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Radiation Planning Assistant - A Streamlined, Fully Automated Radiotherapy Treatment Planning System

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AAPM Task Group Report 306: Quality control and assurance for tomotherapy: An update to Task Group Report 148.

Quan Chen¹, Yi Rong², Jay W Burmeister^3,4

¹Radiation Oncology, City of Hope Medical Center, Duarte, California, USA.

Medical Physics

|December 13, 2022

Summary

New AAPM Task Group 306 guidelines update quality assurance (QA) for helical tomotherapy, addressing modern platform advancements. Recommendations cover updated tolerance limits, testing, and risk-based approaches for new technologies and treatment planning systems.

Keywords:

quality assurance tomotherapy

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Area of Science:

Medical Physics
Radiation Oncology
Quality Assurance

Background:

AAPM Task Group (TG) 148 provided initial quality assurance (QA) guidance for helical tomotherapy.
Significant technological advancements have occurred in tomotherapy since TG 148, including treatment delivery, imaging, motion management, and treatment planning systems (TPSs).

Purpose of the Study:

To update and supplement existing QA recommendations for helical tomotherapy in light of new technologies.
To provide guidance on commissioning and QA for tomotherapy TPSs.
To offer risk-based recommendations for clinical implementation of new tomotherapy technologies and workflows.

Main Methods:

Review and update recommendations on tolerance limits, frequencies, and testing methodologies from TG 148.
Supplement Medical Physics Practice Guidelines (MPPG) for tomotherapy TPS commissioning and QA.
Conduct a failure mode and effects analysis (FMEA) for tomotherapy-related failures.

Main Results:

Detailed QA test recommendations and tolerance levels are provided for dynamic jaws, binary multileaf collimators, and Synchrony motion management.
A subset of MPPG 5.a. TPS commissioning and QA checks applicable to tomotherapy are recommended.
Multi-institutional analysis of tomotherapy-related failure modes and their effects was obtained via FMEA.

Conclusions:

TG 306 provides essential updated guidance for helical tomotherapy QA, incorporating recent technological developments.
The recommendations aim to ensure the safe and effective clinical use of advanced tomotherapy systems.
Updated QA protocols are crucial for maintaining high standards in radiation therapy delivery.