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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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An End-to-end Quality Assurance Procedure for Ethos Online Adaptive Radiotherapy.

S A Yoganathan^1,2, Amine Khemissi¹, Satheesh Paloor¹

¹Department of Radiation Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

Journal of Medical Physics

|April 21, 2025

Summary

This study presents an end-to-end (E2E) quality assurance (QA) test for online adaptive radiation therapy (OART) systems. The Ethos OART system demonstrated high accuracy in contouring, synthetic CT generation, and dosimetry, exceeding 96% gamma pass rate.

Keywords:

Adaptive Ethos end-to-end online quality assurance radiotherapy

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Area of Science:

Medical Physics
Radiation Oncology
Quality Assurance

Background:

Online adaptive radiation therapy (OART) presents unique quality assurance (QA) challenges.
Traditional QA methods may not be sufficient for OART systems.
Innovative QA methodologies are required for OART systems.

Purpose of the Study:

To introduce and validate an end-to-end (E2E) QA test for the Ethos OART system.
To evaluate the accuracy of contouring, synthetic CT (sCT), and dosimetry in OART.
To establish a straightforward E2E test for preclinical validation and monthly QA of OART systems.

Main Methods:

Developed initial treatment plans using deformed CT images of standard phantoms.
Created and delivered adaptive plans using physical QA phantoms with detectors.
Utilized OCTAVIUS-4D, ArcCHECK, and RUBY phantoms for evaluation.

Main Results:

Achieved a gamma pass rate exceeding 96% (2% local/2 mm).
Demonstrated point dose deviations below 0.5%.
Obtained Dice coefficients >0.9 for body contours and mean absolute errors <27 HU for sCT accuracy.

Conclusions:

The Ethos OART system shows superior performance with high accuracy.
The developed E2E QA test is effective for assessing OART workflow accuracy.
This method is suitable for preclinical validation and routine monthly QA of OART systems.