ABSTRACT
Rationale and Management of the Quality System . . . . . . . . . . . . . . . . . . . . . . . . . 793
Philip Mayles and David Thwaites (with Jean-Claude Rosenwald)
Chapter 38
Quality Control of Megavoltage Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 809
Edwin Aird, Philip Mayles, and Cephas Mubata
Chapter 39
Quality Assurance of the Treatment Planning Process . . . . . . . . . . . . . . . . . . . . . . 841
Jean-Claude Rosenwald
Chapter 40
Quality Control of Treatment Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 867
Philip Evans and Ginette Marinello
Chapter 41
Recording and Verification-Networking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 897
Margaret Bidmead
Chapter 42
Data Communication with DICOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 909
John Sage, John Brunt, and Philip Mayles
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 921
Quality assurance is an essential part of the radiotherapy process. In recent years, it has
become accepted that this is not just about ensuring that the treatment machines are correctly
calibrated, but that it includes every part of the process. The ISO9000 standard has been used
as the basis for such a system in a number of countries (Bleehen 1991; Leer et al. 1999). This
book is not intended to be a quality assurance manual, so the treatment in this Part is restricted
to the elements of the quality system that require the application of physics. It is the respon-
sibility of the physicist to establish the physical and dosimetric framework underpinning the
delivery of radiotherapy treatments. In Chapter 37, an introduction is given to some general
principles underlying the quality assurance of this framework. In the remaining chapters, the
physical aspects of quality control of each part of the process are considered. Chapter 38
deals with quality control of external beam treatment machines, including in Section 38.8
some practical guidance on dose calibration for photon treatments, the details of which have
already been described in Part D. Chapter 39 deals with quality assurance in treatment plan-
ning including both the purchase and commissioning of the planning system and the ongoing
quality control of the system and of individual patient plans. Quality control of treatment
involves both portal imaging and in vivo dosimetry, and these are dealt with in Chapter 40.
A modern radiotherapy department is heavily dependent on networked systems, and consider-
ation needs to be given to the quality assurance of these. This is covered in Chapter 41. The
Digital Imaging and Communications inMedicine (DICOM) standard is becoming universally
used to transfer data in radiotherapy, and Chapter 42 is devoted to this particular aspect of
network communication.
