VARIAN Medical Systems

Radiotherapy Quality Assurance

Varian Medical Systems’ Perspective

Roman Wicha, PhD

Manager, Treatment Management System

VARIAN Medical Systems

Responsibility for Quality Assurance in RT

Published QA guidelines state that responsibility to design and execute a QA program belongs to the medical facility Establish the type and frequency of QA tests

Reflect how the devices are used clinically

Covers the specific combinations of devices in the facility

VARIAN Medical Systems

Quality Assurance

Machine (device) specific Verifies correct operation of the device Analyzes drifts from commissioning baseline

Patient Specific Verifies patient specific data (e.g. treatment plan) Procedure depends on patient treatment technique

Process Verifies that clinical process is followed Improves adherence to standards of care

VARIAN Medical Systems

QA is an integral part of the

Radiotherapy clinical process

Historical emphasis has been on Dosimetric QA Routine Machine QA & Patient QA

Opportunity to round out QA in Radiotherapy Incorporate complementary Process QA

Quality Assurance in radiotherapy clinics

CONFIDENTIAL

VARIAN Medical Systems

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Many opportunities for light-weight Process QA

VARIAN Medical Systems

Process QA via a checklist

Requires a change to current clinical practice Other medical specialties have adopted “time-out” to

resolve all concerns before beginning a procedure

E.g. The Universal Protocol

Can be implemented manually initially Simple pen and paper approach is workable

Can be implemented within the devices eventually Better compliance and auditing

Streamline checklist process

VARIAN Medical Systems

Checklist as a “time-out”

• Optional• Content pre-defined far from the line of fire• May be used at any point in the process• Context specific

User Configurable

• Checks may be manual or automatic• Can enforce mandatory completion before

process can advance to next stage• Reinforces adherence to clinical best practice

Rules-Based

• Sign-off levels commensurate with complexity or risk of procedure

• Different checklists for different techniques• More details for more complex treatments

Risk-Adjusted

VARIAN Medical Systems

Checklist as a “Time-out” in Radiotherapy

Complements existing QA methodologies Should increase compliance with current practice

Can be implemented at key points in the clinical process More details for more complex or risky procedures

Can be implemented within the RT software Makes it more practical

VARIAN Medical Systems

THANK YOU

CONFIDENTIAL