A first-time survey across 15 cancer centers in Ontario, Canada, on the current practice of patient-specific quality assurance (PSQA) for intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) delivery was conducted. The objectives were to assess the current state of PSQA practice, identify areas for potential improvement, and facilitate the continued improvement in standardization, consistency, efficacy, and efficiency of PSQA regionally. The survey asked 40 questions related to PSQA practice for IMRT/VMAT delivery. The questions addressed PSQA policy and procedure, delivery log evaluation, instrumentation, measurement setup and methodology, data analysis and interpretation, documentation, process, failure modes, and feedback. The focus of this survey was on PSQA activities related to routine IMRT/VMAT treatments on conventional linacs, including stereotactic body radiation therapy but excluding stereotactic radiosurgery. The participating centers were instructed to submit answers that reflected the collective view or opinion of their department and represented the most typical process practiced. The results of the survey provided a snapshot of the current state of PSQA practice in Ontario and demonstrated considerable variations in the practice. A large majority (80%) of centers performed PSQA measurements on all VMAT plans. Most employed pseudo-3D array detectors with a true composite (TC) geometry. No standard approach was found for stopping or reducing frequency of measurements. The sole use of delivery log evaluation was not widely implemented, though most centers expressed interest in adopting this technology. All used the Gamma evaluation method for analyzing PSQA measurements; however, no universal approach was reported on how Gamma evaluation and pass determination criteria were determined. All or some PSQA results were reviewed regularly in two-thirds of the centers. Planning related issues were considered the most frequent source for PSQA failures (40%), whereas the most frequent course of action for a failed PSQA was to review the result and decide whether to proceed to treatment.

中文翻译：

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IMRT 和 VMAT 患者特定质量保证实践调查

对加拿大安大略省的 15 个癌症中心进行了首次调查，调查当前针对调强放射治疗 (IMRT) 和容积调制弧治疗 (VMAT) 实施的患者特定质量保证 (PSQA) 实践。目标是评估 PSQA 实践的当前状态，确定潜在改进的领域，并促进区域性 PSQA 在标准化、一致性、有效性和效率方面的持续改进。该调查询问了 40 个与 IMRT/VMAT 交付的 PSQA 实践相关的问题。这些问题涉及 PSQA 政策和程序、交付日志评估、仪器、测量设置和方法、数据分析和解释、文档、过程、故障模式和反馈。本次调查的重点是与常规直线加速器的常规 IMRT/VMAT 治疗相关的 PSQA 活动，包括立体定向放射治疗，但不包括立体定向放射外科手术。参与中心被要求提交反映其部门集体观点或意见并代表最典型实践过程的答案。调查结果提供了安大略省 PSQA 实践现状的快照，并表明实践中存在相当大的差异。大多数 (80%) 中心对所有 VMAT 计划进行了 PSQA 测量。大多数采用具有真正复合 (TC) 几何形状的伪 3D 阵列探测器。没有找到停止或减少测量频率的标准方法。仅使用交付日志评估未得到广泛实施，尽管大多数中心都表示有兴趣采用这项技术。全部使用 Gamma 评估方法来分析 PSQA 测量值；然而，没有报告关于如何确定 Gamma 评估和通过确定标准的通用方法。三分之二的中心定期审查全部或部分 PSQA 结果。计划相关问题被认为是 PSQA 失败的最常见原因 (40%)，而对于失败的 PSQA，最常见的行动方案是审查结果并决定是否继续治疗。三分之二的中心定期审查全部或部分 PSQA 结果。计划相关问题被认为是 PSQA 失败的最常见原因 (40%)，而对于失败的 PSQA，最常见的行动方案是审查结果并决定是否继续治疗。三分之二的中心定期审查全部或部分 PSQA 结果。计划相关问题被认为是 PSQA 失败的最常见原因 (40%)，而对于失败的 PSQA，最常见的行动方案是审查结果并决定是否继续治疗。