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Nederlandse Commissie voor Stralingsdosimetrie
Netherlands Commission on Radiation DosimetrySubcommittee "Stereotactic radiotherapy: "Recommendations on dosimetry procedures and Quality Control"
In the Netherlands and Belgium a rapidly growing number
of radiotherapy centers are being equipped for intracranial as well as
extracranial stereotactic radiotherapy. Initially, stereotactic
irradiation with a relatively high dose in a single fraction, called
stereotactic radiosurgery (SRS), was based on the work of Leksell using
a dedicated localization helmet and a dedicated Co-60 radiation source,
the GammaKnife. Next there was the development of invasive and
non-invasive frames for localization and treatment frames for
fractionated stereotactic radiotherapy (fSRT) on (modified) linacs.
More recently the development of SRT/SRS tends toward imaged guided
frameless radiotherapy with dedicated linacs (Novalis and Cyberknife)
mainly for intracranial lesions. The irradiation techniques evolved
from arc beams using circular collimators via step and shoot micro MLC
beams to stereotactic IMRT and robotic dose painting. Together with the
interest of extracranial applications equipment for detection and
automatic compensation of intra fractional tumor movements entered the
field of SRT. Most treatment planning for fSRT/SRS is performed using a
treatment planning system (TPS) that is part of the SRT/SRS hardware of
a certain type and brand. Therefore the introduction of stereotactic
radiotherapy in the clinic implies the acceptance, commissioning and QA
of a stereotactic system as an entity. This includes the acceptance,
commissioning and QA of the hardware (linac, mMLC, cone, frames,
couch), software (TPS), imaging-system and systems for detection and
automatic compensation of tumor movements. For the QC and guidelines of
the various subsystems NCS reports are available. The increasing
complexity of SRT/SRS and the increasing number of radiotherapy centers
that offer this kind of SRT/SRS treatments justify an NCS report on
stereotactic radiotherapy that covers the following topics:
- QC of mechanical equipment (immobilization, frames, linac, couch, pointers, …….)
- Recommendations on measurement of beam properties (dosimetry of small beams, recommendation on methods and specific detectors, reference beam data, output factors)
- Acceptance, commissioning and QC TPS. Referring to NCS QC TPS and supplementary specific QC for SRT.
- Supplementary QC CT-scanner, MRI, angiography and other imaging techniques, application of 4D-CT
- Acceptance, commissioning and QC of SRT imaging systems
- Proposal for End to End tests for SRT/SRS
- Recommendation on minimal QC (with tolerances)
- Recommendations on Treatment Verification and Registration and DICOM
- Recommendations on tests for detection and automated compensation of tumor movements
- Recommendations on determination of dose outside lesion (risk radiation induced tumors after treatment of benign lesions and functional neurological SRS).
- Recommendations and/or remarks on special issues related to intra- and extracranial SRT, body SRT, Cone beam, Image Guidance, frameless SRT..
Members of this NCS subcommittee
- Stan Heukelom (Vrije Universiteit Medisch Centrum, Amsterdam, chairman, s.heukelom-at-vumc.nl)
- Hans Marijnissen (Erasmus MC, Rotterdam)
- An Nulens (UZ Gasthuisberg, Leuven)
- Geert Pittomvils (UZ, Gent)
- Esther Raaijmakers (Dr. B. Verbeeten Institute,Tilburg)
- Dirk Verellen (AZ-VUB, Brussel)
- Sandra Vieira (Erasmus MC, Rotterdam, secretary)
- Joep Hermans (MAASTRO linic, Maastricht, representative of the NCS board)
Upcoming events
The NCS lustrum
6e lustrum NCS - 5 oktober 2012 | J.A. de Pooter
Vrijdag 5 oktober 2012 viert de NCS haar 30 jarig bestaan. Deze feestelijke dag zal opgeluisterd worden met een eendaags symposium met als thema ‘dosimetrie rondom de patient’. Tijdens dit symposium zal dit thema belicht worden vanuit de verschillende werkvelden: nucleaire geneeskunde, radiologie, stralingsbescherming en radiotherapie Het symposium zal plaatsvinden bij het LUMC in Leiden. Meer informatie over inschrijving en nadere invulling van het programma volgt nog, en zal te vinden zijn op de website.
NVRB spring meeting - 19-20 April | J.A. de Pooter
"More than 50 years of Radiation Science in the Netherlands: from Molecular Research to Medical Application."
Venue conference centre
‘De Leeuwenhorst’,
Noordwijkerhout, The Netherlands.
For program, registration and abstract submission see: www.NVRB.org