Solari, Esteban Lucas (2016) Implementación de técnicas de control de calidad de IMRF paciente-específico. / Implementation of patient specific quality assurance techniques for IMRT. Maestría en Física Médica, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
En este trabajo se buscó comparar técnicas de aseguramiento de la calidad paciente específico (PSQA) para IMRT, poner a punto las tecnologías disponibles y proponer técnicas para controles rutinarios. Primero se discutió la necesidad de un sistema de PSQA para IMRT y se compararon distintas técnicas. Se realizó la puesta a punto del sistema de dosimetría por películas mediante el comisionamiento de un escáner, un protocolo de manipulación y la calibración del lote. Se desarrollaron los tests propuestos por el TG 119. Se estudiaron distintos criterios de aprobación y se determinó que el arreglo ArcCheck"TM y el criterio gamma de 2mm/2% eran adecuados para QA de rutina en la institución. Se probó el sistema elegido sobre un fantoma CIRS mediante un protocolo end-to-end con heterogeneidades, semejante a un caso clínico. Se verificaron y se entregaron sobre el fantoma planes de IMRT y VMAT, obteniendo buenos resultados dosimétricos. Luego se probó una técnica de verificación de objetivos clínicos, con resultados alentadores. Finalmente se discutieron los alcances del protocolo TG 119, los resultados de la implementación de controles por paciente y las limitaciones y alternativas al criterio gamma utilizado. Puede concluirse que se implementaron con éxito técnicas de PSQA para uso rutinario en la institución, y se plantearon futuras mejoras para mantener altos los estándares de tratamiento.
Resumen en inglés
In this work, it was intended to compare PSQA techniques, to set up available equipment and to propose techniques for routine QA at the institution. First, the need for a PSQA program for IMRT was brought up, and different techniques were compared. A system for the dosimetry with radiochromic films was set up. A film scanner was commissioned, a protocol was developed and the films were calibrated. The tests proposed by TG 119 were carried out. Different passing criteria were studied and it was concluded that the detector array ArcCheck"TM along with a 2mm/2% gamma criterion were adequate for the institution’s routine QA. The selected technique was tried on a CIRS phantom through an end to end protocol that mimicked a clinical situation. IMRT and VMAT plans were created, verified and correctly delivered to the phantom. A clinically relevant verification technique was tested, with encouraging results. Finally, the scope of the TG 119 protocol was discussed along with the results of the implementation of PSQA and the limitations and alternatives to the gamma passing criterion. It was concluded that routine PSQA techniques were successfully implemented and future improvements were stated in order to attain high treatment quality standards.
| Tipo de objeto: | Tesis (Maestría en Física Médica) |
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| Palabras Clave: | Patients; Pacientes; Quality control; Control de calidad; [Intensity modulated radiation therapy; Radioterapia de intensidad modulada; Treatment verification; Verificación de tratamientos] |
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| Materias: | Medicina > Radioterapia |
| Divisiones: | Fundación Centro de Medicina Nuclear y Molecular de Entre Ríos |
| Código ID: | 576 |
| Depositado Por: | Tamara Cárcamo |
| Depositado En: | 18 Abr 2017 14:31 |
| Última Modificación: | 24 Abr 2017 17:10 |
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