UK IMRT Audit 2009 NPL Alanine Dosimetry

Peter Sharpe, Clare Gouldstone, Kamalini Rajendran and Geoff Budgell

*
* Christie NHS Foundation Trust, Manchester

IMRT (Intensity Modulated Radiation Therapy) is an advanced form of radiotherapy in which dose is targeted on the tumour volume by the use of multiple beams of radiation from a number of directions. The technique minimises the dose to healthy tissue and its wider adoption in the UK is being strongly encouraged. A nationwide audit was carried out in 2009 to provide a check for centres already using IMRT and to assist those in the process of implementing it. The level of participation in the audit was extremely high, with a total of 57 out of a potential 62 centres taking part. The audit was carried out by post and involved two main aspects: n films, to provide a check on relative dose n alanine dosimeters, to provide absolute dose measurements. NPL played a major role in the audit with the provision of the alanine dosimetry and the results are described below.

Dosimeters
Four alanine dosimeter pellets were irradiated in PMMA plates positioned at defined locations in the radiation field. One plate containing four pellets was irradiated in a uniform reference field and other plates irradiated in typical IMRT fields. All dosimeters were returned to NPL for measurement of the dose received and the centre simultaneously supplied their estimates of dose to the coordinators.

Figure 1: Alanine pellet

Figure 2: Perspex plate for holding alanine pellets set up for an IMRT measurement before placing the 5 cm water-equivalent material on top.

snoisulcnoC

stluseR

Introduction

Results
The results are summarised in Figures 3 & 4. All centres showing results outside an acceptance limit of 5% were contacted and the problem resolved.

noitcudortnI sretemisoD

Figure 3: Histogram of the alanine measurements relative to the centres estimate of dose for the 10x10 cm reference fields. One further centre was outside the limits shown.

Figure 4: Histogram of the alanine measurements relative to the Treatment Planning System predicted dose for the IMRT fields. Three further centres were outside the limits shown.

Conclusions

Alanine dosimeters provide a convenient way of performing postal audits of radiotherapy centres. The performance of UK centres compares well with similar studies in other countries and provides confidence in the implementation of IMRT in the UK

National Physical Laboratory, Hampton Road, Teddington, Middlesex, United Kingdom, TW11 0LW