AAPM Newsletter | Mar/Apr 2020 Vo l u m e 4 5 , N o . 2
VOLUNTARY INDEPENDENT PEER REVIEW Q&A BY REBECCA HOWELL Director of the MD Anderson Radiation Dosimetry Service
Why participate in peer review? I think the number one reason is that patient safety is directly linked to accurate beam output. Participating in independent and routine validation of your beams’ calibrations provides confidence and the peace of mind that there are no output issues at your center. There is a lot of confusion within the radiation oncology community about the MD Anderson Radiation Dosimetry Service (RDS) and the Imaging and Radiation Oncology Core (IROC) Houston. Are you the same service? Well, the answer is both yes and no. Yes, in that we are both part of the same team, the MD Anderson Section of Outreach Physics, which comprises IROC-Houston, the RDS, and the Accredited Dosimetry Calibration Laboratory (ADCL). Our collective mission in Outreach Physics is to broadly reach out to the radiation oncology community in the United States and worldwide to ensure patient safety through independent quality assurance (QA) services. Both IROC and the RDS provide independent peer review of beam output calibrations for external beam radiotherapy machines through a mail audit system. Both IROC and the RDS are located at the same physical address (with our labs/offices occupying different portions of the building) and we have a very collaborative relationship.
Twitter: @DrRebeccaHowel1
APRIL 4–7, 2020
2020
Renaissance Minneapolis Hotel, the Depot Minneapolis, MN Don’t miss the opportunity to earn up to 11 SAM credits! This year’s Spring Clinical Meeting offers: • practical information designed to provide easy access for clinical physicists in a compact format for up-to-date clinical education. • clinical topics of current interest and additional opportunities to meet continuing education requirements.
The key difference between the two groups is to whom we offer services. IROC provides output checks for institutions that participate in clinical trials. The output checks are a requirement of participation. Specifically, IROC monitors all photon beams and three electron beams for each linac at participating institutions. The RDS is a voluntary for-fee service that is available on-demand. Many RDS customers participate in clinical trials and have annual beam monitoring through IROC. For those dual-service institutions, the RDS monitors the electron beams not monitored by IROC, with shipment times that may be coordinated and aligned. Some of the IROC centers also use the RDS for more frequent (e.g., mid-year or quarterly) output checks. Another difference between IROC and RDS is that we use different dosimeters in our mail audit systems. IROC uses optically stimulated luminescent dosimeters (OSLDs) and RDS uses thermoluminescent dosimeters (TLDs). Both dosimeters have similar uncertainties of <1.5% as described in AAPM Task Group Report 191 (Kry et al 2019). Also, the doses reported by both IROC and RDS are traceable to a primary standard and based on TLDs/OSLDs irradiated at a Secondary Standards Dosimetry Laboratory, the MD Anderson ADCL. Can you elaborate on what you mean by on-demand service? What I mean by on-demand is that our customers choose (1) which beams they want to monitor, e.g., all beams, some beams, or a single beam; (2) at what frequency
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