The IAEA has a long-standing history of providing radiotherapy dosimetry audits in its Member States. This publication summarizes the methodologies resulting from the work of four coordinated research projects (CRPs) and offers information on experiences collected during the development of dosimetry audit programmes and their implementation at national levels. It also sets the framework and provides advice on the structure of dosimetry audit centres and discusses the general approach for audit development and the necessary background to conduct dosimetry audits in radiotherapy by national organizations. It provides technical and scientific details, as well as practical experiences of the audit steps developed under these CRPs. Any organization developing national audit programmes for radiotherapy can use this publication as a reference and to learn from the experiences of other national audit networks.

• 1. Introduction
  • 1.1. Radiotherapy provision for cancer treatment
  • 1.2. Accuracy required in radiotherapy
  • 1.3. Qa in radiotherapy
  • 1.4. Discrepancies in radiation treatment
  • 1.5. The need for independent quality audit in radiotherapy generally and in radiotherapy dosimetry
  • 1.6. Iaea and other approaches to independent quality audit of radiotherapy dosimetry
  • 1.7. Extension of the scope of radiotherapy dosimetry audit within the iaea framework
  • 1.8. Scope of the publication
• 2. Overview of Coordinated Research proJects on dosimetry audit in radiotherapy
  • 2.1. Overview of the framework of the development of the audits
  • 2.2. Overview of the process for the development of audits
    • 2.2.1. Background
    • 2.2.2. Process for audit development
• 3. Guidelines for establishing A national Dosimetry audit network for radiotherapy
  • 3.1. Introduction
  • 3.2. Aim of the dan
  • 3.3. National radiotherapy infrastructure database
  • 3.4. Structure of the dan
  • 3.5. Dac development and operations
  • 3.6. Dac audits and required resources
  • 3.7. Summary
• 4. Audit steps — methodology and testing
  • 4.1. Step 1: tld audits for photon beams in reference conditions
    • 4.1.1. Introduction to the step 1 audit
    • 4.1.2. Methodology of the step 1 audit
    • 4.1.3. Development and testing of the step 1 audit methodology
    • 4.1.4. Results of the national runs for the step 1 audit
    • 4.1.5. Summary and conclusions for the step 1 audit
  • 4.2. Step 2a: tld audits for photon beams in non-reference conditions
    • 4.2.1. Introduction to the step 2a audit
    • 4.2.2. Methodology of the step 2a audit
    • 4.2.3. Development and testing of the step 2a audit methodology
    • 4.2.4. Results of the national runs for the step 2a audit
    • 4.2.5. Summary and conclusions for the step 2a audit
  • 4.3. Step 2b: tld audits for electron beams in reference and non-reference conditions on the beam axis
    • 4.3.1. Introduction to the step 2b audit
    • 4.3.2. Methodology of the step 2b audit
    • 4.3.3. Development and testing of the step 2b audit methodology
    • 4.3.4. Results of the national runs for the step 2b audit
    • 4.3.5. Summary and conclusions for the step 2b audit
  • 4.4. Step 3: Audits for photon beams in reference conditions and non-reference conditions off-axis
    • 4.4.1. Introduction to the step 3 audit
    • 4.4.2. Methodology of the step 3 audit
    • 4.4.3. Development and testing of the step 3 audit methodology
    • 4.4.4. Results of the national runs for the step 3 audit
    • 4.4.5. Summary and conclusions for step 3 audit
  • 4.5. Step 4: dose audits of complex treatment technique parameters: irregular photon beams shaped with an mlc
    • 4.5.1. Introduction to the step 4 audit
    • 4.5.2. Methodology of the step 4 audit
    • 4.5.3. Development and testing of the step 4 audit methodology
    • 4.5.4. Results of the national runs for the step 4 audit
    • 4.5.5. Summary and conclusions for the step 4 audit
  • 4.6. Step 5: audits of complex treatment parameters for photon beams; situations involving heterogeneities
    • 4.6.1. Introduction to the step 5 audit
    • 4.6.2. Methodology of the step 5 audit
    • 4.6.3. Development and testing of the step 5 audit methodology
    • 4.6.4. Results of the national runs for the step 5 audit
    • 4.6.5. Summary and conclusions for the step 5 audit
  • 4.7. Step 6: audits of complex treatment parameters: small photon fields shaped by an mlc
    • 4.7.1. Introduction to the step 6 audit
    • 4.7.2. Methodology of the step 6 audit
    • 4.7.3. Development and testing of the step 6 audit methodology
    • 4.7.4. Results of the national runs for the step 6 audit
    • 4.7.5. Summary and conclusions for the step 6 audit
  • 4.8. Step 7a: quality audits of output factors of small fields shaped with mlc
    • 4.8.1. Introduction to the step 7a audit
    • 4.8.2. Methodology of the step 7a audit
    • 4.8.3. Development and testing of the step 7a audit methodology
    • 4.8.4. Results of the national runs for the step 7a audit
    • 4.8.5. Summary and conclusions for the step 7a audit
  • 4.9. Step 7b: film quality audit of mlc performance for imrt dose delivery
    • 4.9.1. Introduction to the step 7b audit
    • 4.9.2. Methodology of the step 7b audit
    • 4.9.3. Testing of the step 7b audit methodology
    • 4.9.4. Results of the national runs for the step 7b audit
    • 4.9.5. Summary and conclusions for the step 7b audit
  • 4.10. Step 8: film quality audit for relative dosimetry of a photon beam single imrt field
    • 4.10.1. Introduction to the step 8 audit
    • 4.10.2. Methodology of the step 8 audit
    • 4.10.3. Development and testing of the step 8 audit methodology
    • 4.10.4. Results of the national runs for the step 8 audit
    • 4.10.5. Summary and conclusions for the step 8 audit
  • 4.11. Step 9: ‘end-to-end’ dosimetric quality audit for imrt, including imaging, treatment planning and delivery
    • 4.11.1. Introduction to the step 9 audit
    • 4.11.2. Methodology of the step 9 audit
    • 4.11.3. Development and testing of the step 9 audit methodology
    • 4.11.4. Results of the national runs for the step 9 audit
    • 4.11.5. Summary and conclusions for the step 9 audit
• 5. CONCLUSION
• Appendix I CHARACTERISTICS OF TLD SYSTEMS OF DOSIMETRY AUDIT CENTRES
• Appendix II CHARACTERISTICS OF THE FILM DOSIMETRY SYSTEM
• REFERENCES
• LIST OF ABBREVIATIONS
• ANNEX: SUPPLEMENTARY FILES
• CONTRIBUTORS TO DRAFTING AND REVIEW