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Qa Checklist Final

The document discusses QA procedures for respiratory gating in radiation therapy. Respiratory gating tracks a patient's breathing to guide radiation delivery for tumors near the lungs, chest, or abdomen. QA follows TG76 guidelines using dynamic phantoms and checks target localization and treatment accuracy, with tumor motion within 5mm and stricter limits for stereotactic treatments. Dosimetric errors are reported but acceptable over larger fraction numbers.

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16 views2 pages

Qa Checklist Final

The document discusses QA procedures for respiratory gating in radiation therapy. Respiratory gating tracks a patient's breathing to guide radiation delivery for tumors near the lungs, chest, or abdomen. QA follows TG76 guidelines using dynamic phantoms and checks target localization and treatment accuracy, with tumor motion within 5mm and stricter limits for stereotactic treatments. Dosimetric errors are reported but acceptable over larger fraction numbers.

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© © All Rights Reserved
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QA checklist

Please review the table below. For the QA that your clinic performs, you need to at least observe
the procedure. If you are able to assist or perform any of the following procedures, that’s even
better! At the completion of the Fall QA course, submit the table below leaving an “x” in the
boxes that apply to the procedures that you have observed or participated in and have your
preceptor sign the form. Submit this table to the dropbox by the last day of the course in Fall
Semester. Make sure you mention this assignment to your preceptor or physicist prior to the
beginning of the QA course, so they are able to help get you involved in as much QA as possible.

Type of QA Observed Assisted

Daily Warm-up QA for Linac X X


Daily Warm-up QA for CT Simulator X
Monthly Linac X X
Monthly CT Simulator X
IMRT X X
SRS X
Brachytherapy X
Write-up
Respiratory Gating*
attached

IGRT system X X
Treatment Planning System X
 

 
09/23/2022
Preceptor signature Date

*If Respiratory gating is not performed in your clinic, research this topic and provide a short
summary of the QA to be performed along with the current tolerances.
Respiratory Gating QA
Respiratory gating is a system that tracks a patient’s respiratory cycle and uses that
information to guide radiation deliverance accordingly. This applies to tumors that are located
close to the lung, chest, or abdomen where breathing may cause inaccurate dose deliverance.
Respiratory motion causes tumor movement so the gating technique tracks the different phases
of the respiratory cycle to determine when treatment is to be delivered.
Respiratory gating QA follows TG76 guidelines. Dynamic phantoms that simulate human
organs are used to check for target localization and treatment accuracy.1 According to the TG76
report, the tumor motion should be within a 5mm range of motion in any direction but may be
reduced to a smaller range for special procedures such as stereotactic body radiotherapy.2 Strict
QA procedures should be carried out on imaging, planning, and deliverance using radiotherapy
respiration devices. Dosimetric errors of up to 20% within fields in low-dose gradient regions
and even larger errors on edges of fields within high-dose gradient regions were reported but
acceptable for treatments over larger treatment fractions.2 With treatment courses of up to 30
fractions, the dosimetric errors from respiratory motion tend to average out. IMRT treatments
with single or few fractions should proceed with caution and margins should be assessed.2

References
1. Thomason C, Vann A, Hilsendager L. QA of Imaging Systems: Quality Assurance.
[Softchalk]. La Crosse, WI. UW-L Medical Dosimetry Program; 2022.
2. Keall PJ, Mageras GS, Balter JM, et al. The management of respiratory motion in
radiation oncology report of AAPM Task Group 76. Med Phys. 2006;33(10):3874-3900.
http://doi.org/10.1118/1.2349696

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