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Radiotherapy QA

Quality assurance in radiotherapy

QuestionAnswer
What is quality control? Regulatory process through which the actual quality performance is measured, compared with existing standards.
What is a quality standard? Set of accepted criteria against which the quality of the activity can be assessed.
Why do we need QA? It is law- IRR17. It reduces uncertainties and errors, It reduces likelihood of accidents and errors. It highlights problems sooner allowing them to be rectified prior to errors. It ensures we don't undertreat a tumour or over treat healthy tissue.
What is ISO 9001 A formal QA accreditation. Demonstrates that there is high and consistent quality of standards.
Who is responsible for QA? Ultimate responsibility sits with the employed. However, QA is a huge part of a radiographer's role. The MDT are involved at various stages.
What is acceptance testing? A check that the equipment ordered is working as expected.
What is commissioning? Set of tests performed by a representative of the employer (usually Medical Physics), to ensure the equipment is ready for clinical use, and to establish baseline values against which routine QA can be compared
If a QA equipment measurement is out of tolerance and exceeds the action level, what should happen? The machine should not be used clinically. A suspension level is put on the equipment.
What is the action level for lasers? 2mm
What is the action level for x-ray output consistency? 3%
Name 5 monthly tests and their action levels for the linac. X-ray and electron output consistancy 2%. Backup monitor constancy 2%. X-ray central axis dosimetry 2%. Electron CAD parameter constancy 2mm. Xray beam flatness constancy 2%. Electron beam flatness constacny 2%. X-ray and electron symmetry 3%. and others.
Why is QA for CT important? Information from CT relating to patient position and tissue densities is used to calculate dose in the planning system. Essential that geometry and CT densities are accurate.
What frequency should patient chart QA do AAPM recommend? AAPM Task Group 40 recommendations: Review weekly. Review before 3rd fraction. Review at completion of treatment. Reviewer signs and dates.
What devices can be used for in-vivo QA? Diodes and TLDs.
What is the purpose of the record and verify system? Compare set-up parameters with prescribed values. If discrepancies present, this is highlighted.
What is the action level for "table top sag" in annual linac tests? 2mm
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