The development of a new basic treatment equivalent model to assess linear accelerator throughput.

Area of Science:

• Radiation Oncology
• Medical Physics
• Health Services Research

Background:

• The Basic Treatment Equivalent (BTE) model was developed to enhance the measurement of linear accelerator (LINAC) throughput in radiotherapy.
• Accurate throughput measurement is crucial for optimizing radiotherapy workflows and resource allocation.

Purpose of the Study:

• To evaluate the impact of treatment setup and patient characteristics on radiotherapy fraction duration.
• To refine the existing BTE model by incorporating significant influencing factors.
• To compare the efficacy of BTE per hour versus fields per hour as measures of LINAC throughput.

Main Methods:

• Stopwatch measurements of fraction durations were collected across multiple New South Wales radiation oncology departments.
• Data on patient, equipment, and staff variables were gathered to identify predictors of fraction duration.
• A revised BTE equation was developed, and statistical analyses compared BTE per hour with fields per hour for throughput prediction.

Main Results:

• Seventeen factors significantly affected fraction duration, explaining 46% of the variance.
• Key predictors of prolonged fraction duration included high field counts, portal imaging, lack of automation, bolus use, and initial treatment fractions.
• BTE per hour demonstrated superior predictive capability for LINAC throughput compared to fields per hour.

Conclusions:

• The updated BTE model provides a more accurate measure of LINAC throughput.
• The model effectively integrates weightings for critical treatment and patient factors influencing fraction duration.
• Routine collection and integration of BTE data into electronic radiotherapy systems are recommended for improved throughput assessment.