Evidence map›Paper›PMID 38553788›Full record

ArticleJournal of applied clinical medical physics2024

Commissioning and clinical implementation of an independent dose calculation system for scanned proton beams.

Ralf Dreindl, Marta Bolsa-Ferruz, Rosa Fayos-Sola, Fatima Padilla Cabal, Lukas Scheuchenpflug, Alessio Elia, Antonio Amico, Antonio Carlino, Markus Stock, Loïc Grevillot

Abstract read
In one paragraph

Article in Journal of applied clinical medical physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ralf DreindlMedAustron Ion Therapy Center, Wiener Neustadt, Austria.ORCID https://orcid.org/0000-0002-5475-8170
Marta Bolsa-FerruzMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Rosa Fayos-SolaMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Fatima Padilla CabalMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Lukas ScheuchenpflugMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Alessio EliaMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Antonio AmicoMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Antonio CarlinoMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Markus StockMedAustron Ion Therapy Center, Wiener Neustadt, Austria.
Loïc GrevillotMedAustron Ion Therapy Center, Wiener Neustadt, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeExperimental patient-specific QA (PSQA) is a time and resource-intensive process, with a poor sensitivity in detecting errors. Radiation therapy facilities aim to substitute it by means of independent dose calculation (IDC) in combination with a comprehensive beam delivery QA program. This paper reports on the commissioning of the IDC software tool myQA iON (IBA Dosimetry) for proton therapy and its clinical implementation at the MedAustron Ion Therapy Center.

methodsThe IDC commissioning work included the validation of the beam model, the implementation and validation of clinical CT protocols, and the evaluation of patient treatment data. Dose difference maps, gamma index distributions, and pass rates (GPR) have been reviewed. The performance of the IDC tool has been assessed and clinical workflows, simulation settings, and GPR tolerances have been defined.

resultsBeam model validation showed agreement of ranges within ± 0.2 mm, Bragg-Peak widths within ± 0.1 mm, and spot sizes at various air gaps within ± 5% compared to physical measurements. Simulated dose in 2D reference fields deviated by -0.3% ± 0.5%, while 3D dose distributions differed by 1.8% on average to measurements. Validation of the CT calibration resulted in systematic differences of 2.0% between IDC and experimental data for tissue like samples. GPRs of 99.4 ± 0.6% were found for head, head and neck, and pediatric CT protocols on a 2%/2 mm gamma criterion. GPRs for the adult abdomen protocol were at 98.9% on average with 3%/3 mm. Root causes of GPR outliers, for example, implants were identified and evaluated.

conclusionIDC has been successfully commissioned and integrated into the MedAustron clinical workflow for protons in 2021. IDC has been stepwise and safely substituting experimental PSQA since February 2021. The initial reduction of proton experimental PSQA was about 25% and reached up to 90% after 1 year.

Indexed as

Organs at RiskProton TherapyRadiotherapy DosageRadiotherapy Planning, Computer-AssistedSoftwareAlgorithmsCalibrationHumansNeoplasmsPhantoms, ImagingQuality Assurance, Health CareRadiotherapy, Intensity-ModulatedTomography, X-Ray Computedbeam time reductionclinical implementationcommissioningindependent dose calculationpencil beam scanningproton therapy

Identifiers

PMID38553788
PMCPMC11087175

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.