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