Aranguiz, Gonzalo J. (2022) Evaluación de herramienta automatizada para el control de calidad pretratamiento y dosimetría in vivo / Assessment of an automated systems for pre-treatment QA and in vivo dosimetry. Maestría en Física Médica, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
En radioterapia, para lograr producir el máximo control posible del tumor y, a la vez, minimizar el riesgo de daño al tejido sano, es necesario tener un alto nivel de precisión en cada etapa del proceso. Para ello, debe establecerse un programa de garantía de calidad y definir tolerancias de aceptación para los errores en la dosis entregada. En las técnicas modernas de radioterapia de haz externo de intensidad modulada, son necesarios controles de calidad paciente específicos (PSQA) basados en mediciones para verificar la capacidad del equipo de tratamiento de entregar la fluencia planificada para cada campo irradiado. Para adquirir estas mediciones, cada vez más servicios hacen uso del dispositivo electrónico de imágenes portales (EPID) integrado en los aceleradores lineales modernos. Con los EPID pueden realizarse verificaciones tanto antes como durante el tratamiento, pero se requiere de software adicional para el procesamiento y análisis de las mediciones adquiridas. Uno de los sistemas que ofrecen esta solución es SunCHECKTM Patient (Sun Nuclear Corporation). En la presente tesis, se evalúa la plataforma mediante pruebas en condiciones controladas con fantomas y en una implementación clínica inicial para el monitoreo de planes aplicados sobre pacientes de la Fundación CEMENER. La herramienta demostró ser capaz de detectar errores debidos a cambios de espesor en el paciente, a variaciones en el posicionamiento y a la atenuación de objetos interpuestos en el haz. Se observó que su sensibilidad para detectar variaciones relacionadas con el paciente es mejor en campos irradiados con gantry fijo que en haces de arcoterapia. Durante el monitoreo de planes clínicos se encontraron errores que hubieran pasado inadvertidos de no ser por la plataforma. Por otro lado, se describieron algunas fallas relacionadas con la implementación del sistema en el servicio. La herramienta evaluada es novedosa y presenta diversos tipos de análisis. En esta primera experiencia de uso en el país, se obtuvieron resultados muy alentadores y se espera seguir avanzando hacia su implementación en la verificación rutinaria de los tratamientos entregados en el servicio.
Resumen en inglés
In radiation therapy, in order to maximize tumor control while minimizing the risk of damage to normal tissue, it is necessary to have a high level of precision at each stage of the process. For this to be possible, a quality assurance program must be established, together with acceptance tolerances for errors in delivered dose. In modern intensity modulated external beam radiation therapy techniques, measurement based patient-specific quality controls (PSQA) are necessary to verify the ability of the treatment machine to deliver the planned fluence for each beam. To perform this measurements, an increasing number of centers use electronic portal imaging devices (EPIDs), included in almost every modern linear accelerator. With EPIDs, verifications can be performed both before and during treatment, but additional software is required for the measurements to be processed and analyzed. One of such softwares is SunCHECKTM Patient (Sun Nuclear Corporation). In this thesis, the software is assessed through tests under controlled conditions with phantoms, and in an early clinical implementation for the monitoring of patient treatments in the CEMENER Foundation. The platform proved to be able to detect errors due to changes of patient thickness, positioning and unexpected beam attenuation by objects in the field. Its sensitivity to detect patient related errors was found to be better with fixed gantry irradiations than with arc therapy. During the monitoring of clinical plans, errors were detected by means of the system that would have otherwise passed unnoticed. On the other hand, some issues emerged during the implementation of the platform in the center that need to be addressed in the future to exploit its full capabilities. The assessed software is novel and offers various types of analysis. As the first experience of its use in our country, it rendered very encouraging results, and further work is expected to be done in the future towards the adoption of the platform as a tool for daily verification treatment delivery in the center.
| Tipo de objeto: | Tesis (Maestría en Física Médica) |
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| Palabras Clave: | Dosimetry; Dosimetría; Radiotherapy; Radioterapia; [In vivo dosimetry; Dosimetría in vivo; QA; Control de calidad paciente especifico; Treatment verification; Verificación pre tratamiento] |
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| Materias: | Medicina > Radioterapia |
| Divisiones: | Centro de Medicina Nuclear y Molecular de Entre Ríos (CEMENER) |
| Código ID: | 1135 |
| Depositado Por: | Tamara Cárcamo |
| Depositado En: | 09 Mar 2023 15:18 |
| Última Modificación: | 09 Mar 2023 15:18 |
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