Quality assurance for online adaptive radiotherapy
Chairs
Sara Hackett (NL), Sebastian Klüter (DE)
Motivation
Online adaptive radiotherapy uses anatomical information of inter- and intra-fractional changes to guide plan adaptation throughout treatment. However, an online adaptive workflow presents challenges for patient-specific quality assurance processes.
Since adapted plans cannot be verified by measurement, other methods of assuring correct delivery are needed. While diligent commissioning, independent dose calculation, logfile analysis and other established tools certainly play a role, no broad, platform-independent agreement on essential QA aspects for online adaptive treatments has yet been reached. Moreover, online adaptive workflows condense a process usually taking days into minutes, which poses new risks that can be as severe for patients as technical errors. Several departments have performed failure mode and effects analysis to identify high-priority risks (and appropriate mitigation strategies), but these analyses are department- and vendor-specific.
A platform-independent consensus for quality management of online adaptive treatments is needed by radiotherapy departments, encompassing both traditional QA methods as well as process-based QA. Relevant failure modes and mitigation strategies need to be agreed on, so that appropriate software tools can be developed by the industry to sufficiently address the needs of all users.
This workshop will bring together physicists and clinical and computer scientists with an interest in quality assurance and quality management for online adaptive treatments, with an eventual goal of producing a white paper addressing the following subjects:
- Identification and impact analysis of the most relevant failure modes for online adaptive radiotherapy,
- Implementation of process quality assurance for the most relevant failure modes and definition of corresponding efficient clinical workflows,
- Recommendations for commissioning and treatment uncertainty quantification in online adaptive therapy,
- Recommendations for patient-specific online plan-QA,
- Definition of needs from vendors of treatment modalities and of quality assurance software
Programme
Pre-meeting online session
- Introduction to the workshop and of participants
- Outline of motivation for and goals of the workshop
In-person programme (13th – 14th October 2023)
Speakers and discussion chairs include:
- Markus Alber, Heidelberg, Germany (physicist)
- Eric Ford, Seattle, U.S. (physicist)
- Sara Hackett, Utrecht, Netherlands (physicist)
- Sebastian Klüter, Heidelberg, Germany (physicist)
- Simeon Nill, London, U.K. (physicist)
- Bas Nijsten, Maastricht, Netherlands (physicist)
13 October
- Invited talk: Use of failure mode and effects analysis for quality management and incident learning for online adaptive therapy.
- Invited talk: Role of independent dose calculation for plan QA in online adaptive therapy and the importance of the patient model.
- Break-out discussions:
- Failure Mode and Effects analysis for online adaptive radiotherapy: what are the most relevant failure modes (and how can the effects be mitigated)?
- Tools for (plan) quality assurance for online adaptive radiotherapy: what are the requirements and how can these tools be implemented to minimize or avoid delays in treatment?
14 October 2023
- Overview of yesterday’s discussions and conclusions
- Invited talk: The value of patient-specific quality assurance for online adaptive radiotherapy.
- Invited talk: The use of log-file analysis for patient-specific quality assurance.
- Breakout discussions:
- The role of patient-specific plan measurements in commissioning and quality assurance management for online adaptive radiotherapy.
- Commissioning and patient-specific (plan) QA in online adaptive radiotherapy: how to be sure that a plan is delivered correctly, and how to know where the limits of the system are.
- Wrap-up: preparation of conclusions and formation of committee for white paper