PurposeExperimental patient‐specific QA (PSQA) is a time and resource‐intensive process, with a poor sensitivity in detecting errors. Radiation therapy facilities aim to substitute it by means of independent dose calculation (IDC) in combination with a comprehensive beam delivery QA program. This paper reports on the commissioning of the IDC software tool myQA iON (IBA Dosimetry) for proton therapy and its clinical implementation at the MedAustron Ion Therapy Center.MethodsThe IDC commissioning work included the validation of the beam model, the implementation and validation of clinical CT protocols, and the evaluation of patient treatment data. Dose difference maps, gamma index distributions, and pass rates (GPR) have been reviewed. The performance of the IDC tool has been assessed and clinical workflows, simulation settings, and GPR tolerances have been defined.ResultsBeam model validation showed agreement of ranges within ± 0.2 mm, Bragg‐Peak widths within ± 0.1 mm, and spot sizes at various air gaps within ± 5% compared to physical measurements. Simulated dose in 2D reference fields deviated by ‐0.3% ± 0.5%, while 3D dose distributions differed by 1.8% on average to measurements. Validation of the CT calibration resulted in systematic differences of 2.0% between IDC and experimental data for tissue like samples. GPRs of 99.4 ± 0.6% were found for head, head and neck, and pediatric CT protocols on a 2%/2 mm gamma criterion. GPRs for the adult abdomen protocol were at 98.9% on average with 3%/3 mm. Root causes of GPR outliers, for example, implants were identified and evaluated.ConclusionIDC has been successfully commissioned and integrated into the MedAustron clinical workflow for protons in 2021. IDC has been stepwise and safely substituting experimental PSQA since February 2021. The initial reduction of proton experimental PSQA was about 25% and reached up to 90% after 1 year.

中文翻译：

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扫描质子束独立剂量计算系统的调试和临床实施

目的实验性患者特异性 QA (PSQA) 是一个时间和资源密集型过程，检测错误的灵敏度较差。放射治疗设施旨在通过独立剂量计算 (IDC) 与综合射束传输 QA 计划相结合来替代它。本文报道了IDC用于质子治疗的软件工具myQA iON（IBA Dosimetry）在MedAustron离子治疗中心的调试及其临床实施。方法IDC调试工作包括射束模型的验证、临床CT的实施和验证。方案以及患者治疗数据的评估。剂量差异图、伽玛指数分布和通过率 (GPR) 已得到审查。 IDC 工具的性能已经过评估，临床工作流程、模拟设置和探地雷达容差也已定义。结果光束模型验证显示范围在 ± 0.2 毫米以内、布拉格峰宽度在 ± 0.1 毫米以内以及不同空气下的光斑尺寸一致与物理测量相比，差距在±5%以内。 2D 参考场中的模拟剂量偏差为 ‐0.3% ± 0.5%，而 3D 剂量分布与测量值平均相差 1.8%。 CT 校准的验证导致 IDC 和组织样样品的实验数据之间存在 2.0% 的系统差异。根据 2%/2 mm 伽玛标准，头部、头颈部和儿科 CT 协议的 GPR 为 99.4 ± 0.6%。成人腹部方案的 GPR 平均为 98.9%，误差为 3%/3 mm。 GPR 异常值的根本原因，例如，识别和评估了植入物。结论IDC 已成功调试并于 2021 年集成到 MedAustron 质子临床工作流程中。自 2021 年 2 月以来，IDC 已逐步安全地替代实验性 PSQA。质子的初步减少实验性PSQA约为25%，1年后达到90%。