Given the findings of TG-219 (which we discuss in this blog), it is clear that a robust system for plan second check and per-fraction QA is essential to high-quality patient care and avoiding preventable errors. Historically, this has been hard to accomplish with the limited time and resources of a busy clinical environment and the quality of tools available on the market. However, as advancements in the field have emerged, it is not only possible but crucial that clinics begin to adopt new best practices for their QA processes. This includes incorporating an independent Monte Carlo-based second check solution.
This process can seem intimidating given the additional resources required, but below we have outlined 3 basic steps you can take to prepare your clinic to adopt a solution that meets the standards outlined in TG-219.
1. Prepare Quality Measurement Data
Any second check solution will only be as good as the data used as the baseline for the beam modeling process. This is particularly important for a solution using a Monte Carlo algorithm. To ensure the highest quality and utility of your Monte Carlo dose calculations, it is important to confirm the measurement data is up-to-date and complete. Generally, the most important measurements for Monte Carlo beam modeling are Depth Dose Curves (DDCs)/Percentage Depth Doses (PDDs), Output Factors (OFs), and Cross Profiles (CPs)/Off-Center Ratios (OCRs) (all acquired in water across a number of different field sizes). Many of the measurements needed for this process are already included in the scheduled commissioning performed on your machines, so this is less work than it can seem when looking at a list of requirements.
2. Involve your IT department
The computing power needed to run these advanced algorithms and processes is important to consider when working to adopt a new second check solution. It’s important to involve your IT department in these conversations early to understand the current state of the hardware in use and any changes or additions that might need to be made. Given the potential for hardware shortages and cost impacting deployment timelines, the earlier you can involve your IT stakeholders, the better.
3. Perform In-Depth Commissioning
Obviously, it is important to thoroughly vet any new system you bring into your clinic. This process is particularly important when commissioning a Monte Carlo algorithm for second check dose calculation. Not only is this the time to confirm that your new system is working properly, but the processes you will follow to commission your new Monte Carlo beams models will also give you the opportunity to identify possibly hidden systematic errors in the existing configuration of your system. During this process, you have the opportunity to compare both your existing system data and the results from your new Monte Carlo beam models back to the measurement data. This gives you the ability to ensure that all of your tools are accurately representing the most crucial information needed for safe and effective treatment planning.
Following these steps is certain to make the rollout of your Monte Carlo QA solution a smooth process. At MIM, we walk sites through these steps as part of an evaluation of MIM SureCalc® MonteCarlo. Schedule a meeting to talk through your clinical needs today.
