A18.
Figure A18.
Time to commission IVD (physics).
Figure A19.
Figure A19.
Time to maintain IVD (physics).
Figure A20.
Figure A20.
Time spent on patient results (physics).
Figure A21.
Figure A21.
Time spent on IVD per week (physics).
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References

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