Automated quality assurance of imaging dose and protocol adherence in computed tomography radiotherapy planning using
Niklas A Lackner1,2,3,4, Andre Karius5,6,7,8, Tobias Brandt5,6,7,8
1Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Universitätsstr. 27, 91054, Erlangen, Germany. niklas.lackner@uk-erlangen.de.
Summary
Optimizing computed tomography (CT) scans for radiotherapy patients can reduce radiation exposure. Analysis of CT doses and scan lengths revealed opportunities to improve workflows and patient safety through revised protocols.
Area of Science:
- Medical Physics
- Radiotherapy
- Diagnostic Imaging
Background:
- Computed tomography (CT) scans are indispensable for radiotherapy planning, providing critical data for accurate dose calculations.
- Patient radiation exposure during CT imaging for radiotherapy requires careful management and optimization.
Purpose of the Study:
- To retrospectively evaluate imaging doses, scan lengths, and protocol adherence in CT scans used for radiotherapy planning.
- To identify areas for optimization in CT imaging protocols to reduce patient radiation exposure.
Main Methods:
- Retrieved CT data from patients undergoing external beam radiotherapy and brachytherapy (04/2021-12/2024).
- Extracted imaging doses (CTDIvol, DLP) and analyzed anatomical scan length differences using automated organ segmentation.
- Assessed standard operating procedure (SOP) adherence and performed quality assurance checks on protocol consistency.
Main Results:
- Brain protocols showed the highest CTDIvol, while head and neck protocols had the highest DLP.
- The lung 4D protocol resulted in a higher effective dose compared to the standard lung protocol.
- Significant anatomical scan length variations were noted in the upper abdomen and spine, indicating potential workflow improvements.
Conclusions:
- Improving CT workflows for radiotherapy patients is achievable and necessary.
- Revising institutional SOPs, optimizing X-ray tube modulation, and refining scan length boundaries are recommended to enhance CT protocols for radiotherapy.
