Auto-contouring may reduce workload, interobserver variation, and time associated with manual contouring of organs at risk. Manual contouring remains the standard due in part to uncertainty around the time and workload savings after accounting for the review and editing of auto-contours. This preliminary study compares a standard manual contouring workflow with 2 auto-contouring workflows (atlas and deep learning) for contouring the bladder and rectum in patients with prostate cancer. Methods and Materials: Three contouring workflows were defined based on the initial contour-generation method including manual (MAN), atlas-based auto-contour (ATLAS), and deep-learning auto-contour (DEEP). For each workflow, initial contour generation was retrospectively performed on 15 patients with prostate cancer. Then, radiation oncologists (ROs) edited each contour while blinded to the manner in which the initial contour was generated. Workflows were compared by time (both in initial contour generation and in RO editing), contour similarity, and dosimetric evaluation. Results: Mean durations for initial contour generation were 10.9 min, 1.4 min, and 1.2 min for MAN, DEEP, and ATLAS, respectively. Initial DEEP contours were more geometrically similar to initial MAN contours. Mean durations of the RO editing steps for MAN, DEEP, and ATLAS contours were 4.1 min, 4.7 min, and 10.2 min, respectively. The geometric extent of RO edits was consistently larger for ATLAS contours compared with MAN and DEEP. No differences in clinically relevant dose-volume metrics were observed between workflows. Conclusion: Auto-contouring software affords time savings for initial contour generation; however, it is important to also quantify workload changes at the RO editing step. Using deep-learning auto-contouring for bladder and rectum contour generation reduced contouring time without negatively affecting RO editing times, contour geometry, or clinically relevant doseevolume metrics.
The purpose of this work was to investigate the influence of a new transmission detector on 6 MV x-ray beam properties. The device, COMPASS (IBA Dosimetry, Germany), contains 1600 plane parallel ionization chambers with a detector spacing of 6.5 mm and an active volume of 0.02 cm3. Surface dose measurements were carried out using a Markus chamber and radiochromic film for a range of field sizes and source-to-surface distances (SSDs). The surface dose and dose in the build-up region for COMPASS fields were compared to open fields. For moderately narrow beam geometric conditions, the increase in surface dose was small. For the largest field size investigated (20x20 cm2) at a 90 cm SSD, the surface dose with the detector was 34.9% versus 26.8% in the open field. However, the increase in surface dose in COMPASS fields was less than that observed with a standard block tray in the field (38.7% in the above example). It was found that beyond dmax, the difference in relative dose (profiles and PDDs) between open and COMPASS fields was insignificant. The mean transmission factor of the detector was 0.967 (standard deviation=0.002) measured over a range of field sizes from 3x3 to 20x20 cm2 at SSDs from 70 cm to 90 cm. In summary, the transmission detector was found to increase the relative dose in the buildup region but had a negligible effect on the beam parameters beyond dmax.
A close partnership between the Canadian Partnership for Quality Radiotherapy (CPQR) and the Canadian Organization of Medical Physicist's (COMP) Quality Assurance and Radiation Safety Advisory Committee (QARSAC) has resulted in the development of a suite of Technical Quality Control (TQC) guidelines for radiation treatment equipment; they outline specific performance objectives and criteria that equipment should meet in order to assure an acceptable level of radiation treatment quality. The adopted framework for the development and maintenance of the TQCs ensures the guidelines incorporate input from the medical physics community during development, measures the workload required to perform the QC tests outlined in each TQC, and remain relevant (i.e., “living documents”) through subsequent planned reviews and updates. The framework includes consolidation of existing guidelines and/or literature by expert reviewers, structured stages of public review, external field‐testing, and ratification by COMP. This TQC development framework is a cross‐country initiative that allows for rapid development of robust, community‐driven living guideline documents that are owned by the community and reviewed to keep relevant in a rapidly evolving technical environment. Community engagement and uptake survey data shows 70% of Canadian centers are part of this process and that the data in the guideline documents reflect, and are influencing, the way Canadian radiation treatment centers run their technical quality control programs. For a medium‐sized center comprising six linear accelerators and a comprehensive brachytherapy program, we evaluate the physics workload to 1.5 full‐time equivalent physicists per year to complete all QC tests listed in this suite.PACS number(s): 87.55.Qr, 87.56.Fc, 87.56.‐v
The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This announcement provides an introduction to the guidelines, describing their scope and how they should be interpreted. Details of recommended tests can be found in separate, equipment specific TQC guidelines published in the JACMP (COMP Reports), or the website of the Canadian Partnership for Quality Radiotherapy (www.cpqr.ca).
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