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Quality Assurance

Quality Assurance

Quality assurance is the overarching term used to describe the activities employed to ensure the proper performance of a system. These activities can be classified into three categories: quality control, quality assessment, and internal corrective measures. Typically, these activities work cyclically: quality control is performed before and during the analysis, while quality assessment occurs during and after the investigation. Internal corrective measures are implemented based on the findings...

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Updated: Mar 12, 2026

Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition

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On the new metrics for IMRT QA verification.

Alejandro Garcia-Romero¹, Araceli Hernandez-Vitoria¹, Esther Millan-Cebrian¹

¹Servicio de Fisica y Proteccion Radiologica, Hospital Clinico Universitario "Lozano Blesa" de Zaragoza, Avenida San Juan Bosco 15, Zaragoza E-50009, Spain.

Medical Physics

|November 4, 2016

Summary

New metrics for intensity-modulated radiation therapy (IMRT) verification improve plan acceptance and rejection criteria. These advanced methods, including dose difference global functions and 3D gamma analysis, offer more reliable clinical assessments than conventional approaches.

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Area of Science:

Medical Physics
Radiation Oncology
Radiotherapy Verification

Background:

Intensity-modulated radiation therapy (IMRT) verification is crucial for patient safety and treatment efficacy.
Conventional metrics for IMRT verification present discrepancies and may not accurately reflect clinical relevance.
There is a need for improved metrics that provide more reliable acceptance and rejection criteria.

Purpose of the Study:

To identify new metrics for more reliable acceptance/rejection criteria in IMRT verification.
To address discrepancies among conventional IMRT verification metrics.
To evaluate new metrics based on dose-volume histogram data, dose differences, and modified radiobiological models (tumor control probability [TCP] and normal tissue complication probability [NTCP]).

Main Methods:

Analysis of 58 treatment plans using both conventional and newly proposed metrics.
Development of new metrics based on dose-volume histogram processing, including continuous functions, dose differences, and modified TCP/NTCP models.
Calculation of 3D gamma functions and a radiobiological robustness index for plan classification.

Main Results:

A dose difference global function, optimized via ROC analysis, effectively condenses dose difference metrics.
Modified radiobiological models (TCP/NTCP) show better correlation with dose changes than conventional models.
The robustness index predicts plan rejection probability, and the 3D gamma metric correlates well with dose difference metrics, performing effectively in acceptance/rejection processes.

Conclusions:

The dose difference global function and 3D gamma metric are effective classifiers for dose differences.
Modified TCP and NTCP functions improve the correlation between radiobiological models and dose-based metrics.
New metrics, particularly the robustness index and 3D gamma, offer clinically relevant assessments and should replace conventional verification methods.