Authors (including presenting author) :
WONG WC(1)
Affiliation :
(1)Medical Physics Unit, Clinical Oncology Department, Tuen Mun Hospital
Introduction :
From 2017 to 2021, over ten thousand new cases were treated by radiotherapy in TMH. About 3% annual increase is observed. Maintaining high standards in treatment delivery is challenging when the need for radiotherapy is rising with limited resources. In 2021, we have developed and launched our integrated quality management system for radiological equipment to automate and centralize our workflow, echoing the call of the smart hospital development strategy. We managed to achieve the following objectives:
Objectives :
1) To enhance our quality assurance (QA) service model and automate the workflow for improving the efficiency of QA in radiotherapy.
2) To improve the treatment quality and safety by screening treatment plans with a pre-treatment 2nd dose check system.
3) To monitor the treatment status in real-time via a web-based dashboard in-vivo dosimetry system.
4) To align regulatory and professional body guidelines such as AAPM and IAEA.
5) To centralize QA information databases allowing multi-users online access across different clinics.
6) To enhance the flexibility of QA procedure by integrating multiple vendor QA systems.
Methodology :
Multiple QA and radiation oncology information systems (OIS) including “SunCHECK”, “PTW Verisoft”, “Medlever” and “MOSAIQ” are employed and bridged by our in-house developed application. Workflow is as follow:
1) Radiotherapy treatment plans will be verified by “SunCHECK” and “PTW Verisoft” based on international standards.
2) Data will be extracted by our in-house developed application and the QA result will be fed to “MOSAIQ” via the HL7 protocol.
3) The “Medlever” Dashboard will read the “MOSAIQ” database and display patient treatment planning progress.
4) Real-time treatment status will be monitored by medical physicists via the online in-vivo dosimetry system across the HA intranet.
Result & Outcome :
From May to Dec 2021, the 2nd dose check system covered 35.4 % of new cases in TMH radiotherapy with 451 CRT, 266 VMAT and 36 IMRT cases. The in-vivo dosimetry system covered 7302 treatment fractions. There was a net man-hour saving of 10-15 minutes per case or around 120 hours for 753 new cases for pretreatment QA. More promising result is expected if 100% QA can be covered for pretreatment and in-vivo dosimetry.
This new radiotherapy quality assurance workflow comprising multiple RT, OIS and in-house software is working well in synergy. It is saving significant manpower, equipment, and time resources.
