The ICRU endeavors to collect and evaluate the latest data and information pertinent to the problems of radiation measurement and dosimetry and to recommend the most acceptable values and techniques for current use. The Commission’s recommendations are kept under continual review in order to keep abreast of the rapidly expanding uses of radiation. The ICRU feels that it is the responsibility of national organizations to introduce their own detailed technical procedures for the development and maintenance of standards. However, it urges that all countries adhere as closely as possible to the internationally recommended basic concepts of radiation quantities and units. The Commission feels that its responsibility lies in developing a system of quantities and units having the widest possible range of applicability. Situations can arise from time to time for which an expedient solution of a current problem might seem advisable. Generally speaking, however, the Commission feels that action based on expediency is inadvisable from a long-term viewpoint; it endeavors to base its decisions on the long-range advantages to be expected. The ICRU invites and welcomes constructive comments and suggestions regarding its recommendations and reports. These may be transmitted to the Chairman.
{"title":"International Commission on Radiation Units and Measurements","authors":"Hans-Georg Menzel","doi":"10.1093/jicru/ndx006","DOIUrl":"https://doi.org/10.1093/jicru/ndx006","url":null,"abstract":"The ICRU endeavors to collect and evaluate the latest data and information pertinent to the problems of radiation measurement and dosimetry and to recommend the most acceptable values and techniques for current use. The Commission’s recommendations are kept under continual review in order to keep abreast of the rapidly expanding uses of radiation. The ICRU feels that it is the responsibility of national organizations to introduce their own detailed technical procedures for the development and maintenance of standards. However, it urges that all countries adhere as closely as possible to the internationally recommended basic concepts of radiation quantities and units. The Commission feels that its responsibility lies in developing a system of quantities and units having the widest possible range of applicability. Situations can arise from time to time for which an expedient solution of a current problem might seem advisable. Generally speaking, however, the Commission feels that action based on expediency is inadvisable from a long-term viewpoint; it endeavors to base its decisions on the long-range advantages to be expected. The ICRU invites and welcomes constructive comments and suggestions regarding its recommendations and reports. These may be transmitted to the Chairman.","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"14 2","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndx006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68020522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An important limitation on the accuracy of the dose delivered to the patient in radiation therapy is determined by the accuracy of the treatment planning dose calculation algorithm. Existing recommendations for the commissioning and verification of treatment planning system (TPS) dose calculations are given by AAPM TG 53 (Fraass et al., 1998), IAEA TRS 430 (IAEA, 2004), NCS Report 15 (Reynaert et al., 2006). The American Association of Physicists in Medicine Task Group Report 67 described benchmark tests for the validation of dose calculation algorithms. These reports, however, are general and not sufficiently specific for small fields. This Section reviews some general features and addresses a few pertinent issues specific to dose calculation algorithms for small fields. An overview of historical and general aspects of treatment planning algorithms can be found in ICRU Report 83. This Section will concentrate on the details that should be considered when implementing these algorithms for small field stereotactic radiation therapy/stereotactic body radiotherapy (SRT/SBRT).
{"title":"4. Treatment Planning Algorithms","authors":"","doi":"10.1093/jicru_ndx014","DOIUrl":"https://doi.org/10.1093/jicru_ndx014","url":null,"abstract":"An important limitation on the accuracy of the dose delivered to the patient in radiation therapy is determined by the accuracy of the treatment planning dose calculation algorithm. Existing recommendations for the commissioning and verification of treatment planning system (TPS) dose calculations are given by AAPM TG 53 (Fraass et al., 1998), IAEA TRS 430 (IAEA, 2004), NCS Report 15 (Reynaert et al., 2006). The American Association of Physicists in Medicine Task Group Report 67 described benchmark tests for the validation of dose calculation algorithms. These reports, however, are general and not sufficiently specific for small fields. This Section reviews some general features and addresses a few pertinent issues specific to dose calculation algorithms for small fields. An overview of historical and general aspects of treatment planning algorithms can be found in ICRU Report 83. This Section will concentrate on the details that should be considered when implementing these algorithms for small field stereotactic radiation therapy/stereotactic body radiotherapy (SRT/SBRT).","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"1 1","pages":"65 - 75"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90184108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the context of this Report, stereotactic radiotherapy (SRT) encompasses stereotactic radiosurgery (SRS), stereotactic body radiation therapy (SBRT), and stereotactic ablative body radiation therapy (SABR). SRT involves stereotactic localization techniques (i.e., use of a three-dimensional coordinate system to localize the target) combined with the delivery of multiple small photon fields in a few high-dose fractions. There is wide diversity in the clinical prescriptions for SRS and SBRT, some of which are based on preclinical studies, some based on modeling using the linear-quadratic (LQ) model, and others that result from trial-and-error experiences. The limitations of the LQmodel in scenarios of SRS/SBRTmight suggest the possible existence of new cell-death mechanisms related to stem cells, vascular damage, bystander effects, and immune-mediated effects, or combinations of these. Therefore, there is a need to develop a better rationale for current practice and future hypofractionation clinical trials by incorporating classical and new radiobiology and appropriately upgrading the modeling schemes for high doses to reflect new evidence-based understanding of tumor control and normal-tissue tolerances at higher doses per fraction. The understanding of the radiobiology of hypofractionation has been the subject of renewed intense interest driven by clinical successes and socio-economical benefits of shortened treatment times and potentially improved outcomes. The role of clinical medical physics in radiation therapy is to ensure that the prescription is delivered accurately. Comprehensive quality assurance encompasses all aspects of radiation medicine ranging from SRT device acceptance, commissioning, image guidance, and delivery. Recent incidents in radiation therapy using small fields have indicated that the dosimetry of small fields is complex and prone to errors. The requirements in terms of accurate beam calibration, treatment planning, accuracy of delivery, and quality assurance are more stringent than in other areas of radiation therapy. The active collaboration among all professions in the SRT program is critical for treatment quality and patient safety. Three main features dominate the dosimetry of small beams from accelerators. Firstly, absorbeddose distributions formed by small beams are characterized by a lack of charged-particle equilibrium over a much greater fraction of the treatment volume than for conventional radiotherapies. This has implications in dose measurements as well as treatment-planning dose calculations, especially in the vicinity of tissue heterogeneities. Secondly, in small beams, part of the source is often occluded by the collimation system, leading to beam-penumbra overlap and a drastic reduction in output fluence rate. Overlap of penumbra leads to effective-beam broadening in small beams compared to the geometric beam definition. Thirdly, the measurement of absorbed dose from small beams is highly dependent on t
{"title":"Executive Summary","authors":"J. Stockdale","doi":"10.1093/jicru_ndx004","DOIUrl":"https://doi.org/10.1093/jicru_ndx004","url":null,"abstract":"In the context of this Report, stereotactic radiotherapy (SRT) encompasses stereotactic radiosurgery (SRS), stereotactic body radiation therapy (SBRT), and stereotactic ablative body radiation therapy (SABR). SRT involves stereotactic localization techniques (i.e., use of a three-dimensional coordinate system to localize the target) combined with the delivery of multiple small photon fields in a few high-dose fractions. There is wide diversity in the clinical prescriptions for SRS and SBRT, some of which are based on preclinical studies, some based on modeling using the linear-quadratic (LQ) model, and others that result from trial-and-error experiences. The limitations of the LQmodel in scenarios of SRS/SBRTmight suggest the possible existence of new cell-death mechanisms related to stem cells, vascular damage, bystander effects, and immune-mediated effects, or combinations of these. Therefore, there is a need to develop a better rationale for current practice and future hypofractionation clinical trials by incorporating classical and new radiobiology and appropriately upgrading the modeling schemes for high doses to reflect new evidence-based understanding of tumor control and normal-tissue tolerances at higher doses per fraction. The understanding of the radiobiology of hypofractionation has been the subject of renewed intense interest driven by clinical successes and socio-economical benefits of shortened treatment times and potentially improved outcomes. The role of clinical medical physics in radiation therapy is to ensure that the prescription is delivered accurately. Comprehensive quality assurance encompasses all aspects of radiation medicine ranging from SRT device acceptance, commissioning, image guidance, and delivery. Recent incidents in radiation therapy using small fields have indicated that the dosimetry of small fields is complex and prone to errors. The requirements in terms of accurate beam calibration, treatment planning, accuracy of delivery, and quality assurance are more stringent than in other areas of radiation therapy. The active collaboration among all professions in the SRT program is critical for treatment quality and patient safety. Three main features dominate the dosimetry of small beams from accelerators. Firstly, absorbeddose distributions formed by small beams are characterized by a lack of charged-particle equilibrium over a much greater fraction of the treatment volume than for conventional radiotherapies. This has implications in dose measurements as well as treatment-planning dose calculations, especially in the vicinity of tissue heterogeneities. Secondly, in small beams, part of the source is often occluded by the collimation system, leading to beam-penumbra overlap and a drastic reduction in output fluence rate. Overlap of penumbra leads to effective-beam broadening in small beams compared to the geometric beam definition. Thirdly, the measurement of absorbed dose from small beams is highly dependent on t","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"42 1","pages":"7 - 9"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72781550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"7. Prescribing, Recording, and Reporting","authors":"","doi":"10.1093/jicru/ndx010","DOIUrl":"https://doi.org/10.1093/jicru/ndx010","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"14 2","pages":"101-109"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndx010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68020520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The role of clinical medical physics in radiation therapy is to ensure that the prescription is delivered accurately. This means that there is a need for a comprehensive quality assurance program, which encompasses all aspects of radiation medicine ranging from therapy machine acceptance, commissioning and calibration, image guidance and delivery, and that all procedures and workflows are in place to deliver the prescription accurately. The dosimetric portion of the quality assurance program starts with accurate calibration of the beam and the measurement of output factors and other dosimetric functions. In this context, the requirements in terms of accurate beam calibration, treatment planning, delivery, and quality assurance of stereotactic radiation therapy are as stringent, if not more stringent, as in conventional radiation therapy (Thwaites, 2013). Recent incidents in radiation therapy (Ford and Evans, 2014; IAEA, 2014) using small fields have indicated that dosimetry of small fields is complex and prone to errors. In general, absorbed dose determination in small fields requires multiple levels of redundancy including the use of different detectors with appropriate detector-dependent correction factors for the measurements, a critical analysis of measured data on equipment of the same type in comparison with peer centers, corroboration of data with manufacturer “golden beam data” (i.e., reference data), etc. As will be clear from the present section, simple pooling of relative reading data from different detector types is not the same as the relative dose in small fields; accurate depth and field-size dependent correction factors are required to ensure that the detector signal is faithfully converted into absorbed dose. In addition, the execution of an independent third-party dosimetry end-to-end review (e.g., Imaging and Radiation Oncology Core, IROC, MD Anderson Houston) is strongly suggested. Because of this complexity, an institution starting a new small-field radiation therapy program should consider training programs for physicists, radiation therapy planning personnel and radiation oncologists that includes a review of the basis of small field dosimetry. The active collaboration between all professions in the SRT program is critical for treatment quality and patient safety. In 3D conformal radiation therapy, higher energies (defined for the purpose of this discussion as photon beams created from accelerating potentials of larger than 10MV) are regularly used to improve coverage in the case of deep-seated tumors. The secondary electron path for a 15MV beam may be of the order of 3 cm or more thereby significantly affecting penumbra width. This leads to problems in the application of SRT using higher energies especially for small targets in regions involving lower density, such as lung. In these conditions, the accuracy requirements imposed on the dose calculation algorithm used for treatment planning are more difficult to meet for hig
临床医学物理学在放射治疗中的作用是确保处方准确送达。这意味着需要一个全面的质量保证计划，包括放射医学的各个方面，从治疗机器验收、调试和校准、图像引导和交付，以及所有程序和工作流程都到位，以准确地交付处方。质量保证程序的剂量计量部分从光束的精确校准和输出因子和其他剂量计量功能的测量开始。在这种情况下，立体定向放射治疗在精确的光束校准、治疗计划、输送和质量保证方面的要求与传统放射治疗一样严格，如果不是更严格的话(Thwaites, 2013)。最近的放射治疗事件(Ford and Evans, 2014;国际原子能机构，2014年)使用小场表明，小场的剂量测定是复杂的，容易出错。一般来说，在小范围内测定吸收剂量需要多级冗余，包括使用不同的探测器，并对测量结果进行适当的探测器相关校正系数，对同类型设备上的测量数据进行批判性分析，与同行中心进行比较，与制造商的“金束数据”(即参考数据)进行数据验证，等等。从本节可以清楚地看出，简单地汇集来自不同类型探测器的相对读数数据与小场中的相对剂量是不一样的;需要精确的深度和场大小相关的校正因子，以确保探测器信号忠实地转换为吸收剂量。此外，强烈建议执行独立的第三方剂量学端到端审查(例如，成像和放射肿瘤学核心，IROC, MD安德森休斯顿)。由于这种复杂性，开始一个新的小场放射治疗项目的机构应该考虑对物理学家、放射治疗计划人员和放射肿瘤学家的培训计划，其中包括对小场剂量学基础的回顾。SRT项目中所有专业之间的积极合作对治疗质量和患者安全至关重要。在三维适形放射治疗中，通常使用高能量(本讨论的目的定义为大于10MV的加速电位产生的光子束)来提高深部肿瘤的覆盖范围。15MV光束的二次电子路径可以是3cm或更大的数量级，从而显著影响半影宽度。这导致SRT在使用高能量的应用中出现问题，特别是在涉及低密度区域的小目标，如肺。在这种情况下，当能量越高(>10MV)，对用于治疗计划的剂量计算算法的精度要求就越难以满足。其次，准直系统，如mlc，通常阻挡6MV光子比阻挡15MV或更高能量的光子要好。与低光子能量(≤10MV)相比，这种效应和其他效应导致高光子能量(>10MV)下超过半影的剂量更为显著，最终影响离轴比(OAR)节约。最后，高能量(>10MV)的光子束通过(γ， n)反应产生中子。在18MV时，准直产生的中子截面比10MV光子大两个数量级(Maglieri et al.， 2015)。这可能会导致直线元件的激活以及不必要的场外患者暴露，尽管这对剂量学的影响需要进一步调查(Horst等人，2015)。基于所有这些原因，本报告建议在临床实施SRT计划时使用能量较低的光子束(≤10MV)。这一建议与ICRU报告83一致，该报告指出，在IMRT中使用高能光束是不合理的(ICRU, 2010)。在本节中，总结了小束放射治疗中剂量学的具体物理方面。所介绍的命名法涵盖了小光束，将给出其定义条件。关于参考剂量学和输出因子的讨论，本节遵循原子能机构- aapm工作守则的建议
{"title":"2. Small Field Dosimetry","authors":"Field Dosimetry","doi":"10.1093/jicru_ndx012","DOIUrl":"https://doi.org/10.1093/jicru_ndx012","url":null,"abstract":"The role of clinical medical physics in radiation therapy is to ensure that the prescription is delivered accurately. This means that there is a need for a comprehensive quality assurance program, which encompasses all aspects of radiation medicine ranging from therapy machine acceptance, commissioning and calibration, image guidance and delivery, and that all procedures and workflows are in place to deliver the prescription accurately. The dosimetric portion of the quality assurance program starts with accurate calibration of the beam and the measurement of output factors and other dosimetric functions. In this context, the requirements in terms of accurate beam calibration, treatment planning, delivery, and quality assurance of stereotactic radiation therapy are as stringent, if not more stringent, as in conventional radiation therapy (Thwaites, 2013). Recent incidents in radiation therapy (Ford and Evans, 2014; IAEA, 2014) using small fields have indicated that dosimetry of small fields is complex and prone to errors. In general, absorbed dose determination in small fields requires multiple levels of redundancy including the use of different detectors with appropriate detector-dependent correction factors for the measurements, a critical analysis of measured data on equipment of the same type in comparison with peer centers, corroboration of data with manufacturer “golden beam data” (i.e., reference data), etc. As will be clear from the present section, simple pooling of relative reading data from different detector types is not the same as the relative dose in small fields; accurate depth and field-size dependent correction factors are required to ensure that the detector signal is faithfully converted into absorbed dose. In addition, the execution of an independent third-party dosimetry end-to-end review (e.g., Imaging and Radiation Oncology Core, IROC, MD Anderson Houston) is strongly suggested. Because of this complexity, an institution starting a new small-field radiation therapy program should consider training programs for physicists, radiation therapy planning personnel and radiation oncologists that includes a review of the basis of small field dosimetry. The active collaboration between all professions in the SRT program is critical for treatment quality and patient safety. In 3D conformal radiation therapy, higher energies (defined for the purpose of this discussion as photon beams created from accelerating potentials of larger than 10MV) are regularly used to improve coverage in the case of deep-seated tumors. The secondary electron path for a 15MV beam may be of the order of 3 cm or more thereby significantly affecting penumbra width. This leads to problems in the application of SRT using higher energies especially for small targets in regions involving lower density, such as lung. In these conditions, the accuracy requirements imposed on the dose calculation algorithm used for treatment planning are more difficult to meet for hig","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"108 1","pages":"31 - 53"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91339427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 79 year old male presented with increased shortness of breath and mass on a chest xray in February 2015. The mass was located in the left middle lobe and had a diameter of 12mm on a CTscan. Bronchoscopy revealed a squamous cell carcinoma and the PET(CT) scan showed a solitary PET-positive nodule in the lung. The patient had a history of COPD GOLD class III with a FEV1 (forced expiratory volume) of 1130ml (46 % of the predicted value) and a history of cerebrovascular accidents and transient ischemic attack. The ventilation/perfusion scan showed that the right lung contributed 48 % of the ventilation/perfusion capacity while the left lung contributed 42 %. As the patient had mediocre lung function, he was considered inoperable. This patient was referred for curative stereotactic treatment with the CyberKnife.
{"title":"Appendix A: Clinical Examples","authors":"","doi":"10.1093/jicru_ndx002","DOIUrl":"https://doi.org/10.1093/jicru_ndx002","url":null,"abstract":"A 79 year old male presented with increased shortness of breath and mass on a chest xray in February 2015. The mass was located in the left middle lobe and had a diameter of 12mm on a CTscan. Bronchoscopy revealed a squamous cell carcinoma and the PET(CT) scan showed a solitary PET-positive nodule in the lung. The patient had a history of COPD GOLD class III with a FEV1 (forced expiratory volume) of 1130ml (46 % of the predicted value) and a history of cerebrovascular accidents and transient ischemic attack. The ventilation/perfusion scan showed that the right lung contributed 48 % of the ventilation/perfusion capacity while the left lung contributed 42 %. As the patient had mediocre lung function, he was considered inoperable. This patient was referred for curative stereotactic treatment with the CyberKnife.","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"1 1","pages":"111 - 122"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76154745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"1. Introduction","authors":"","doi":"10.1093/jicru/ndx008","DOIUrl":"https://doi.org/10.1093/jicru/ndx008","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"14 2","pages":"11-30"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndx008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68020527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"2. Small Field Dosimetry","authors":"","doi":"10.1093/jicru/ndx012","DOIUrl":"https://doi.org/10.1093/jicru/ndx012","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"14 2","pages":"31-53"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndx012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68020524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A comprehensive quality assurance (QA) program should aim to ensure the safest and highest achievable accuracy of radiation treatment by establishing a systematic approach in setting up and in maintaining the program. The goal of QA is to reduce the uncertainty in SRT treatment and to set an error tolerance limit for SRT treatment. The overall uncertainty of an SRT system is the combination of uncertainties resulting from several components, which mainly consist of uncertainties in the:
{"title":"6. Quality Assurance","authors":"","doi":"10.1093/jicru_ndx011","DOIUrl":"https://doi.org/10.1093/jicru_ndx011","url":null,"abstract":"A comprehensive quality assurance (QA) program should aim to ensure the safest and highest achievable accuracy of radiation treatment by establishing a systematic approach in setting up and in maintaining the program. The goal of QA is to reduce the uncertainty in SRT treatment and to set an error tolerance limit for SRT treatment. The overall uncertainty of an SRT system is the combination of uncertainties resulting from several components, which mainly consist of uncertainties in the:","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"1 1","pages":"93 - 99"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75341653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"5. Image-Guided Beam Delivery","authors":"","doi":"10.1093/jicru/ndx007","DOIUrl":"https://doi.org/10.1093/jicru/ndx007","url":null,"abstract":"","PeriodicalId":91344,"journal":{"name":"Journal of the ICRU","volume":"14 2","pages":"77-92"},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/jicru/ndx007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68020517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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