Implementing Radformation at Personalized Radiation Oncology: Enhancing Efficiency and Precision

RadMachine is a data quality management application implemented at Personalized Radiation Oncology (PRO) to streamline quality assurance (QA) tests. It offers various functions assisting medical physicists in a radiation oncology clinic, including inputting, analyzing, managing, exporting, and monitoring QA data. Physicists create test lists following the recommendations provided by the American Association of Medical Physics (AAPM). These lists track results for units such as the Varian Edge, Varian BRAVOS, and Siemens SOMATOM go. Open Pro CT scanner. Ancillary equipment used for testing also has assigned test lists to store calibration factors and receive calibration expiration reminders. The primary goal of utilizing RadMachine is to standardize data management and tests performed, ensuring consistency even when different physicists are covering duties. QA is conducted daily and monthly for the Varian Edge and Siemens SOMATOM go. Open Pro computer tomography (CT) scanner to verify proper unit performance. Therapists complete daily QA tasks in RadMachine, which physicists subsequently review. Monthly QA is undertaken by the physicists themselves. The Varian Edge's monthly QA comprises six test list types: dosimetry for photons and electrons, imaging, multileaf collimator (MLC), beam profile, and mechanical aspects. Monthly QA for the CT scanner evaluates its image quality characteristics and spatial accuracy. The Nuclear Regulatory Commission (NRC) oversees radioactive sources. The Varian BRAVOS, a high dose rate afterloader with a high dose rate Iridium-192 (192Ir) source used for treatment, undergoes tests created in RadMachine to verify source activity, dwell position, timer accuracy, and safety interlocks. PRO also employs the radioactive source Lutetium-177 (177Lu) for its radiopharmaceutical program, requiring accurate measurements before and after infusion. Quality control tests on ancillary equipment ensure accurate readings. RadMachine facilitates data accessibility for regulatory review in a clear and organized manner. A debugging phase ensured all test lists were functioning properly. Previous QA data, recorded using spreadsheets, were used to validate the test lists' return values. Once all test lists were debugged, all previous QA performed before using RadMachine was inputted into the system. However, not all data were recorded in RadMachine. Some images did not meet RadMachine's requirements, such as the phantom not being fully imaged or insufficient separation between the phantom and the stand. The next steps for RadMachine involve setting up a dedicated server to host RadMachine and its local agent. This will allow PRO to fully utilize RadMachine's automation features. Full automation includes automatically downloading images and scans into RadMachine. Additionally, test lists will need to be built to record results for the annual QA.